Abstract
Despite accumulating evidence of physiological abnormalities related to posttraumatic stress disorder (PTSD), the current diagnostic criteria for PTSD still rely on clinical interviews. In this study, we investigated the diagnostic potential of multimodal neuroimaging for identifying posttraumatic symptom trajectory after trauma exposure. Thirty trauma-exposed individuals and 29 trauma-unexposed healthy individuals were followed up over a 5-year period. Three waves of assessments using multimodal neuroimaging, including structural magnetic resonance imaging (MRI) and diffusion-weighted MRI, were performed. Based on previous findings that the structural features of the fear circuitry-related brain regions may dynamically change during recovery from the trauma, we employed a machine learning approach to determine whether local, connectivity, and network features of brain regions of the fear circuitry including the amygdala, orbitofrontal and ventromedial prefrontal cortex (OMPFC), hippocampus, insula, and thalamus could distinguish trauma-exposed individuals from trauma-unexposed individuals at each recovery stage. Significant improvement in PTSD symptoms was observed in 23%, 52%, and 88% of trauma-exposed individuals at 1.43, 2.68, and 3.91 years after the trauma, respectively. The structural features of the amygdala were found as major classifiers for discriminating trauma-exposed individuals from trauma-unexposed individuals at 1.43 years after the trauma, but these features were nearly normalized at later phases when most of the trauma-exposed individuals showed clinical improvement in PTSD symptoms. Additionally, the structural features of the OMPFC showed consistent predictive values throughout the recovery period. In conclusion, the current study provides a promising step forward in the development of a clinically applicable predictive model for diagnosing PTSD and predicting recovery from PTSD.
Highlights
Posttraumatic stress disorder (PTSD) represents a characteristic constellation of symptoms related to uncontrollable state of fear following the experience of a traumatic event [1]
In our previous studies on the survivors of a subway fire disaster, we found that increased cortical thickness in the dorsolateral prefrontal cortex [9] and elevated structural connectivity between the amygdala and orbitofrontal and ventromedial prefrontal cortex (OMPFC) [10] were related to PTSD symptom improvement, and such involvement of specific brain structural features could dynamically change during recovery from PTSD
The present study included longitudinal multimodal neuroimaging data acquired from the cohort of disaster survivors who were diagnosed with PTSD in the early aftermath of the trauma
Summary
Posttraumatic stress disorder (PTSD) represents a characteristic constellation of symptoms related to uncontrollable state of fear following the experience of a traumatic event [1]. Due to the direct relevance of PTSD symptoms to fear response, brain regions of the fear circuit have important roles in the pathogenesis of PTSD [2]. It has been reported that the prefrontal cortex is involved in the pathophysiology of PTSD in relation to other anxiety disorders [6]. In PTSD, neuroanatomical abnormalities involving brain regions of the fear circuit have been observed in terms of changes in connectivity features as well as local features in both function and structure [7, 8]. Despite increasing knowledge about such brain changes that are involved in the pathophysiology of PTSD, the potential use of brain features for diagnosing PTSD or predicting symptom changes during recovery has rarely been investigated
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
