Abstract
IntroductionRecent research suggests that traumatized patients are characterized by disrupted resting‐state functional connectivity. We examined whether neural networks involved in resting‐state change over the course of a phase‐oriented inpatient treatment for complex traumatized and dissociative disorder patients. We also investigated associations between these network alterations and clinical symptoms and emotion regulation skills.MethodsPre‐ and post‐treatment, electroencephalography (EEG) was recorded during resting‐state in patients (n = 23) with a complex dissociative disorder (CDD) or complex posttraumatic stress disorder (cPTSD). Patients also completed clinical and emotion regulation questionnaires. To reduce variance in the collected data, patients were exclusively tested as one prototypical dissociative part referred to as Apparently Normal Part (ANP). Functional network connectivity was examined and compared with a matched healthy control group (n = 37), also measured twice.ResultsPrior to treatment and compared with controls, patients had a significantly lower functional connectivity strength within eyes‐open and eyes‐closed resting‐state networks in the theta and alpha frequency band. Following treatment, functional connectivity strength within these networks was comparable to the control group and comprised areas belonging to the default mode network (DMN) and prefrontal as well as anterior cingulate control regions. Treatment‐related network normalizations in the theta frequency band were associated with a self‐reported increase in the use of cognitive reappraisal strategies and reduction in emotion regulation difficulties.ConclusionPhase‐oriented trauma treatment can strengthen resting‐state network connectivity and can increase the capacity of complex traumatized and dissociative patients as ANP to handle emotional challenges effectively.
Highlights
Recent research suggests that traumatized patients are characterized by disrupted resting-state functional connectivity
Functional connectivity strength within these networks was comparable to the control group and comprised areas belonging to the default mode network (DMN) and prefrontal as well as anterior cingulate control regions
We investigated the relationship between treatment-related changes in mean functional connectivity values in the four networks and the changes in self-reported emotion regulation abilities
Summary
In- and outpatient treatment studies found evidence that long-term specialized treatment approaches are effective in reducing dissociative and comorbid psychiatric symptoms in complex posttraumatic stress disorder (cPTSD) and dissociative disorder patients (Brand et al, 2009). We may not have measured a neutral affective state but the participants’ ability to relax following the perception of cues that had aroused them emotionally Based on this line of reasoning, we expect to observe functional connectivity changes in fear-related neural circuits involving areas implicated in emotion (i.e., insula), cognitive control (i.e., prefrontal cortex [PFC], anterior cingulate cortex [ACC]), and memory (i.e., hippocampus, parahippocampal gyrus). This hypothesis is only subordinate as we do not have a control group that was presented emotionally neutral pictures only It is in line with our previous EEG functional connectivity emotion regulation study (Schlumpf et al, 2019) and fMRI investigations of exposure-based treatment effects on functional networks in PTSD patients at rest (Shou et al, 2017; Zhu et al, 2018) and during confrontation with reminders of traumatic events (Cisler et al, 2014; Helpman et al, 2016). We did not formulate a hypothesis on possible relationships between functional connectivity increase and questionnaire data on symptom reduction and/or improvement in emotion regulation
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