Individual prediction of psychotherapy outcome in posttraumatic stress disorder using neuroimaging data

Trauma-focused psychotherapy is the first-line treatment for posttraumatic stress disorder (PTSD) but 30-50% of patients do not benefit sufficiently. We investigated whether structural and resting-state functional magnetic resonance imaging (MRI/rs-fMRI) data could distinguish between treatment responders and non-responders on the group and individual level. Forty-four male veterans with PTSD underwent baseline scanning followed by trauma-focused psychotherapy. Voxel-wise gray matter volumes were extracted from the structural MRI data and resting-state networks (RSNs) were calculated from rs-fMRI data using independent component analysis. Data were used to detect differences between responders and non-responders on the group level using permutation testing, and the single-subject level using Gaussian process classification with cross-validation. A RSN centered on the bilateral superior frontal gyrus differed between responders and non-responder groups (PFWE < 0.05) while a RSN centered on the pre-supplementary motor area distinguished between responders and non-responders on an individual-level with 81.4% accuracy (P < 0.001, 84.8% sensitivity, 78% specificity and AUC of 0.93). No significant single-subject classification or group differences were observed for gray matter volume. This proof-of-concept study demonstrates the feasibility of using rs-fMRI to develop neuroimaging biomarkers for treatment response, which could enable personalized treatment of patients with PTSD.

 



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Reference: 
Paul Zhutovsky, Rajat M. Thomas, Miranda Olff, Sanne J. H. van Rooij, Mitzy Kennis, Guido A. van Wingen and Elbert Geuze | 2019
In: Translational Psychiatry ISSN: 2158-3188 | 9 | 1 | 326
https://doi.org/10.1038/s41398-019-0663-7
Keywords: 
Genetic Markers, Genetics, Males, Methodology, Posttraumatic Stress Disorder, Predictors, Psychotherapy, Psychotrauma, PTSD (DSM-IV), PTSD (en), Veterans
Affiliation author(s):