A potential target for noninvasive neuromodulation of PTSD symptoms derived from focal brain lesions in veterans
Year: 2024
Type: article
Abstract: Neuromodulation trials for PTSD have yielded mixed results, and the optimal neuroanatomical target remains unclear. We analyzed three datasets to study brain circuitry causally linked to PTSD in military Veterans. After penetrating traumatic brain injury (n=193), lesions that reduced probability of PTSD were preferentially connected to a circuit including the medial prefrontal cortex (mPFC), amygdala, and anterolateral temporal lobe (cross-validation p=0.01). In Veterans without lesions (n=180), PTSD was specifically associated with connectivity within this circuit (p<0.01). Connectivity change within this circuit correlated with PTSD improvement after transcranial magnetic stimulation (TMS) (n=20) (p<0.01), even though the circuit was not directly targeted. Finally, we directly targeted this circuit with fMRI-guided accelerated TMS, leading to rapid resolution of symptoms in a patient with severe lifelong PTSD. All results were independent of depression severity. This lesion-based PTSD circuit may serve as a neuromodulation target for Veterans with PTSD.
Source: Nature Neuroscience
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Funders: U.S. Department of Health and Human Services, U.S. Department of Veterans Affairs, Brain and Behavior Research Foundation, National Institutes of Health, National Institute on Aging, National Institute of Mental Health, National Institute of General Medical Sciences, National Institute of Neurological Disorders and Stroke
Awards: G1081682709, Treating hyperexcitability in Alzheimer's disease with levetiracetam to improve brain function and cognition, Personalized circuit-based neuromodulation targets for depression, G1312554544, G1475990596, Targeted modulation of symptom-specific brain circuits with transcranial magnetic stimulation, G1967858092, Low intensity focused ultrasound: a new paradigm for depression and anxiety, G266014273, G2873997698, Reliability of Repetitive TMS-induced Modulation of Cortical Excitability, G3752441084, G396640900, G3974763934, COBRE Center for Neuromodulation (CCN), G6263931873, Transdiagnostic memory, mood and motor circuits in Alzheimer's and neurodegenerative disease, White Matter Damage in Subconcussive Blast Exposure, G7150617895, G8325351721, A causal wiring diagram of transdiagnostic brain functions, Using human brain connectivity to identify the causal neuroanatomical substrate of depression symptoms
OpenAlex ID: W4402769894