Callier Center, University of Texas at Dallas, Dallas, TX, USA.
Callier Center, University of Texas at Dallas, Dallas, TX, USA.
Biol Psychol. 2023 Sep;182:108648. doi: 10.1016/j.biopsycho.2023.108648. Epub 2023 Jul 22.
An elevated P3a amplitude to trauma-related stimuli is strongly associated with posttraumatic stress disorder (PTSD), yet little is known about whether this response to trauma-related stimuli is affected by treatment that decreases PTSD symptoms. As an analysis of secondary outcome measures from a randomized controlled trial, we investigated the latency and amplitude changes of the P3a in responses in a three-condition oddball visual task that included trauma-related (combat scenes) and trauma-unrelated (threatening animals) distractors. Fifty-five U.S. veterans diagnosed with combat-related PTSD were randomized to receive either active or sham repetitive transcranial magnetic stimulation (rTMS). All received cognitive processing therapy, CPT+A, which requires a written account of the index trauma. They were tested before and 6 months after protocol completion. P3a amplitude and response time decreases were driven largely by the changes in the responses to the trauma-related stimuli, and this decrease correlated to the decrease in PTSD symptoms. The amplitude changes were greater in those who received rTMS + CPT than in those who received sham rTMS + CPT, suggesting that rTMS plays beneficial role in reducing arousal and threat bias, which may allow for more effective engagement in trauma-focused PTSD treatment.
对创伤相关刺激的 P3a 振幅升高与创伤后应激障碍（PTSD）强烈相关，但对于这种对创伤相关刺激的反应是否会受到降低 PTSD 症状的治疗影响，知之甚少。作为一项随机对照试验的次要结果分析，我们研究了在包括创伤相关（战斗场景）和创伤无关（威胁动物）分心物的三条件视觉Oddball 任务中，P3a 的潜伏期和振幅变化。55 名被诊断患有与战斗相关 PTSD 的美国退伍军人被随机分配接受活性或假重复经颅磁刺激（rTMS）治疗。所有人都接受认知加工治疗（CPT），这需要对索引创伤进行书面描述。他们在方案完成前和 6 个月后接受测试。P3a 振幅和反应时间的降低主要是由对创伤相关刺激的反应变化驱动的，这种降低与 PTSD 症状的降低相关。接受 rTMS+CPT 的患者的振幅变化大于接受 sham rTMS+CPT 的患者，这表明 rTMS 在降低唤醒和威胁偏见方面发挥了有益作用，这可能使创伤聚焦 PTSD 治疗更有效。
