Chou Tina, Dougherty Darin D, Sorg Scott F, Pitman Roger K, Tanev Kaloyan S
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass. (all authors); Home Base Program, A Red Sox Foundation and Massachusetts General Hospital Program, Boston (Sorg, Tanev).
J Neuropsychiatry Clin Neurosci. 2025 Spring;37(2):163-169. doi: 10.1176/appi.neuropsych.20240058. Epub 2024 Oct 10.
Posttraumatic stress disorder (PTSD) is a highly heterogeneous disorder, which makes it difficult to link clinical phenotypes with biomarkers to improve treatment outcomes. Findings from previous studies suggest that cognitive measures such as verbal memory or attention paired with within-ventral attention network (VAN) or salience network resting-state functional connectivity may predict treatment response among individuals with PTSD.
In a sample comprising 20 individuals with PTSD and 10 healthy control group individuals, the investigators subtyped individuals by using both discriminant function analysis and standardized norms for a single measure of memory and neuropsychological batteries of memory, attention, and executive functioning; attempted to replicate previous findings of lower within-VAN connectivity among individuals with cognitive impairment; and explored whether within-VAN connectivity paired with cognitive impairment predicted treatment outcomes.
PTSD patients with cognitive impairment (defined by using a discriminant function analysis with verbal memory performance) had greater within-VAN resting-state functional connectivity compared with control group individuals and cognitively intact PTSD patients at a level that fell short of statistical significance (F=3.41; df=2, 21; η=0.237). The interaction between verbal memory performance and within-VAN connectivity also predicted treatment-related change in PTSD symptoms at a level that also fell short of statistical significance (β=-0.442).
These findings somewhat support the clinical utility of identifying cognitive phenotypes within PTSD (by using discriminant function analysis and verbal memory performance) to predict treatment outcomes.
创伤后应激障碍（PTSD）是一种高度异质性的疾病，这使得将临床表型与生物标志物联系起来以改善治疗效果变得困难。先前研究的结果表明，诸如言语记忆或注意力等认知测量指标，再结合腹侧注意网络（VAN）内或突显网络静息态功能连接，可能预测PTSD个体的治疗反应。
在一个由20名PTSD个体和10名健康对照组个体组成的样本中，研究人员通过判别函数分析和单一记忆测量以及记忆、注意力和执行功能的神经心理测验的标准化常模对个体进行亚型分类；试图重复先前关于认知障碍个体VAN内连接性较低的研究结果；并探讨VAN内连接性与认知障碍相结合是否能预测治疗效果。
与对照组个体和认知功能完整的PTSD患者相比，有认知障碍的PTSD患者（通过对言语记忆表现进行判别函数分析来定义）在VAN内静息态功能连接性方面更高，但未达到统计学显著性水平（F = 3.41；自由度 = 2, 21；η = 0.237）。言语记忆表现与VAN内连接性之间的相互作用也预测了PTSD症状与治疗相关的变化，同样未达到统计学显著性水平（β = -0.442）。
这些发现一定程度上支持了在PTSD中识别认知表型（通过判别函数分析和言语记忆表现）以预测治疗效果的临床实用性。
