van Lutterveld Remko, Sterk Myrthe, Spitoni Cristian, Kennis Mitzy, van Rooij Sanne J H, Geuze Elbert
Brain Research and Innovation Centre, Ministry of Defence, Utrecht, the Netherlands.
Department of Psychiatry, University Medical Center, Utrecht, the Netherlands.
Chronic Stress (Thousand Oaks). 2025 Jan 12;9:24705470241311285. doi: 10.1177/24705470241311285. eCollection 2025 Jan-Dec.
Trauma-focused psychotherapy is treatment of choice for post-traumatic stress disorder (PTSD). However, about half of patients do not respond. Recently, there is increased interest in brain criticality, which assesses the phase transition between order and disorder in brain activity. Operating close to this borderline is theorized to facilitate optimal information processing. We studied if brain criticality is related to future response to treatment, hypothesizing that treatment responders' brains function closer to criticality.
Functional magnetic resonance imaging resting-state scans were acquired from 46 male veterans with PTSD around the start of treatment. Psychotherapy consisted of trauma-focused cognitive behavioral therapy, eye movement desensitization and reprocessing, or a combination thereof. Treatment response was assessed using the Clinician-Administered PTSD Scale, and criticality was assessed using an Ising temperature approach for seven canonical brain networks (ie, the visual, somatomotor, dorsal attention, ventral attention, limbic, frontoparietal and default mode networks) to measure distance to criticality.
The brains of prospective treatment responders were closer to criticality than nonresponders (P = 0.017), while no significant interaction effect between group and brain network was observed (P = 0.486). In addition, average criticality across networks correlated with future treatment response (P = 0.028).
These results show that the brains of prospective PTSD psychotherapy treatment responders operate closer to criticality than nonresponders, and this occurs across the entire brain instead of in separate canonical brain networks. These results suggest that effective psychotherapy is mediated by brains operating closer to criticality.
创伤聚焦心理治疗是创伤后应激障碍（PTSD）的首选治疗方法。然而，约一半的患者对此没有反应。最近，人们对大脑临界性的兴趣日益增加，大脑临界性评估大脑活动中有序和无序之间的相变。理论上，在这个临界边界附近运作有助于优化信息处理。我们研究了大脑临界性是否与未来的治疗反应相关，假设治疗反应者的大脑功能更接近临界状态。
在治疗开始时，对46名患有创伤后应激障碍的男性退伍军人进行了静息态功能磁共振成像扫描。心理治疗包括创伤聚焦认知行为疗法、眼动脱敏再处理疗法或两者结合。使用临床医生管理的创伤后应激障碍量表评估治疗反应，并使用伊辛温度方法对七个典型脑网络（即视觉、躯体运动、背侧注意、腹侧注意、边缘、额顶叶和默认模式网络）评估临界性，以测量与临界状态的距离。
预期治疗反应者的大脑比无反应者更接近临界状态（P = 0.017），而未观察到组与脑网络之间的显著交互作用（P = 0.486）。此外，各网络的平均临界性与未来治疗反应相关（P = 0.028）。
这些结果表明，预期的创伤后应激障碍心理治疗反应者的大脑比无反应者更接近临界状态，并且这种情况发生在整个大脑而不是单独的典型脑网络中。这些结果表明，有效的心理治疗是由更接近临界状态运作的大脑介导的。
