Longitudinal changes in cortical thickness associated with psychotherapy for PTSD in adolescents
Topic: Psychotherapy
Abstract
Objectives: The neural changes that accompany successful treatments may suggest targets for novel approaches. It is unknown whether neural changes occur synchronously across all networks. This study examined the temporal series of neural changes associated with symptom improvement in youth with PTSD.
Methods: Adolescent patients (n = 37; Mage = 14.7; 82% female) with PTSD, received an average of 18 weeks of psychotherapy, during which an MRI scan of brain anatomy was collected at 4 timepoints. The resulting 148 images were analyzed to quantify cortical thickness. Individual subject changes in cortical thickness were submitted to optimal scaling regression to predict symptom improvement.
Results:The significant model of symptom improvement at the end of treatment included a series of neural changes (p = .001). Decreases in orbital frontal cortex (OFC) thickness occurred early in treatment, followed by decreases in posterior cingulate thickness, and finally decreases in inferior frontal and orbital frontal thickness.
Conclusions: Neural changes during therapy occur at different rates depending on the network and region. Decreases in orbital frontal thickness are consistent with developmental processes and with previous studies of symptom improvement.