title: Treatment Outcome-Related White Matter Differences in Veterans with Posttraumatic Stress Disorder.
abstract: Posttraumatic stress disorder (PTSD) is a debilitating disorder that has been associated with brain abnormalities, including white matter alterations. However, little is known about the effect of treatment on these brain alterations. To investigate the course of white matter alterations in PTSD, we used a longitudinal design investigating treatment effects on white matter integrity using diffusion tensor imaging (DTI). Diffusion tensor and magnetization transfer images were obtained pre- and posttreatment from veterans with (n=39) and without PTSD (n=22). After treatment, 16 PTSD patients were remitted, and 23 had persistent PTSD based on PTSD diagnosis. The dorsal and hippocampal cingulum bundle, stria terminalis, and fornix were investigated as regions of interest. Exploratory whole-brain analyses were also performed. Groups were compared with repeated-measures ANOVA for fractional anisotropy (FA), and magnetization transfer ratio. Persistently symptomatic PTSD patients had increasing FA of the dorsal cingulum over time, and at reassessment these FA values were higher than both combat controls and the remitted PTSD group. Group-by-time interactions for FA were found in the hippocampal cingulum, fornix, and stria terminalis, posterior corona radiata, and superior longitudinal fasciculus. Our results indicate that higher FA of the dorsal cingulum bundle may be an acquired feature of persistent PTSD that develops over time. Furthermore, treatment might have differential effects on the hippocampal cingulum, fornix, stria terminalis, posterior corona radiata, and superior longitudinal fasciculus in remitted vs persistent PTSD patients. This study contributes to a better understanding of the neural underpinnings of PTSD treatment outcome.
authors.affiliation: 1] Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands [2] Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands.
authors.forename: Mitzy
authors.initials: M
authors.lastname: Kennis
authors.affiliation: 1] Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands [2] Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands.
authors.forename: Sanne J H
authors.initials: SJ
authors.lastname: van Rooij
authors.affiliation: Department of Psychiatry, University of Wisconsin, Madison, WI, USA.
authors.forename: Do P M
authors.initials: do PM
authors.lastname: Tromp
authors.affiliation: Department of Psychiatry, University of Wisconsin, Madison, WI, USA.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Fox
authors.affiliation: 1] Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands [2] Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands.
authors.forename: Arthur R
authors.initials: AR
authors.lastname: Rademaker
authors.affiliation: Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: René S
authors.initials: RS
authors.lastname: Kahn
authors.affiliation: Department of Psychiatry, University of Wisconsin, Madison, WI, USA.
authors.forename: Ned H
authors.initials: NH
authors.lastname: Kalin
authors.affiliation: 1] Brain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands [2] Research Centre Military Mental Healthcare, Ministry of Defence, Utrecht, The Netherlands.
authors.forename: Elbert
authors.initials: E
authors.lastname: Geuze
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D007839:Functional Laterality; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013313:Stress Disorders, Post-Traumatic / Q000473:pathology* / Q000628:therapy*; D016896:Treatment Outcome; D014728:Veterans; D066127:White Matter / Q000473:pathology*; D055815:Young Adult
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