title: PTSD REMISSION AFTER PROLONGED EXPOSURE TREATMENT IS ASSOCIATED WITH ANTERIOR CINGULATE CORTEX THINNING AND VOLUME REDUCTION.
abstract: Brain structures underlying posttraumatic stress disorder (PTSD) have been a focus of imaging studies, but associations between treatment outcome and alterations in brain structures remain largely unexamined. We longitudinally examined the relation of structural changes in the rostral anterior cingulate cortex (rACC), a previously identified key region in the PTSD fear network, to outcome of prolonged exposure (PE) treatment.
  
  
  
  The sample included 78 adults (53 women): 41 patients with PTSD and 37 trauma-exposed healthy volunteers (TE-HCs). Patients underwent a 10-week course of PE treatment and completed pre- and posttreatment assessments and magnetic resonance imaging (MRI) structural scans. TE-HCs also underwent assessment and MRI at baseline and 10 weeks later. PE remitters (n = 11), nonremitters (n = 14), and TE-HCs, were compared at baseline on demographic and clinical characteristics and ACC structure. Remitters, nonremitters, and TE-HCs were compared for pre- to posttreatment clinical and structural ACC change, controlling for potential confounding variables.
  
  
  
  There were no baseline differences in structure between PTSD and TE-HCs or remitters and nonremitters. Following treatment, PTSD remitters exhibited cortical thinning and volume decrease in the left rACC compared with PTSD nonremitters and TE-HCs.
  
  
  
  These results, while in need of replication, suggest that PE treatment for PTSD, by extinguishing maladaptive trauma associations, may promote synaptic plasticity and structure change in rACC. Future research should explore possible underlying mechanisms.
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: Liat
authors: L
authors: Helpman
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: Santiago
authors: S
authors: Papini
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: Binod T
authors: BT
authors: Chhetry
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: Erel
authors: E
authors: Shvil
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: Mikael
authors: M
authors: Rubin
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: Gregory M
authors: GM
authors: Sullivan
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: John C
authors: JC
authors: Markowitz
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: J John
authors: JJ
authors: Mann
authors: Department of Psychiatry, Columbia University Medical Center, New York State Psychiatric Institute, New York, New York.
authors: Yuval
authors: Y
authors: Neria
mesh_terms: D000328:Adult; D001931:Brain Mapping / Q000379:methods; D005260:Female; D006179:Gyrus Cinguli / Q000473:pathology*; D006801:Humans; D007171:Implosive Therapy / Q000379:methods*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009929:Organ Size; D012074:Remission Induction; D013313:Stress Disorders, Post-Traumatic / Q000628:therapy*; D016896:Treatment Outcome
keywords: ACC; posttraumatic stress disorder; structural imaging; trauma; treatment