Individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity

Randomized controlled trials have shown efficacy of trauma-focused psychotherapies in youth with posttraumatic stress disorder (PTSD). However, response varies considerably among individuals. Currently, no biomarkers are available to assist clinicians in identifying youth who are most likely to bene...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Paul Zhutovsky, Jasper B. Zantvoord, Judith B.M. Ensink, Rosanne op den Kelder, Ramon J.L. Lindauer, Guido A. van Wingen
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	PTSD Psychotherapy Adolescent Resting-state fMRI Machine learning Clinical outcome Computer applications to medicine. Medical informatics R858-859.7 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/e861e5f8926d41508ada2593da5ff0ac
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:e861e5f8926d41508ada2593da5ff0ac
record_format	dspace
spelling	oai:doaj.org-article:e861e5f8926d41508ada2593da5ff0ac2021-12-02T05:01:30ZIndividual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity2213-158210.1016/j.nicl.2021.102898https://doaj.org/article/e861e5f8926d41508ada2593da5ff0ac2021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2213158221003429https://doaj.org/toc/2213-1582Randomized controlled trials have shown efficacy of trauma-focused psychotherapies in youth with posttraumatic stress disorder (PTSD). However, response varies considerably among individuals. Currently, no biomarkers are available to assist clinicians in identifying youth who are most likely to benefit from treatment. In this study, we investigated whether resting-state functional magnetic resonance imaging (rs-fMRI) could distinguish between responders and non-responders on the group- and individual patient level. Pre-treatment rs-fMRI was recorded in 40 youth (ages 8–17 years) with (partial) PTSD before trauma-focused psychotherapy. Change in symptom severity from pre- to post-treatment was assessed using the Clinician-Administered PTSD scale for Children and Adolescents to divide participants into responders (≥30% symptom reduction) and non-responders. Functional networks were identified using meta-independent component analysis. Group-differences within- and between-network connectivity between responders and non-responders were tested using permutation testing. Individual predictions were made using multivariate, cross-validated support vector machine classification. A network centered on the bilateral superior temporal gyrus predicted treatment response for individual patients with 76% accuracy (pFWE = 0.02, 87% sensitivity, 65% specificity, area-under-receiver-operator-curve of 0.82). Functional connectivity between the frontoparietal and sensorimotor network was significantly stronger in non-responders (t = 5.35, pFWE = 0.01) on the group-level. Within-network connectivity was not significantly different between groups. This study provides proof-of-concept evidence for the feasibility to predict trauma-focused psychotherapy response in youth with PTSD at an individual-level. Future studies are required to test if larger cohorts could increase accuracy and to test further generalizability of the prediction models.Paul ZhutovskyJasper B. ZantvoordJudith B.M. EnsinkRosanne op den KelderRamon J.L. LindauerGuido A. van WingenElsevierarticlePTSDPsychotherapyAdolescentResting-state fMRIMachine learningClinical outcomeComputer applications to medicine. Medical informaticsR858-859.7Neurology. Diseases of the nervous systemRC346-429ENNeuroImage: Clinical, Vol 32, Iss , Pp 102898- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	PTSD Psychotherapy Adolescent Resting-state fMRI Machine learning Clinical outcome Computer applications to medicine. Medical informatics R858-859.7 Neurology. Diseases of the nervous system RC346-429
spellingShingle	PTSD Psychotherapy Adolescent Resting-state fMRI Machine learning Clinical outcome Computer applications to medicine. Medical informatics R858-859.7 Neurology. Diseases of the nervous system RC346-429 Paul Zhutovsky Jasper B. Zantvoord Judith B.M. Ensink Rosanne op den Kelder Ramon J.L. Lindauer Guido A. van Wingen Individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity
description	Randomized controlled trials have shown efficacy of trauma-focused psychotherapies in youth with posttraumatic stress disorder (PTSD). However, response varies considerably among individuals. Currently, no biomarkers are available to assist clinicians in identifying youth who are most likely to benefit from treatment. In this study, we investigated whether resting-state functional magnetic resonance imaging (rs-fMRI) could distinguish between responders and non-responders on the group- and individual patient level. Pre-treatment rs-fMRI was recorded in 40 youth (ages 8–17 years) with (partial) PTSD before trauma-focused psychotherapy. Change in symptom severity from pre- to post-treatment was assessed using the Clinician-Administered PTSD scale for Children and Adolescents to divide participants into responders (≥30% symptom reduction) and non-responders. Functional networks were identified using meta-independent component analysis. Group-differences within- and between-network connectivity between responders and non-responders were tested using permutation testing. Individual predictions were made using multivariate, cross-validated support vector machine classification. A network centered on the bilateral superior temporal gyrus predicted treatment response for individual patients with 76% accuracy (pFWE = 0.02, 87% sensitivity, 65% specificity, area-under-receiver-operator-curve of 0.82). Functional connectivity between the frontoparietal and sensorimotor network was significantly stronger in non-responders (t = 5.35, pFWE = 0.01) on the group-level. Within-network connectivity was not significantly different between groups. This study provides proof-of-concept evidence for the feasibility to predict trauma-focused psychotherapy response in youth with PTSD at an individual-level. Future studies are required to test if larger cohorts could increase accuracy and to test further generalizability of the prediction models.
format	article
author	Paul Zhutovsky Jasper B. Zantvoord Judith B.M. Ensink Rosanne op den Kelder Ramon J.L. Lindauer Guido A. van Wingen
author_facet	Paul Zhutovsky Jasper B. Zantvoord Judith B.M. Ensink Rosanne op den Kelder Ramon J.L. Lindauer Guido A. van Wingen
author_sort	Paul Zhutovsky
title	Individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity
title_short	Individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity
title_full	Individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity
title_fullStr	Individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity
title_full_unstemmed	Individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity
title_sort	individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/e861e5f8926d41508ada2593da5ff0ac
work_keys_str_mv	AT paulzhutovsky individualpredictionoftraumafocusedpsychotherapyresponseinyouthwithposttraumaticstressdisorderusingrestingstatefunctionalconnectivity AT jasperbzantvoord individualpredictionoftraumafocusedpsychotherapyresponseinyouthwithposttraumaticstressdisorderusingrestingstatefunctionalconnectivity AT judithbmensink individualpredictionoftraumafocusedpsychotherapyresponseinyouthwithposttraumaticstressdisorderusingrestingstatefunctionalconnectivity AT rosanneopdenkelder individualpredictionoftraumafocusedpsychotherapyresponseinyouthwithposttraumaticstressdisorderusingrestingstatefunctionalconnectivity AT ramonjllindauer individualpredictionoftraumafocusedpsychotherapyresponseinyouthwithposttraumaticstressdisorderusingrestingstatefunctionalconnectivity AT guidoavanwingen individualpredictionoftraumafocusedpsychotherapyresponseinyouthwithposttraumaticstressdisorderusingrestingstatefunctionalconnectivity
_version_	1718400802967519232

Individual prediction of trauma-focused psychotherapy response in youth with posttraumatic stress disorder using resting-state functional connectivity

Ejemplares similares