This study investigated group differences and longitudinal changes in brain volume before and after trauma-focused cognitive behavioral therapy (TF-CBT) in 20 unmedicated youth with maltreatment-related posttraumatic stress disorder (PTSD) and 20 non–trauma-exposed healthy control (HC) participants. We collected MRI scans of brain anatomy before and after 5 months of TF-CBT or the same time interval for the HC group. FreeSurfer software was used to segment brain images into 95 cortical and subcortical volumes, which were submitted to optimal scaling regression with lasso variable selection. The resulting model of group differences at baseline included larger right medial orbital frontal and left posterior cingulate corticies and smaller right midcingulate and right precuneus corticies in the PTSD relative to the HC group, R² = .67. The model of group differences in pre- to posttreatment change included greater longitudinal changes in right rostral middle frontal, left pars triangularis, right entorhinal, and left cuneus corticies in the PTSD relative to the HC group, R² = .69. Within the PTSD group, pre- to posttreatment symptom improvement was modeled by longitudinal decreases in the left posterior cingulate cortex, R² = .45, and predicted by baseline measures of a smaller right isthmus (retrosplenial) cingulate and larger left caudate, R² = .77. In sum, treatment was associated with longitudinal changes in brain regions that support executive functioning but not those that discriminated PTSD from HC participants at baseline. Additionally, results confirm a role for the posterior/retrosplenial cingulate as a correlate of PTSD symptom improvement and predictor of treatment outcome.

中文翻译：

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创伤后应激障碍青少年与以创伤为中心的认知行为疗法相关的脑容量变化

本研究调查了 20 名患有虐待相关创伤后应激障碍 (PTSD) 的未接受药物治疗的青年和 20 名未受过创伤的健康对照者 (HC) 在以创伤为中心的认知行为疗法 (TF-CBT) 前后的组别差异和脑容量的纵向变化）参与者。我们收集了 TF-CBT 5 个月前后或 HC 组相同时间间隔的大脑解剖 MRI 扫描。FreeSurfer 软件用于将大脑图像分割成 95 个皮质和皮质下体积，这些体积被提交给具有套索变量选择的最佳比例回归。与 HC 组相比，在基线时产生的组差异模型包括 PTSD 中较大的右侧内侧眶额叶和左侧后扣带回皮质以及较小的右侧中扣带回和右侧楔前叶皮质，R ² = .67。治疗前后变化的组间差异模型包括，相对于 HC 组，PTSD 中右侧额中额叶、左侧三角部、右侧内嗅和左侧楔叶皮质的纵向变化更大，R ² = .69。在 PTSD 组中，治疗前到治疗后的症状改善是通过左后扣带皮层的纵向减少建模的，R ² = .45，并通过较小的右侧峡部（压后）扣带回和较大的左尾状核R ^{2的基线测量来预测}= .77。总之，治疗与支持执行功能的大脑区域的纵向变化有关，但与那些在基线时区分 PTSD 和 HC 参与者的区域无关。此外，结果证实了后扣带回/压后扣带回作为 PTSD 症状改善和治疗结果预测因子的相关作用。