Emotional processing and cognitive control are implicated as being dysfunctional in posttraumatic stress disorder (PTSD) and targeted in cognitive processing therapy (CPT), a trauma-focused treatment for PTSD. The N2 event-related potential has been interpreted in the context of emotional processing and cognitive control. In this analysis of secondary outcome measures from a randomized controlled trial, we investigated the latency and amplitude changes of the N2 in responses to task-relevant target tones and task-irrelevant distractor sounds (e.g., a trauma-related gunshot and a trauma-unrelated lion's roar) and the associations between these responses and PTSD symptom changes. United States military veterans (N = 60) diagnosed with combat-related PTSD were randomized to either active or sham repetitive transcranial magnetic stimulation (rTMS) and received a CPT intervention that included a written trauma account element (CPT+A). Participants were tested before and 6 months after protocol completion. Reduction in N2 amplitude to the gunshot stimulus was correlated with reductions in reexperiencing, |r| = .445, and hyperarousal measures, |r| = .364. In addition, in both groups, the latency of the N2 event-related potential to the distractors became longer with treatment and the N2 latency to the task-relevant stimulus became shorter, η_p² = .064, both of which are consistent with improved cognitive control. There were no between-group differences in N2 amplitude and latency. Normalized N2 latencies, reduced N2 amplitude to threatening distractors, and the correlation between N2 amplitude reduction and PTSD symptom reduction reflect improved cognitive control, consistent with the CPT+A objective of addressing patients’ abilities to respond more appropriately to trauma triggers.

中文翻译：

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听觉 N2 与创伤后应激障碍治疗反应的相关性

情绪处理和认知控制与创伤后应激障碍 (PTSD) 的功能障碍有关，并以认知处理治疗 (CPT) 为目标，这是一种以创伤为中心的 PTSD 治疗。N2 事件相关电位已在情绪处理和认知控制的背景下进行了解释。在这项对随机对照试验的次要结果测量的分析中，我们调查了 N2 响应与任务相关的目标音和与任务无关的干扰声音（例如，与创伤相关的枪声和与创伤无关的声音）的潜伏期和振幅变化。狮子吼）以及这些反应与 PTSD 症状变化之间的关联。美国退伍军人（N = 60) 被诊断为与战斗相关的 PTSD 被随机分配到主动或假重复经颅磁刺激 (rTMS) 组，并接受 CPT 干预，其中包括书面创伤描述元素 (CPT+A)。参与者在协议完成之前和之后 6 个月进行了测试。枪击刺激的 N2 振幅减少与重新体验的减少相关，| r | = .445，以及过度唤醒措施，| r | = .364。此外，在两组中，N2 事件相关电位对干扰物的潜伏期随着治疗而变长，而对任务相关刺激的 N2 潜伏期变短，η _p ² = .064，这两者都与改善的认知控制一致。N2 波幅和潜伏期无组间差异。标准化的 N2 潜伏期、降低的 N2 幅度对威胁性干扰因素以及 N2 幅度降低和 PTSD 症状减轻之间的相关性反映了认知控制的改善，这与 CPT+A 的目标一致，即解决患者对创伤触发因素做出更适当反应的能力。