Inhibitory neural activity predicts response to cognitive-behavioral therapy for posttraumatic stress disorder

  • Falconer E
  • Allen A
  • Felmingham K
 et al. 
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Objective: Despite cognitive-behavioral therapy (CBT) being an effective
treatment for posttraumatic stress disorder (PTSD), many patients do not
respond to CBT. Understanding the neural bases of treatment response may
inform treatment refinement, thereby improving treatment response rates.
Adequate working memory function is proposed to enable engagement in
Method: This study employed a Go/No-Go task to examine inhibitory
function and its functional brain correlates as predictors of response
to CBT in PTSD. Participants were recruited between October 2003 and May
2005. Thirteen treatment-seeking patients who met DSM-IV criteria for
PTSD completed the Go/No-Go task while undergoing functional magnetic
resonance imaging (fMRI), after which they entered 8 once-weekly
sessions of CBT. PTSD severity was measured before treatment and again
at 6 months following treatment completion using the
Clinician-Administered PTSD Scale (primary outcome measure).
Results: After controlling for initial PTSD severity and ongoing
depressive symptoms, greater activity in left dorsal striatal (Z = 3.19,
P =.001) and frontal (Z = 3.03, P =.001) networks during inhibitory
control was associated with lower PTSD symptom severity after treatment,
suggesting better treatment response.
Conclusions: These results suggest that neural circuitry underpinning
inhibitory control plays a role in the outcome of CBT for patients with

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