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      The Electrical Aftermath: Brain Signals of Posttraumatic Stress Disorder Filtered Through a Clinical Lens

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          Abstract

          This review aims to identify patterns of electrical signals identified using electroencephalography (EEG) linked to posttraumatic stress disorder (PTSD) diagnosis and symptom dimensions. We filter EEG findings through a clinical lens, evaluating nuances in findings according to study criteria and participant characteristics. Within the EEG frequency domain, greater right than left parietal asymmetry in alpha band power is the most promising marker of PTSD symptoms and is linked to exaggerated physiological arousal that may impair filtering of environmental distractors. The most consistent findings within the EEG time domain focused on event related potentials (ERPs) include: 1) exaggerated frontocentral responses (contingent negative variation, mismatch negativity, and P3a amplitudes) to task-irrelevant distractors, and 2) attenuated parietal responses (P3b amplitudes) to task-relevant target stimuli. These findings suggest that some individuals with PTSD suffer from attention dysregulation, which could contribute to problems concentrating on daily tasks and goals in lieu of threatening distractors. Future research investigating the utility of alpha asymmetry and frontoparietal ERPs as diagnostic and predictive biomarkers or intervention targets are recommended.

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          Most cited references 201

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          Updating P300: an integrative theory of P3a and P3b.

           John Polich (2007)
          The empirical and theoretical development of the P300 event-related brain potential (ERP) is reviewed by considering factors that contribute to its amplitude, latency, and general characteristics. The neuropsychological origins of the P3a and P3b subcomponents are detailed, and how target/standard discrimination difficulty modulates scalp topography is discussed. The neural loci of P3a and P3b generation are outlined, and a cognitive model is proffered: P3a originates from stimulus-driven frontal attention mechanisms during task processing, whereas P3b originates from temporal-parietal activity associated with attention and appears related to subsequent memory processing. Neurotransmitter actions associating P3a to frontal/dopaminergic and P3b to parietal/norepinephrine pathways are highlighted. Neuroinhibition is suggested as an overarching theoretical mechanism for P300, which is elicited when stimulus detection engages memory operations.
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            Psychometric properties of the PTSD checklist (PCL)

            The psychometric properties of the PTSD Checklist (PCL), a new, brief, self-report instrument, were determined on a population of 40 motor vehicle accident victims and sexual assault victims using diagnoses and scores from the CAPS (Clinician Administered PTSD Scale) as the criteria. For the PCL as a whole, the correlation with the CAPS was 0.929 and diagnostic efficiency was 0.900 versus CAPS. Examination of the individual items showed wide ranging values of individual item correlations ranging from 0.386 to 0.788, and with diagnostic efficiencies of 0.700 or better for symptoms. We support the value of the PCL as a brief screening instrument for PTSD.
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              Thirty years and counting: finding meaning in the N400 component of the event-related brain potential (ERP).

              We review the discovery, characterization, and evolving use of the N400, an event-related brain potential response linked to meaning processing. We describe the elicitation of N400s by an impressive range of stimulus types--including written, spoken, and signed words or pseudowords; drawings, photos, and videos of faces, objects, and actions; sounds; and mathematical symbols--and outline the sensitivity of N400 amplitude (as its latency is remarkably constant) to linguistic and nonlinguistic manipulations. We emphasize the effectiveness of the N400 as a dependent variable for examining almost every aspect of language processing and highlight its expanding use to probe semantic memory and to determine how the neurocognitive system dynamically and flexibly uses bottom-up and top-down information to make sense of the world. We conclude with different theories of the N400's functional significance and offer an N400-inspired reconceptualization of how meaning processing might unfold.
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                Author and article information

                Affiliations
                1Department of Psychology , Queens College, City University of New York , Flushing, NY, United States
                2Laureate Institute for Brain Research , Tulsa, OK, United States
                3Department of Community Medicine, Oxley College of Health Sciences, University of Tulsa , Tulsa, OK, United States
                4Department of Psychology, The Graduate Center, City University of New York , New York, NY, United States
                Author notes

                Edited by: Agorastos Agorastos, Aristotle University of Thessaloniki, Greece

                Reviewed by: Payam Norouzzadeh, North Carolina State University, United States; Tara Thiagarajan, Sapien Labs, United States

                *Correspondence: Jennifer Lorraine Stewart jstewart@ 123456laureateinstitute.org

                †These authors have contributed equally to this work.

                This article was submitted to Mood and Anxiety Disorders, a section of the journal Frontiers in Psychiatry

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                31 May 2019
                2019
                : 10
                10.3389/fpsyt.2019.00368
                6555259
                Copyright © 2019 Butt, Espinal, Aupperle, Nikulina and Stewart

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Counts
                Figures: 2, Tables: 5, Equations: 0, References: 211, Pages: 30, Words: 18479
                Funding
                Funded by: William K. Warren Foundation 10.13039/100001380
                Categories
                Psychiatry
                Review

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