An executive function subtype of PTSD with unique neural markers and clinical trajectories

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Abstract

Previous work identified a cognitive subtype of PTSD with impaired executive function (i.e., impaired EF-PTSD subtype) and aberrant resting-state functional connectivity between frontal parietal control (FPCN) and limbic (LN) networks. To better characterize this cognitive subtype of PTSD, this study investigated (1) alterations in specific FPCN and LN subnetworks and (2) chronicity of PTSD symptoms. In a post-9/11 veteran sample ( N = 368, 89% male), we identified EF subgroups using a standardized neuropsychological battery and a priori cutoffs for impaired, average, and above-average EF performance. Functional connectivity between two subnetworks of the FPCN and three subnetworks of the LN was assessed using resting-state fMRI ( n = 314). PTSD chronicity over a 1–2-year period was assessed using a reliable change index ( n = 175). The impaired EF-PTSD subtype had significantly reduced negative functional connectivity between the FPCN subnetwork involved in top-down control of emotion and two LN subnetworks involved in learning/memory and social/emotional processing. This impaired EF-PTSD subtype had relatively chronic PTSD, while those with above-average EF and PTSD displayed greater symptom reduction. Lastly, FPCN-LN subnetworks partially mediated the relationship between EF and PTSD chronicity ( n = 121). This study reveals (1) that an impaired EF-PTSD subtype has a specific pattern of FPCN-LN subnetwork connectivity, (2) a novel above-average EF-PTSD subtype displays reduced PTSD chronicity, and (3) both cognitive and neural functioning predict PTSD chronicity. The results indicate a need to investigate how individuals with this impaired EF-PTSD subtype respond to treatment, and how they might benefit from personalized and novel approaches that target these neurocognitive systems.

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Author and article information

Contributors

Audreyana Jagger-Rickels:

ORCID: http://orcid.org/0000-0003-2268-8101

acrickel@bu.edu

Journal

Journal ID (nlm-ta): Transl Psychiatry

Journal ID (iso-abbrev): Transl Psychiatry

Title: Translational Psychiatry

Publisher: Nature Publishing Group UK (London )

ISSN (Electronic): 2158-3188

Publication date (Electronic): 27 June 2022

Publication date PMC-release: 27 June 2022

Publication date Collection: 2022

Volume: 12

Electronic Location Identifier: 262

Affiliations

[1 ]GRID grid.410370.1, ISNI 0000 0004 4657 1992, National Center for PTSD (NCPTSD), , VA Boston Healthcare System, ; Boston, MA USA

[2 ]GRID grid.410370.1, ISNI 0000 0004 4657 1992, Boston Attention and Learning Lab (BALLAB), , VA Boston Healthcare System, ; Boston, MA USA

[3 ]GRID grid.189504.1, ISNI 0000 0004 1936 7558, Department of Psychiatry, , Boston University School of Medicine, ; Boston, MA USA

[4 ]GRID grid.33489.35, ISNI 0000 0001 0454 4791, Department of Psychological and Brain Sciences, , University of Delaware, ; Newark, DE USA

[5 ]GRID grid.410370.1, ISNI 0000 0004 4657 1992, Translational Research Center for TBI and Stress Disorders (TRACTS), , VA Boston Healthcare System, ; Boston, MA USA

[6 ]GRID grid.38142.3c, ISNI 000000041936754X, Department of Psychiatry, , Harvard Medical School, ; Boston, MA USA

[7 ]GRID grid.410370.1, ISNI 0000 0004 4657 1992, Geriatric Research, Education and Clinical Center (GRECC), , VA Boston Healthcare System, ; Boston, MA USA

[8 ]GRID grid.410370.1, ISNI 0000 0004 4657 1992, Neuroimaging Research for Veterans (NeRVe) Center, , VA Boston Healthcare System, ; Boston, MA USA

Author information

Audreyana Jagger-Rickels http://orcid.org/0000-0003-2268-8101

Article

Publisher ID: 2011

DOI: 10.1038/s41398-022-02011-y

PMC ID: 9237057

PubMed ID: 35760805

SO-VID: 51acef53-e249-41fd-99f6-1c771e933247

License:

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.