A pilot study of closed-loop neuromodulation for treatment-resistant post-traumatic stress disorder

Abstract

<jats:title>Abstract</jats:title><jats:p>The neurophysiological mechanisms in the human amygdala that underlie post-traumatic stress disorder (PTSD) remain poorly understood. In a first-of-its-kind pilot study, we recorded intracranial electroencephalographic data longitudinally (over one year) in two male individuals with amygdala electrodes implanted for the management of treatment-resistant PTSD (TR-PTSD) under clinical trial NCT04152993. To determine electrophysiological signatures related to emotionally aversive and clinically relevant states (trial primary endpoint), we characterized neural activity during unpleasant portions of three separate paradigms (negative emotional image viewing, listening to recordings of participant-specific trauma-related memories, and at-home-periods of symptom exacerbation). We found selective increases in amygdala theta (5–9 Hz) bandpower across all three negative experiences. Subsequent use of elevations in low-frequency amygdala bandpower as a trigger for closed-loop neuromodulation led to significant reductions in TR-PTSD symptoms (trial secondary endpoint) following one year of treatment as well as reductions in aversive-related amygdala theta activity. Altogether, our findings provide early evidence that elevated amygdala theta activity across a range of negative-related behavioral states may be a promising target for future closed-loop neuromodulation therapies in PTSD.</jats:p>

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Published Version (Please cite this version)

10.1038/s41467-023-38712-1

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Gill, Jay L, Julia A Schneiders, Matthias Stangl, Zahra M Aghajan, Mauricio Vallejo, Sonja Hiller, Uros Topalovic, Cory S Inman, et al. (n.d.). A pilot study of closed-loop neuromodulation for treatment-resistant post-traumatic stress disorder. Nature Communications, 14(1). 10.1038/s41467-023-38712-1 Retrieved from https://hdl.handle.net/10161/31668.

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Suthana

Nanthia Suthana

Instructor in the Department of Neurosurgery

The Suthana Laboratory aims to advance our understanding of the neural mechanisms underlying memory and emotion, with a focus on developing innovative neuromodulation and neuroimaging technologies. By integrating intracranial electrophysiological recordings with non-invasive peripheral measurements, the lab seeks to improve treatments for neurological and psychiatric disorders, and provide new tools for studying brain function in real-world contexts.


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