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Impaired executive function exacerbates neural markers of posttraumatic stress disorder

Published online by Cambridge University Press:  21 April 2021

Audreyana Jagger-Rickels Open the ORCID record for Audreyana Jagger-Rickels [Opens in a new window] ,
Anna Stumps ,
David Rothlein ,
Hannah Park ,
Francesca Fortenbaugh ,
Agnieszka Zuberer ,
Jennifer R. Fonda ,
Catherine B. Fortier ,
Joseph DeGutis  and
William Milberg
...Show all authors
Audreyana Jagger-Rickels*
Affiliation:
National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
Anna Stumps
Affiliation:
Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA
David Rothlein
Affiliation:
National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
Hannah Park
Affiliation:
Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA
Francesca Fortenbaugh
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
Agnieszka Zuberer
Affiliation:
Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany
Jennifer R. Fonda
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
Catherine B. Fortier
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
Joseph DeGutis
Affiliation:
Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA
William Milberg
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Geriatric Research, Education and Clinical Center (GRECC), VABoston Healthcare System, Boston, Massachusetts, USA
Regina McGlinchey
Affiliation:
Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Harvard Medical School, Boston, MA, USA Geriatric Research, Education and Clinical Center (GRECC), VABoston Healthcare System, Boston, Massachusetts, USA
Michael Esterman
Affiliation:
National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA Boston Attention and Learning Lab (BALAB), VA Boston Healthcare System, Boston, MA, USA Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System, Boston, MA, USA Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA Neuroimaging Research for Veterans (NeRVe) Center, VA Boston Healthcare System, Boston, MA, USA
*
Author for correspondence: Audreyana Jagger-Rickels, E-mail: acrickel@bu.edu
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Abstract

Background

A major obstacle in understanding and treating posttraumatic stress disorder (PTSD) is its clinical and neurobiological heterogeneity. To address this barrier, the field has become increasingly interested in identifying subtypes of PTSD based on dysfunction in neural networks alongside cognitive impairments that may underlie the development and maintenance of symptoms. The current study aimed to determine if subtypes of PTSD, based on normative-based cognitive dysfunction across multiple domains, have unique neural network signatures.

Methods

In a sample of 271 veterans (90% male) that completed both neuropsychological testing and resting-state fMRI, two complementary, whole-brain functional connectivity analyses explored the link between brain functioning, PTSD symptoms, and cognition.

Results

At the network level, PTSD symptom severity was associated with reduced negative coupling between the limbic network (LN) and frontal-parietal control network (FPCN), driven specifically by the dorsolateral prefrontal cortex and amygdala Hubs of Dysfunction. Further, this relationship was uniquely moderated by executive function (EF). Specifically, those with PTSD and impaired EF had the strongest marker of LN-FPCN dysregulation, while those with above-average EF did not exhibit PTSD-related dysregulation of these networks.

Conclusion

These results suggest that poor executive functioning, alongside LN-FPCN dysregulation, may represent a neurocognitive subtype of PTSD.

Keywords

Biomarkerexecutive functionfMRIneurocognitive subtypesPTSDresting-state
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 16 , December 2022 , pp. 3985 - 3998
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Creative Commons
This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press.
Copyright
Copyright © US Department of Veterans Affairs, 2021

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