P3a amplitude to trauma-related stimuli reduced after successful trauma-focused PTSD treatment

Gail D Tillman; Elizabeth Ellen Morris; Christina Bass; Mary Turner; Kelsey Watson; Jared T Brooks; Tyler Rawlinson; F Andrew Kozel; Michael A Kraut; Michael A Motes; John Hart Jr

doi:10.1016/j.biopsycho.2023.108648

P3a amplitude to trauma-related stimuli reduced after successful trauma-focused PTSD treatment

Biol Psychol. 2023 Sep:182:108648. doi: 10.1016/j.biopsycho.2023.108648. Epub 2023 Jul 22.

Authors

Affiliations

¹ Callier Center, University of Texas at Dallas, Dallas, TX, USA. Electronic address: gtillman@utdallas.edu.
² Callier Center, University of Texas at Dallas, Dallas, TX, USA.
³ Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX, USA.
⁴ Department of Behavioral Sciences and Social Medicine, Florida State University, Tallahassee, FL, USA.
⁵ Department of Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁶ Callier Center, University of Texas at Dallas, Dallas, TX, USA; Departments of Psychiatry University of Texas Southwestern Medical Center, Dallas, TX, USA; Departments of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA.

PMID: 37482132
DOI: 10.1016/j.biopsycho.2023.108648

Abstract

An elevated P3a amplitude to trauma-related stimuli is strongly associated with posttraumatic stress disorder (PTSD), yet little is known about whether this response to trauma-related stimuli is affected by treatment that decreases PTSD symptoms. As an analysis of secondary outcome measures from a randomized controlled trial, we investigated the latency and amplitude changes of the P3a in responses in a three-condition oddball visual task that included trauma-related (combat scenes) and trauma-unrelated (threatening animals) distractors. Fifty-five U.S. veterans diagnosed with combat-related PTSD were randomized to receive either active or sham repetitive transcranial magnetic stimulation (rTMS). All received cognitive processing therapy, CPT+A, which requires a written account of the index trauma. They were tested before and 6 months after protocol completion. P3a amplitude and response time decreases were driven largely by the changes in the responses to the trauma-related stimuli, and this decrease correlated to the decrease in PTSD symptoms. The amplitude changes were greater in those who received rTMS + CPT than in those who received sham rTMS + CPT, suggesting that rTMS plays beneficial role in reducing arousal and threat bias, which may allow for more effective engagement in trauma-focused PTSD treatment.

Keywords: Cognitive processing therapy; Event-related potential; Hyperarousal; OIF/OEF/OND veterans; Repetitive transcranial magnetic stimulation.

Publication types

Randomized Controlled Trial
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, Non-U.S. Gov't

MeSH terms

Combat Disorders* / psychology
Humans
Stress Disorders, Post-Traumatic* / psychology
Stress Disorders, Post-Traumatic* / therapy
Transcranial Magnetic Stimulation / methods
Treatment Outcome
Veterans* / psychology