Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder

Amit Etkin; Adi Maron-Katz; Wei Wu; Gregory A. Fonzo; Julia Huemer; Petra E. Vértes; Brian Patenaude; Jonas Richiardi; Madeleine S. Goodkind; Corey J. Keller; Jaime Ramos-Cejudo; Yevgeniya V. Zaiko; Kathy K. Peng; Emmanuel Shpigel; Parker Longwell; Russ T. Toll; Allison Thompson; Sanno Zack; Bryan Gonzalez; Raleigh Edelstein; Jingyun Chen; Irene Akingbade; Elizabeth Weiss; Roland Hart; Silas Mann; Kathleen Durkin; Steven H. Baete; Fernando E. Boada; Afia Genfi; Jillian Autea; Jennifer Newman; Desmond J. Oathes; Steven E. Lindley; Duna Abu-Amara; Bruce A. Arnow; Nicolas Crossley; Joachim Hallmayer; Silvia Fossati; Barbara O. Rothbaum; Charles R. Marmar; Edward T. Bullmore; Ruth O’Hara

doi:10.1126/scitranslmed.aal3236

Research ArticlePsychiatry

Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder

Amit Etkin ¹,²,³,⁴,*,†,
Adi Maron-Katz¹,²,³,⁴,*,
Wei Wu ¹,²,³,⁴,⁵,*,
Gregory A. Fonzo ¹,²,³,⁴,*,
Julia Huemer¹,²,³,*,
Petra E. Vértes ⁶,⁷,⁸,*,
Brian Patenaude¹,²,³,⁴,
Jonas Richiardi⁹,¹⁰,
Madeleine S. Goodkind¹¹,¹²,
Corey J. Keller¹,²,³,⁴,
Jaime Ramos-Cejudo⁴,¹³,
Yevgeniya V. Zaiko¹,²,³,
Kathy K. Peng¹,³,
Emmanuel Shpigel¹,²,³,⁴,
Parker Longwell¹,²,³,⁴,
Russ T. Toll ¹,²,³,⁴,
Allison Thompson¹,
Sanno Zack¹,
Bryan Gonzalez⁴,¹³,
Raleigh Edelstein¹,²,³,⁴,
Jingyun Chen⁴,¹³,
Irene Akingbade¹,³,⁴,
Elizabeth Weiss¹,³,
Roland Hart⁴,¹³,
Silas Mann⁴,¹³,
Kathleen Durkin⁴,¹³,
Steven H. Baete⁴,¹¹,¹²,
Fernando E. Boada⁴,¹⁴,¹⁵,
Afia Genfi⁴,¹³,
Jillian Autea¹,²,³,⁴,
Jennifer Newman⁴,¹³,
Desmond J. Oathes¹⁶,
Steven E. Lindley¹,³,
Duna Abu-Amara⁴,¹³,
Bruce A. Arnow¹,
Nicolas Crossley¹⁷,¹⁸,
Joachim Hallmayer¹,²,³,
Silvia Fossati⁴,¹³,
Barbara O. Rothbaum¹⁹,
Charles R. Marmar ⁴,¹³,
Edward T. Bullmore⁶,²⁰,²¹ and
Ruth O’Hara ¹,³

¹Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
²Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.
³Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.
⁴Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.
⁵School of Automation Science and Engineering, South China University of Technology, Guangzhou, Guangdong 510640, China.
⁶Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.
⁷School of Mathematical Sciences, Queen Mary University of London, London E1 4NS, UK.
⁸The Alan Turing Institute, London NW1 2DB, UK.
⁹Department of Medical Radiology, Lausanne University Hospital, Lausanne, Switzerland.
¹⁰Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.
¹¹New Mexico Veterans Affairs Healthcare System, Albuquerque, NM 87108, USA.
¹²Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131, USA.
¹³Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA.
¹⁴Center for Advanced Imaging Innovation and Research (CAI2R), NYU School of Medicine, New York, NY 10016, USA.
¹⁵Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY 10016, USA.
¹⁶Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.
¹⁷Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, 6513677 Santiago, Chile.
¹⁸Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.
¹⁹Trauma and Anxiety Recovery Program, Department of Psychiatry, Emory University School of Medicine, Atlanta, GA 30322, USA.
²⁰Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK.
²¹ImmunoPsychiatry, Alternative Discovery and Development, GlaxoSmithKline, Stevenage SG1 2NY, UK.

↵†Corresponding author. Email: amitetkin{at}stanford.edu

↵* These authors contributed equally to this work.

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Science Translational Medicine 03 Apr 2019:
Vol. 11, Issue 486, eaal3236
DOI: 10.1126/scitranslmed.aal3236

Amit Etkin

Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.Wu Tsai Neurosciences Institute at Stanford, Stanford University, Stanford, CA 94304, USA.Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.

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For correspondence: amitetkin@stanford.edu

Adi Maron-Katz

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Wei Wu

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Gregory A. Fonzo

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Julia Huemer

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Petra E. Vértes

Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.School of Mathematical Sciences, Queen Mary University of London, London E1 4NS, UK.The Alan Turing Institute, London NW1 2DB, UK.

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Brian Patenaude

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Jonas Richiardi

Department of Medical Radiology, Lausanne University Hospital, Lausanne, Switzerland.Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland.

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Madeleine S. Goodkind

New Mexico Veterans Affairs Healthcare System, Albuquerque, NM 87108, USA.Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131, USA.

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Corey J. Keller

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Jaime Ramos-Cejudo

Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.Department of Psychiatry, New York University Langone School of Medicine, New York, NY 10016, USA.

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Yevgeniya V. Zaiko

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Kathy K. Peng

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Emmanuel Shpigel

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Parker Longwell

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Russ T. Toll

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Allison Thompson

Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.

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Sanno Zack

Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.

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Bryan Gonzalez

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Raleigh Edelstein

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Jingyun Chen

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Irene Akingbade

Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.Sierra Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Veterans Affairs Palo Alto Healthcare System, Palo Alto, CA 94394, USA.Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.

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Elizabeth Weiss

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Roland Hart

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Silas Mann

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Kathleen Durkin

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Steven H. Baete

Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.New Mexico Veterans Affairs Healthcare System, Albuquerque, NM 87108, USA.Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, NM 87131, USA.

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Fernando E. Boada

Steven and Alexandra Cohen Veterans Center for Post-traumatic Stress and Traumatic Brain Injury, New York University Langone School of Medicine, New York, NY 10016, USA.Center for Advanced Imaging Innovation and Research (CAI2R), NYU School of Medicine, New York, NY 10016, USA.Center for Biomedical Imaging, Department of Radiology, NYU School of Medicine, New York, NY 10016, USA.

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Afia Genfi

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Jillian Autea

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Jennifer Newman

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Desmond J. Oathes

Center for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.

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Steven E. Lindley

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Duna Abu-Amara

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Bruce A. Arnow

Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.

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Nicolas Crossley

Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, 6513677 Santiago, Chile.Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AF, UK.

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Joachim Hallmayer

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Silvia Fossati

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Barbara O. Rothbaum

Trauma and Anxiety Recovery Program, Department of Psychiatry, Emory University School of Medicine, Atlanta, GA 30322, USA.

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Charles R. Marmar

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Edward T. Bullmore

Department of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK.ImmunoPsychiatry, Alternative Discovery and Development, GlaxoSmithKline, Stevenage SG1 2NY, UK.

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Ruth O’Hara

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A subgroup of patients with post-traumatic stress disorder, characterized by a particular brain and behavioral signature, showed a poor treatment outcome.

Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder

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