Brain Response to Treatment for Pediatric PTSD
Condition: Emotions; Memory Deficits; Post-traumatic Syndrome
MeSH terms: Memory Disorders
Study type: Interventional

Summary: 
      This study will examine how brain activation changes as a result of behavioral treatment for
      posttraumatic stress disorder (PTSD) in adolescents. The investigators will conduct
      functional magnetic resonance imaging (fMRI) scans before and after the widely-used
      trauma-focused cognitive behavioral therapy to better understand how the brain recovers from
      illness. This study will provide much needed information about brain abnormalities in abused
      youth, and could lead to improvements in behavioral treatments for patients who do not
      respond to current treatments.
    

Detailed description: 
      This is a neuroimaging study of changes in brain function associated with trauma-focused
      cognitive behavioral therapy (TF-CBT)for abused youth suffering from PTSD. By scanning
      patients before and after treatment, the investigators will identify mediators (potential
      mechanisms) of recovery from PTSD.

      Childhood maltreatment is unfortunately common, and can lead to significant problems in
      school, emotional difficulties, and physical ailments. Frequently, abused children develop
      symptoms of posttraumatic stress disorder (PTSD), such as re-experiencing aspects of the
      trauma, avoiding trauma-related situations, and suffering from chronic hyperarousal. PTSD can
      inflict significant stress-related damage on the brain at any age, but may be particularly
      damaging during developmental periods such as adolescence. Therefore, effective treatments
      for PTSD in youth are critical, and this depends in part on our ability to understand the
      neural abnormalities underlying pediatric PTSD, and the brain changes accompanying recovery
      from PTSD.

      TF-CBT is the "gold-standard" treatment for this population however, some patients continue
      to experience symptoms of PTSD following treatment. Examining neural changes associated with
      successful treatment may suggest adjunctive or additional steps to enhance recovery in
      non-responders or partly responsive patients.

      The investigators will assess brain activation in response to an emotion-related task in 40
      adolescents with PTSD before and after a 12 week TF-CBT treatment, conducted at Stanford
      University. The fidelity of TF-CBT treatment will be assured through ongoing consultation
      between clinicians and treatment co-creator Judith Cohen, M.D. Neuroimaging analyses will
      assess patterns of activation associated with response to TF-CBT. Also, the investigators
      will scan 30 age-matched healthy controls recruited from the same community, to compare with
      patients to identify abnormalities in brain structure and function in the PTSD group.
      Controls will be scanned before and after a 12-week interval as well, to allow analyses of
      test/retest reliability of fMRI measures in this age group.
    

Intervention name(s): Trauma-focused cognitive behavioral therapy
Intervention type(s): Behavioral
Intervention description(s): the 'gold-standard' behavioral treatment for children/adolescents with posttraumatic stress disorder
Other intervention name(s): TF-CBT
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: fMRI; neuroimaging; PTSD; adolescent; trauma; brain