Trial reportScience translational medicine2019
Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder.
Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
In one paragraph
Trial report in Science translational medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03840369 (Pathophysiological Understanding and Treatment of PTSD), which is not on this map. Cited by 54 papers, 3 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 3 pooled it
7.6field-weighted citation impact, top 2% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Pathophysiological Understanding and Treatment of PTSD: an rTMS Approach
Who cites it
54 citing papers in PubMed, 3 syntheses or guidelines pooled it, 100 citations in OpenAlex.
- PTSD subtypes and their underlying neural biomarkers: a systematic review.Psychological medicine · 2025Pooled it
- Repetitive Transcranial Magnetic Stimulation for the Treatment of Post-traumatic Stress Disorder: A Systematic Review and Network Meta-analysis: La Stimulation Magnétique Transcrânienne Répétitive Pour le Traitement du Trouble de Stress Post-Traumatique : Une Revue Systématique et une Méta-Analyse en Réseau.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2021Pooled it
- Predicting response to psychiatric surgery: a systematic review of neuroimaging findings.Journal of psychiatry & neuroscience : JPN · 2020Pooled it
- Oxytocin Reduces Subjective Fear in Naturalistic Social Contexts via Enhancing Top-Down Middle Cingulate Amygdala Regulation and Brain-Wide Fear Representations.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2025Trial
- Hyperbaric Oxygen Therapy for PTSD: Threshold Effect for Sustained Symptom Improvement in a Biologically Based Treatment.Brain and behavior · 2025Trial
- Negative Affect Circuit Subtypes and Neural, Behavioral, and Affective Responses to MDMA: A Randomized Clinical Trial.JAMA network open · 2025Trial
- Amygdala and Insula Connectivity Changes Following Psychotherapy for Posttraumatic Stress Disorder: A Randomized Clinical Trial.Biological psychiatry · 2021Trial
- Changes in functional connectivity after theta-burst transcranial magnetic stimulation for post-traumatic stress disorder: a machine-learning study.European archives of psychiatry and clinical neuroscience · 2021Trial
- A Randomized Sham-controlled Trial of 1-Hz and 10-Hz Repetitive Transcranial Magnetic Stimulation (rTMS) of the Right Dorsolateral Prefrontal Cortex in Civilian Post-traumatic Stress Disorder: Un essai randomisé contrôlé simulé de stimulation magnétique transcrânienne repetitive (SMTr) de 1 Hz et 10 Hz du cortex préfrontal dorsolatéral droit dans le trouble de stress post-traumatique chez des civils.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2020Trial
- A randomized, controlled trial of alpha-rhythm EEG neurofeedback in posttraumatic stress disorder: A preliminary investigation showing evidence of decreased PTSD symptoms and restored default mode and salience network connectivity using fMRI.NeuroImage. Clinical · 2020Trial
- Feature selection leads to divergent neurobiological interpretations of brain-based machine learning biomarkers.Nature human behaviour · 2026Article
- Circuit-informed modulation of traumatic memory in PTSD: integrating extinction, suppression, and reconsolidation.Molecular psychiatry · 2026Review
- Altered amygdala and striatal responsivity and prediction error encoding of temporal reward dynamics in post-trauma psychopathology.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2026Article
- A pilot study of brain correlates of long-term treatment with transcutaneous vagal nerve stimulation in posttraumatic stress disorder.Journal of affective disorders reports · 2026Article
- Differential developmental influences on anxiety in adulthood: Behavioral inhibition moderates the dimensions of social involvement predicting anxiety in adulthood.Journal of mood and anxiety disorders · 2026Article
- Overlooked features lead to divergent neurobiological interpretations of brain-based machine learning biomarkers.bioRxiv : the preprint server for biology · 2025Article
- First Application of a Novel Brain Template: Motor Training Improves Cortico-cerebellar Connectivity in Cerebellar Ataxia.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2025Article
- Neuroimaging-based variability in subtyping biomarkers for psychiatric heterogeneity.Molecular psychiatry · 2025Article
- Cognition and Ventral Attention Network Connectivity: Associations With Treatment Response in Posttraumatic Stress Disorder.The Journal of neuropsychiatry and clinical neurosciences · 2025Article
- Brain stimulation enhances dispositional mindfulness in PTSD: an exploratory sham-controlled rTMS trial.Frontiers in psychiatry · 2025Article
Corrections and comments
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Authors and funding
42 authors at 12 institutions in 5 countries.
Amit EtkinDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA. amitetkin@stanford.edu.ORCID 0000-0001-8259-3521
Adi Maron-KatzDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-4246-1748
Wei WuDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-1901-9134
Gregory A FonzoDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
Julia HuemerDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-1942-763X
Petra E VértesDepartment of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.ORCID 0000-0002-0992-3210
Brian PatenaudeDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
Jonas RichiardiDepartment of Medical Radiology, Lausanne University Hospital, Lausanne, Switzerland.ORCID 0000-0002-6975-5634
Madeleine S GoodkindNew Mexico Veterans Affairs Healthcare System, Albuquerque, NM 87108, USA.
Corey J KellerDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-0529-3490
Jaime Ramos-CejudoSteven 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.ORCID 0000-0002-0993-9909
Yevgeniya V ZaikoDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-0151-5455
Kathy K PengDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
Emmanuel ShpigelDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
Parker LongwellDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0001-8344-1685
Russ T TollDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0002-7655-6668
Allison ThompsonDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-3937-0327
Sanno ZackDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
Bryan GonzalezSteven 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.
Raleigh EdelsteinDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-2415-3610
Jingyun ChenSteven 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.
Irene AkingbadeDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0002-1071-327X
Elizabeth WeissDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
Roland HartSteven 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.
Silas MannSteven 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.ORCID 0000-0003-3152-5208
Kathleen DurkinSteven 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.
Steven H BaeteSteven 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.ORCID 0000-0003-3361-3789
Fernando E BoadaSteven 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.ORCID 0000-0002-3289-9917
Afia GenfiSteven 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.
Jillian AuteaDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.
Jennifer NewmanSteven 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.ORCID 0000-0002-5526-9600
Desmond J OathesCenter for Neuromodulation in Depression and Stress, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, USA.ORCID 0000-0001-7346-2669
Steven E LindleyDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-0051-8224
Duna Abu-AmaraSteven 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.ORCID 0000-0003-2050-3484
Bruce A ArnowDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0003-1645-857X
Nicolas CrossleyDepartment of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, 6513677 Santiago, Chile.ORCID 0000-0002-3060-656X
Joachim HallmayerDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0002-8520-4939
Silvia FossatiSteven 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.ORCID 0000-0002-2047-222X
Barbara O RothbaumTrauma and Anxiety Recovery Program, Department of Psychiatry, Emory University School of Medicine, Atlanta, GA 30322, USA.
Charles R MarmarSteven 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.
Edward T BullmoreDepartment of Psychiatry, Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge CB2 0SZ, UK.ORCID 0000-0002-8955-8283
Ruth O'HaraDepartment of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA.ORCID 0000-0001-6583-4995
Neurosciences Institute · USNYU Langone Health · USVA Palo Alto Health Care System · USStanford University · USUniversity of New Mexico · USAdvanced Imaging Research (United States) · USEmory University · USGlaxoSmithKline (United Kingdom) · GBPontificia Universidad Católica de Chile · CLSiemens (Switzerland) · CHTuring Institute · GBUniversity of Pennsylvania · US
Funding
TR&D 4: Revealing Microstructure: Biophysical modeling and validation for discovery and clinical careP41EB017183 · NIBIB · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Daniel K Sodickson · 2014 to 2026
$19.3MA BIOBEHAVIORAL RESEARCH TRAINING PROGRAMT32MH019938 · NIMH · STANFORD UNIVERSITY · PI Corey J Keller, RACHEL MANBER · 1994 to 2026
$9.4MThe Neurobiology of Psychotherapy: Emotional Reactivity and Regulation in PTSDR01MH091860 · NIMH · PALO ALTO VETERANS INSTIT FOR RESEARCH · PI ETKIN, AMIT · 2010 to 2014
$2.2MMedical Research Council MR/K020706/1NIBIB NIH HHS P41 EB017183NIMH NIH HHS R01 MH091860NIMH NIH HHS T32 MH019938
Abstract
A mechanistic understanding of the pathology of psychiatric disorders has been hampered by extensive heterogeneity in biology, symptoms, and behavior within diagnostic categories that are defined subjectively. We investigated whether leveraging individual differences in information-processing impairments in patients with post-traumatic stress disorder (PTSD) could reveal phenotypes within the disorder. We found that a subgroup of patients with PTSD from two independent cohorts displayed both aberrant functional connectivity within the ventral attention network (VAN) as revealed by functional magnetic resonance imaging (fMRI) neuroimaging and impaired verbal memory on a word list learning task. This combined phenotype was not associated with differences in symptoms or comorbidities, but nonetheless could be used to predict a poor response to psychotherapy, the best-validated treatment for PTSD. Using concurrent focal noninvasive transcranial magnetic stimulation and electroencephalography, we then identified alterations in neural signal flow in the VAN that were evoked by direct stimulation of that network. These alterations were associated with individual differences in functional fMRI connectivity within the VAN. Our findings define specific neurobiological mechanisms in a subgroup of patients with PTSD that could contribute to the poor response to psychotherapy.
Indexed as
Magnetic Resonance ImagingAttentionBehaviorBrain MappingComorbidityElectroencephalographyHumansMental RecallNerve NetRestStress Disorders, Post-TraumaticTranscranial Magnetic StimulationTreatment Outcome
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Registered trials
NCT03840369ClinicalTrials.gov
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.