The Neural Web of War
Abstract
The aim of this thesis was to gain more insight in the neural network alterations that may underlie PTSD and trauma-focused therapy outcome. To investigate TheNeural Web of War brain scans of healthy civilians (n=26), and veterans with (n=58) and without (n=29) PTSD were assessed. Structural and functional connectivity analyses were performed. We showed alterations in connectivity related to PTSD, persistence of PTSD, acquisition method, comorbid depression, deployment and/or military training, and resilience. Furthermore, we found indicators for treatment outcome related changes that occur over the course of treatment. However, it was evident that neural networks do not simply recover after treatment, when a patient recovers from PTSD. Our results do shed light on the psychopathology of PTSD and showed that there are many individual differences that may be related to differences in neural networks, not only the presence of PTSD. Furthermore, we confirmed that PTSD patients were a heterogeneous group consisting of patients that recover and patients that have persistent symptoms, potentially related to comorbid disorders. Therefore, our studies provided insight in individual differences that may be used in the future for personalized treatment. To conclude, in this dissertation we applied advanced neuroimaging techniques to study connectivity in veterans with and without PTSD and civilians, which revealed essential information for disentangling The Neural Web of War.