It may be possible to identify individuals at risk of adverse mental health outcomes based on the pattern of brain activity following an acute traumatic event, suggests a new study published in the American Journal of Psychiatry.

A multicenter transdiagnostic longitudinal study investigated the association of acute post-trauma brain activity and future mental health outcomes in 69 participants who were part of the AURORA study. They were recruited from emergency departments within 72 hours of experiencing a car crash. All the participants, aged 18 to 75 years, were oriented to place and time and physically fit to use a smartphone. Two weeks later, they were instructed to carry out standard computer-based tasks and their brain activity was measured at the same time with a functional MRI (fMRI) scan. All participants also self-reported symptoms of post-traumatic stress disorder (PTSD), depression, dissociation, anxiety and impulsivity during the six months post-trauma follow-up along with fMRI scans.

The neural activity pattern obtained from fMRI could be characterized into four types: “Reactive/disinhibited (high activity related to both threat and reward; little activity related to response inhibition), low-reward/high-threat (high activity related to threat; low activity related to reward), high-reward (no activity related to threat; little activity related to response inhibition; high activity related to reward) and inhibited (de-activation related to threat; some activity related to inhibition; low activity related to reward).”

A similar analysis was carried out in another independent group of 77 participants who had experienced other traumatic events also besides motor vehicle accidents. Three of the aforementioned four profiles were identified in this group: reactive/disinhibited, low-reward/high-threat and inhibited.

Persons with the reactive/disinhibited profile exhibited higher levels of symptoms of both PTSD and anxiety. Low reactive activity is generally correlated with depression. Surprisingly, in this study high reward reactivity was seen to be associated with long-term stress symptoms, which suggests reward reactivity as a potential risk factor for stress-related symptoms following trauma.

No association was found between the brain activity types and other mental health outcomes, such as depression, dissociation or impulsivity.

Many people experience negative effects of a traumatic event, while there are others who can withstand them. We still don’t know enough to predict vulnerability to stress or what factors affect mental health. This study has demonstrated a link between post-trauma brain activity and development of anxiety and PTSD after six months of follow-up. It has also identified phenotypes at risk of development of stress-related disorders paving a way for targeted interventions.

References

1. Stevens JS, et al. Brain-based biotypes of psychiatric vulnerability in the acute aftermath of trauma. Am J Psychiatry. 2021 Oct 14;appiajp202120101526. doi: 10.1176/appi.ajp.2021.20101526.
2. 2.      NIH News Release, October 14, 2021. https://www.nih.gov/news-events/news-releases/brain-activity-patterns-after-trauma-may-predict-long-term-mental-health