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      Neural changes following equine‐assisted therapy for posttraumatic stress disorder: A longitudinal multimodal imaging study

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          Abstract

          Background

          While effective treatments for posttraumatic stress disorder (PTSD) exist, many individuals, including military personnel and veterans fail to respond to them. Equine‐assisted therapy (EAT), a novel PTSD treatment, may complement existing PTSD interventions. This study employs longitudinal neuro‐imaging, including structural magnetic resonance imaging (sMRI), resting state‐fMRI (rs‐fMRI), and diffusion tensor imaging (DTI), to determine mechanisms and predictors of EAT outcomes for PTSD.

          Method

          Nineteen veterans with PTSD completed eight weekly group sessions of EAT undergoing multimodal MRI assessments before and after treatment. Clinical assessments were conducted at baseline, post‐treatment and at 3‐month follow‐up.

          Results

          At post‐treatment patients showed a significant increase in caudate functional connectivity (FC) and reduction in the gray matter density of the thalamus and the caudate. The increase of caudate FC was positively associated with clinical improvement seen immediately at post‐treatment and at 3‐month follow‐up. In addition, higher baseline caudate FC was associated with greater PTSD symptom reduction post‐treatment.

          Conclusions

          This exploratory study is the first to demonstrate that EAT can affect functional and structural changes in the brains of patients with PTSD. The findings suggest that EAT may target reward circuitry responsiveness and produce a caudate pruning effect from pre‐ to post‐treatment.

          Abstract

          This study employs longitudinal neuro‐imaging, including structural magnetic resonance imaging (sMRI), resting state‐fMRI (rs‐fMRI), and diffusion tensor imaging (DTI), to determine mechanisms and predictors of EAT outcomes for PTSD.

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          Most cited references46

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          A RATING SCALE FOR DEPRESSION

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            A fast diffeomorphic image registration algorithm.

            This paper describes DARTEL, which is an algorithm for diffeomorphic image registration. It is implemented for both 2D and 3D image registration and has been formulated to include an option for estimating inverse consistent deformations. Nonlinear registration is considered as a local optimisation problem, which is solved using a Levenberg-Marquardt strategy. The necessary matrix solutions are obtained in reasonable time using a multigrid method. A constant Eulerian velocity framework is used, which allows a rapid scaling and squaring method to be used in the computations. DARTEL has been applied to intersubject registration of 471 whole brain images, and the resulting deformations were evaluated in terms of how well they encode the shape information necessary to separate male and female subjects and to predict the ages of the subjects.
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              The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation.

              The Posttraumatic Stress Disorder Checklist (PCL) is a widely used DSM-correspondent self-report measure of PTSD symptoms. The PCL was recently revised to reflect DSM-5 changes to the PTSD criteria. In this article, the authors describe the development and initial psychometric evaluation of the PCL for DSM-5 (PCL-5). Psychometric properties of the PCL-5 were examined in 2 studies involving trauma-exposed college students. In Study 1 (N = 278), PCL-5 scores exhibited strong internal consistency (α = .94), test-retest reliability (r = .82), and convergent (rs = .74 to .85) and discriminant (rs = .31 to .60) validity. In addition, confirmatory factor analyses indicated adequate fit with the DSM-5 4-factor model, χ2 (164) = 455.83, p < .001, standardized root mean square residual (SRMR) = .07, root mean squared error of approximation (RMSEA) = .08, comparative fit index (CFI) = .86, and Tucker-Lewis index (TLI) = .84, and superior fit with recently proposed 6-factor, χ2 (164) = 318.37, p < .001, SRMR = .05, RMSEA = .06, CFI = .92, and TLI = .90, and 7-factor, χ2 (164) = 291.32, p < .001, SRMR = .05, RMSEA = .06, CFI = .93, and TLI = .91, models. In Study 2 (N = 558), PCL-5 scores demonstrated similarly strong reliability and validity. Overall, results indicate that the PCL-5 is a psychometrically sound measure of PTSD symptoms. Implications for use of the PCL-5 in a variety of assessment contexts are discussed.
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                Author and article information

                Contributors
                xi.zhu@nyspi.columbia.edu
                Journal
                Hum Brain Mapp
                Hum Brain Mapp
                10.1002/(ISSN)1097-0193
                HBM
                Human Brain Mapping
                John Wiley & Sons, Inc. (Hoboken, USA )
                1065-9471
                1097-0193
                05 February 2021
                15 April 2021
                : 42
                : 6 ( doiID: 10.1002/hbm.v42.6 )
                : 1930-1939
                Affiliations
                [ 1 ] Department of Psychiatry Columbia University New York New York USA
                [ 2 ] New York State Psychiatric Institute New York New York USA
                [ 3 ] Neuroscience Department University of Rochester Rochester New York USA
                [ 4 ] Department of Psychology University of Haifa Haifa Israel
                [ 5 ] School of Psychological Sciences, Tel Aviv University Tel Aviv Israel
                [ 6 ] Memphis Veterans Administration Medical Center Memphis Tennessee USA
                [ 7 ] The University of Arizona Health Sciences Tucson Arizona USA
                [ 8 ] Rancho Bosque Equestrian Center of Excellence House Hamilton Business Group, PLC Tucson Arizona USA
                [ 9 ] Department of Epidemiology Columbia University Irving Medical Center New York New York USA
                Author notes
                [*] [* ] Correspondence

                Xi Zhu, The New York State Psychiatric Institute, Columbia University Medical Center, 1051 Riverside Drive, New York, New York 10032, USA.

                Email: xi.zhu@ 123456nyspi.columbia.edu

                Author information
                https://orcid.org/0000-0002-9724-7231
                Article
                HBM25360
                10.1002/hbm.25360
                7978114
                33547694
                e7c23f57-79e1-43a2-8e93-f769f646d1d2
                © 2021 The Authors. Human Brain Mapping published by Wiley Periodicals LLC.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 09 January 2021
                : 26 October 2020
                : 21 January 2021
                Page count
                Figures: 5, Tables: 3, Pages: 10, Words: 7696
                Funding
                Funded by: David and Julia Koch Foundation
                Funded by: Earle I. Mack Foundation
                Funded by: Ganek Family Foundation
                Funded by: Gerald Parsky
                Funded by: Gulfstream Park Racing Association
                Funded by: Jockey Club , open-funder-registry 10.13039/100001655;
                Funded by: Live Oak Foundation
                Funded by: Mary & Daniel Loughran Foundation
                Funded by: Meta Aerospace Capital, LTD
                Funded by: Nicholson Family Charity Fund
                Funded by: Peter M. Brant
                Funded by: Reid Family Charitable Fund
                Funded by: Tactical Air Support
                Funded by: Viola Foundation
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                15 April 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.0 mode:remove_FC converted:19.03.2021

                Neurology
                equine assisted therapy,neuroimaging,ptsd,resting state fmri
                Neurology
                equine assisted therapy, neuroimaging, ptsd, resting state fmri

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