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<p>Negative cognitions are targeted in post-traumatic stress disorder (PTSD) psychotherapies through cognitive restructuring, understood to be mediated by distributed thalamocortical brain networks. However, it remains unexplored how altered brain connectivity dynamics during restructuring underpin PTSD symptoms. Here, using ultrahigh-field 7-T functional magnetic resonance imaging, 70 participants with PTSD and 66 trauma-exposed control participants completed a cognitive restructuring paradigm. Dynamic causal modeling tested group differences in effective brain connectivity (<i>n</i> = 57 PTSD, <i>n</i> = 59 controls) within a network centered on the mediodorsal thalamus, a key hub for synchronizing higher-order prefrontal activity. In participants with PTSD, medial prefrontal cortex inhibition of mediodorsal thalamus activity was weaker compared to controls (posterior probability of 0.95), and the modulatory strength of this pathway in PTSD predicted severity of post-traumatic cognitions about the world and others (<i>r</i> = 0.38, <i>P</i> = 0.006). This study identifies impaired cortical modulation of thalamic activity during cognitive restructuring in PTSD, which may contribute to the persistence of negative cognitions.</p>

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Cognitive restructuring and thalamocortical circuit alterations in post-traumatic stress disorder

  • 期刊论文

  • 发表日期：

    2026年3月19日

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  • James A. Agathos,
  • Ben J. Harrison,
  • Kim L. Felmingham,
  • Christopher G. Davey,
  • Richard A. Bryant,
  • Mayuresh S. Korgaonkar,
  • Po-Han Kung,
  • Sevil Ince,
  • Bradford A. Moffat,
  • Rebecca K. Glarin,
  • Trevor C. Steward

摘要

Negative cognitions are targeted in post-traumatic stress disorder (PTSD) psychotherapies through cognitive restructuring, understood to be mediated by distributed thalamocortical brain networks. However, it remains unexplored how altered brain connectivity dynamics during restructuring underpin PTSD symptoms. Here, using ultrahigh-field 7-T functional magnetic resonance imaging, 70 participants with PTSD and 66 trauma-exposed control participants completed a cognitive restructuring paradigm. Dynamic causal modeling tested group differences in effective brain connectivity (n = 57 PTSD, n = 59 controls) within a network centered on the mediodorsal thalamus, a key hub for synchronizing higher-order prefrontal activity. In participants with PTSD, medial prefrontal cortex inhibition of mediodorsal thalamus activity was weaker compared to controls (posterior probability of 0.95), and the modulatory strength of this pathway in PTSD predicted severity of post-traumatic cognitions about the world and others (r = 0.38, P = 0.006). This study identifies impaired cortical modulation of thalamic activity during cognitive restructuring in PTSD, which may contribute to the persistence of negative cognitions.