Cargando…
Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study
The objective of this research project is the identification of a physiological prodrome of post-traumatic stress disorder (PTSD) that has a reliability that could justify preemptive treatment in the sub-syndromal state. Because abnormalities in event-related potentials (ERPs) have been observed in...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2017
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430065/ https://www.ncbi.nlm.nih.gov/pubmed/28555113 http://dx.doi.org/10.3389/fpsyt.2017.00071 |
_version_ | 1783236154692206592 |
---|---|
author | Wang, Chao Costanzo, Michelle E. Rapp, Paul E. Darmon, David Bashirelahi, Kylee Nathan, Dominic E. Cellucci, Christopher J. Roy, Michael J. Keyser, David O. |
author_facet | Wang, Chao Costanzo, Michelle E. Rapp, Paul E. Darmon, David Bashirelahi, Kylee Nathan, Dominic E. Cellucci, Christopher J. Roy, Michael J. Keyser, David O. |
author_sort | Wang, Chao |
collection | PubMed |
description | The objective of this research project is the identification of a physiological prodrome of post-traumatic stress disorder (PTSD) that has a reliability that could justify preemptive treatment in the sub-syndromal state. Because abnormalities in event-related potentials (ERPs) have been observed in fully expressed PTSD, the possible utility of abnormal ERPs in predicting delayed-onset PTSD was investigated. ERPs were recorded from military service members recently returned from Iraq or Afghanistan who did not meet PTSD diagnostic criteria at the time of ERP acquisition. Participants (n = 65) were followed for up to 1 year, and 7.7% of the cohorts (n = 5) were PTSD-positive at follow-up. The initial analysis of the receiver operating characteristic (ROC) curve constructed using ERP metrics was encouraging. The average amplitude to target stimuli gave an area under the ROC curve of greater than 0.8. Classification based on the Youden index, which is determined from the ROC, gave positive results. Using average target amplitude at electrode Cz yielded Sensitivity = 0.80 and Specificity = 0.87. A more systematic statistical analysis of the ERP data indicated that the ROC results may simply represent a fortuitous consequence of small sample size. Predicted error rates based on the distribution of target ERP amplitudes approached those of random classification. A leave-one-out cross validation using a Gaussian likelihood classifier with Bayesian priors gave lower values of sensitivity and specificity. In contrast with the ROC results, the leave-one-out classification at Cz gave Sensitivity = 0.65 and Specificity = 0.60. A bootstrap calculation, again using the Gaussian likelihood classifier at Cz, gave Sensitivity = 0.59 and Specificity = 0.68. Two provisional conclusions can be offered. First, the results can only be considered preliminary due to the small sample size, and a much larger study will be required to assess definitively the utility of ERP prodromes of PTSD. Second, it may be necessary to combine ERPs with other biomarkers in a multivariate metric to produce a prodrome that can justify preemptive treatment. |
format | Online Article Text |
id | pubmed-5430065 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-54300652017-05-29 Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study Wang, Chao Costanzo, Michelle E. Rapp, Paul E. Darmon, David Bashirelahi, Kylee Nathan, Dominic E. Cellucci, Christopher J. Roy, Michael J. Keyser, David O. Front Psychiatry Psychiatry The objective of this research project is the identification of a physiological prodrome of post-traumatic stress disorder (PTSD) that has a reliability that could justify preemptive treatment in the sub-syndromal state. Because abnormalities in event-related potentials (ERPs) have been observed in fully expressed PTSD, the possible utility of abnormal ERPs in predicting delayed-onset PTSD was investigated. ERPs were recorded from military service members recently returned from Iraq or Afghanistan who did not meet PTSD diagnostic criteria at the time of ERP acquisition. Participants (n = 65) were followed for up to 1 year, and 7.7% of the cohorts (n = 5) were PTSD-positive at follow-up. The initial analysis of the receiver operating characteristic (ROC) curve constructed using ERP metrics was encouraging. The average amplitude to target stimuli gave an area under the ROC curve of greater than 0.8. Classification based on the Youden index, which is determined from the ROC, gave positive results. Using average target amplitude at electrode Cz yielded Sensitivity = 0.80 and Specificity = 0.87. A more systematic statistical analysis of the ERP data indicated that the ROC results may simply represent a fortuitous consequence of small sample size. Predicted error rates based on the distribution of target ERP amplitudes approached those of random classification. A leave-one-out cross validation using a Gaussian likelihood classifier with Bayesian priors gave lower values of sensitivity and specificity. In contrast with the ROC results, the leave-one-out classification at Cz gave Sensitivity = 0.65 and Specificity = 0.60. A bootstrap calculation, again using the Gaussian likelihood classifier at Cz, gave Sensitivity = 0.59 and Specificity = 0.68. Two provisional conclusions can be offered. First, the results can only be considered preliminary due to the small sample size, and a much larger study will be required to assess definitively the utility of ERP prodromes of PTSD. Second, it may be necessary to combine ERPs with other biomarkers in a multivariate metric to produce a prodrome that can justify preemptive treatment. Frontiers Media S.A. 2017-05-15 /pmc/articles/PMC5430065/ /pubmed/28555113 http://dx.doi.org/10.3389/fpsyt.2017.00071 Text en Copyright © 2017 Wang, Costanzo, Rapp, Darmon, Bashirelahi, Nathan, Cellucci, Roy and Keyser. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Psychiatry Wang, Chao Costanzo, Michelle E. Rapp, Paul E. Darmon, David Bashirelahi, Kylee Nathan, Dominic E. Cellucci, Christopher J. Roy, Michael J. Keyser, David O. Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study |
title | Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study |
title_full | Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study |
title_fullStr | Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study |
title_full_unstemmed | Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study |
title_short | Identifying Electrophysiological Prodromes of Post-traumatic Stress Disorder: Results from a Pilot Study |
title_sort | identifying electrophysiological prodromes of post-traumatic stress disorder: results from a pilot study |
topic | Psychiatry |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430065/ https://www.ncbi.nlm.nih.gov/pubmed/28555113 http://dx.doi.org/10.3389/fpsyt.2017.00071 |
work_keys_str_mv | AT wangchao identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy AT costanzomichellee identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy AT rapppaule identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy AT darmondavid identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy AT bashirelahikylee identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy AT nathandominice identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy AT celluccichristopherj identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy AT roymichaelj identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy AT keyserdavido identifyingelectrophysiologicalprodromesofposttraumaticstressdisorderresultsfromapilotstudy |