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

Abstract

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-..