Neurobehavioral moderators of post-traumatic stress disorder (PTSD) trajectories: study protocol of a prospective MRI study of recent trauma survivors: study protocol of a prospective MRI study of recent trauma survivors

Ziv Ben-Zion, Naomi B. Fine, Nimrod Jackob Keynan, Roee Admon, Pinchas Halpern, Israel Liberzon, Talma Hendler, Arieh Y. Shalev

Research output: Contribution to journalArticlepeer-review


Background: Post-traumatic stress disorder (PTSD) is triggered by distinct events and is therefore amenable to studies of its early pathogenesis. Longitudinal studies during the year that follows trauma exposure revealed typical symptom trajectories leading to either recovery or protracted PTSD. Thezneurobehavioral correlates of early PTSD symptoms’ trajectories have not been longitudinally explored. Objective: To present the rationale and design of a longitudinal study exploring the relationship between evolving PTSD symptoms and co-occurring cognitive functioning and structural and functional brain imaging parameters. Method: Adult civilians consecutively admitted to a general hospital emergency room (ER) for traumatic injury will be screened for early PTSD symptoms suggestive of chronic PTSD risk, and consecutively evaluated 1, 6 and 14 months following the traumatic event. Consecutive assessments will include structured clinical interviews for PTSD and comorbid disorders, self-reported depression and anxiety symptoms, a web-based assessment of cognitive domains previously linked with PTSD (e.g., memory, executive functions, cognitive flexibility), high-resolution structural MRI of both grey and white matter, functional resting-state connectivity, and fMRI tasks examining emotional reactivity and regulation, as well as motivation processing and sensitivity to risk and reward. Data analyses will explore putative cognitive predictors of non-remitting PTSD, and brain structural and functional correlates of PTSD persistence or recovery. Conclusion: This work will longitudinally document patterns of brain structures, connectivity, and functioning, predictive of (or associated with) emerging PTSD during the critical first year of after the traumatic event. It will thereby inform our understanding of the disorder’s pathogenesis and underlying neuropathology. Challenges to longitudinal MRI studies of recent survivors, and methodological choices used to optimize the study’s design are discussed.

Original languageEnglish
Article number1683941
JournalEuropean Journal of Psychotraumatology
Issue number1
StatePublished - 1 Jan 2019

Bibliographical note

Funding Information:
This work was supported by award number R01-MH-103287 from the National Institute of Mental Health (NIMH) given to AS. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The authors would like to thank the research team at Tel-Aviv Sourasky Medical Center - including Nili Green, Mor Halevi, Sheli Luvton, Yael Shavit, Olga Nevenchannaya, Iris Rashap, Efrat Routledge and Ophir Leshets - for their major contribution in carrying out this research, including subjects’ recruitment and screening, and performing clinical, cognitive and neural assessments. We also extend our gratitude to all the participants of this study, which completed all the assessments at three different time-points after experiencing a traumatic event.

Publisher Copyright:
© 2019, © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.


  • longitudinal study
  • Magnetic Resonance Imaging (MRI)
  • neurobehavioral moderators
  • Post-Traumatic Stress Disorder (PTSD)
  • symptom trajectories

ASJC Scopus subject areas

  • Psychiatry and Mental health


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