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Peddi A, Sendi MSE, Minton ST, Langhinrichsen-Rohling R, Hinojosa CA, West E, Ressler KJ, Calhoun VD, van Rooij SJH. Towards predicting posttraumatic stress symptom severity using portable EEG-derived biomarkers. Sci Rep 2025; 15:5344. [PMID: 39948125 PMCID: PMC11825728 DOI: 10.1038/s41598-025-88426-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2024] [Accepted: 01/28/2025] [Indexed: 02/16/2025] Open
Abstract
Posttraumatic Stress Disorder (PTSD) is a heterogeneous mental health disorder that can develop following a traumatic experience. Understanding its neurobiological basis is crucial to advance early diagnosis and treatment. Electroencephalography (EEG) can be used to explore the neurobiological basis of PTSD. However, only limited research has explored mobile EEG, which is important for scalability. This proof-of-concept study delves into mobile EEG-derived biomarkers for posttraumatic stress (PTS) symptom severity and their potential implications. Participants with partial PTSD, defined as meeting for at least three out of four symptom clusters, including hyperarousal symptoms, were enrolled in the study. Over four weeks, we measured PTS symptom severity using the PTSD checklist for DSM-5 (PCL-5) at multiple timepoints, and we recorded multiple EEG sessions from 21 individuals using a mobile EEG device. In total, we captured 38 EEG sessions, each comprising two recordings ("Recording A" and "Recording B") that lasted approximately 180 s, to evaluate reproducibility. Next, we extracted Shannon entropy, as a measure of the brain flexibility and complexity of the signal and spectral power for the fronto-temporal regions of interest, including electrodes at AF3, AF4, T7, and T8 for each EEG recording session. We calculated the partial correlation between the EEG variables and PCL- 5 measured closest to the EEG session, using age, sex, and the grouping variable 'batch' as covariates. We observed a significant negative correlation between Shannon entropy in fronto- temporal regions and PCL-5 scores. Specifically, this association was evident in the AF3 (r = -0.456, FDR-corrected p = 0.01), AF4 (r = -0.362, FDR-corrected p = 0.04), and T7 (r = -0.472, FDR-corrected p = 0.01) regions. Additionally, we found a significant negative association between the alpha power estimated from AF4 and PCL-5 (r = -0.429, FDR-corrected p = 0.04). Our findings suggest that EEG markers acquired using a mobile EEG device are associated with PTS symptom severity, offering valuable insights into the neurobiological mechanisms underlying PTSD and highlighting the potential benefits of this innovative technology in assessing and monitoring PTSD.
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Affiliation(s)
- Ashritha Peddi
- Georgia State University, Atlanta, GA, USA
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State UniversityGeorgia Institute of TechnologyEmory University, Atlanta, GA, USA
| | - Mohammad S E Sendi
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State UniversityGeorgia Institute of TechnologyEmory University, Atlanta, GA, USA.
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA.
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Sean T Minton
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Cecilia A Hinojosa
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Emma West
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Vince D Calhoun
- Georgia State University, Atlanta, GA, USA
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science, Georgia State UniversityGeorgia Institute of TechnologyEmory University, Atlanta, GA, USA
- Department of Electrical and Computer Engineering at Georgia Institute of Technology, Atlanta, GA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Peddi A, Sendi MSE, Minton ST, Hinojosa CA, West E, Langhinrichsen-Rohling R, Ressler KJ, Calhoun VD, van Rooij SJ. Towards predicting PTSD symptom severity using portable EEG-derived biomarkers. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.07.17.24310570. [PMID: 39072030 PMCID: PMC11275680 DOI: 10.1101/2024.07.17.24310570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Posttraumatic Stress Disorder (PTSD) is a heterogeneous mental health disorder that occurs following traumatic experience. Understanding its neurobiological basis is crucial to advance early diagnosis and treatment. Electroencephalography (EEG) can be used to explore the neurobiological basis of PTSD. However, only limited research has explored mobile EEG, which is important for scalability. This proof-of-concept study delves into mobile EEG-derived biomarkers for PTSD and their potential implications. Over four weeks, we measured PTSD symptoms using the PTSD checklist for DSM-5 (PCL-5) at multiple timepoints, and we recorded multiple EEG sessions from 21 individuals using a mobile EEG device. In total, we captured 38 EEG sessions, each comprising two recordings that lasted approximately 180 seconds, to evaluate reproducibility. Next, we extracted Shannon entropy, as a measure of the randomness or unpredictability of the signal and spectral power for the fronto-temporal regions of interest, including electrodes at AF3, AF4, T7, and T8 for each EEG recording session. We calculated the partial correlation between the EEG variables and PCL-5 measured closest to the EEG session, using age, sex, and the grouping variable 'batch' as covariates. We observed a significant negative correlation between Shannon entropy in fronto-temporal regions and PCL-5 scores. Specifically, this association was evident in the AF3 (r = -0.456, FDR-corrected p = 0.01), AF4 (r = -0.362, FDR-corrected p = 0.04), and T7 (r = -0.472, FDR-corrected p = 0.01) regions. Additionally, we found a significant negative association between the alpha power estimated from AF4 and PCL-5 (r=-0.429, FDR-corrected p=0.04). Our findings suggest that EEG data acquired using a mobile EEG device is associated with PTSD symptom severity, offering valuable insights into the neurobiological mechanisms underlying PTSD.
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Affiliation(s)
- Ashritha Peddi
- Georgia State University, Atlanta, GA
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science: Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA
| | - Mohammad S. E. Sendi
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science: Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA
| | - Sean T. Minton
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Cecilia A. Hinojosa
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Emma West
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Kerry J. Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
- Division of Depression and Anxiety, McLean Hospital, Belmont, MA
- Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Vince D. Calhoun
- Georgia State University, Atlanta, GA
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science: Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, GA
- Department of Electrical and Computer Engineering at Georgia Institute of Technology, Atlanta, GA
| | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
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Hong J, Park JH. Efficacy of Neuro-Feedback Training for PTSD Symptoms: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13096. [PMID: 36293673 PMCID: PMC9603735 DOI: 10.3390/ijerph192013096] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/07/2022] [Accepted: 10/10/2022] [Indexed: 06/16/2023]
Abstract
If the negative emotions experienced in life become trauma, they affect daily life. Neuro-feedback technology has recently been introduced as a treatment, but many different neuro-feedback protocols and methods exits. This study conducted a meta-analysis of neuro-feedback training for post-traumatic stress disorder (PTSD) symptoms to evaluate the effects of functional magnetic resonance imaging (fMRI) and electroencephalogram (EEG)-based neuro-feedback training. A search of PubMed, the Cochrane Library, Web of Science, Science Direct, and ClinicalTrials.gov was conducted from January 2011 to December 2021. The studies' quality was assessed using the Cochrane risk of bias tool and publication bias was assessed by Egger's regression test. Seven studies that met the inclusion criteria were used for the systematic review and meta-analysis. EEG was more effective than fMRI for PTSD symptoms, and the effect on PTSD symptoms was higher than on anxiety and depression. There was no difference in the effectiveness of the training sessions. Our findings showed that EEG-based neuro-feedback training was more helpful for training PTSD symptoms. Additionally, the methods were also shown to be valid for evaluating clinical PTSD diagnoses. Further research is needed to establish a gold standard protocol for the EEG-based neuro-feedback training (EEG-NFT) method for PTSD symptoms.
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Affiliation(s)
- Jian Hong
- Department of ICT Convergence, The Graduate School, Soonchunhyang University, Asan 31538, Korea
| | - Jin-Hyuck Park
- Department of Occupational Therapy, Soonchunhyang University, Asan 31538, Korea
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