Detecting Neurobiological Markers in Treatment Response to Prolonged Exposure Therapy for PTSD: An RCT using Functional Near-infrared Spectroscopy

Abstract

Trauma exposure and post-traumatic stress disorder (PTSD) are a global public health concern, especially in low and middle-income countries (LMICs). University students are a unique population that has been found to have increased levels of trauma exposure and PTSD, yet limited clinical outcome and neurobiological data exist, especially in LMICs, on treatment responses to evidence-based trauma-focused treatments for PTSD among university students in LMICs. The development and integration of neuroimaging tools in psychotherapy enable more robust integration of data from clinical psychology and neuroscience. Our protocol is the first to use functional Near-infrared spectroscopy (fNIRS) to investigate the treatment response of a first-line trauma-focused cognitive behavioural therapy, namely, prolonged exposure therapy, for the treatment of PTSD. Using a pilot randomised controlled trial, university students diagnosed with PTSD will be assessed using clinical outcome measures and fNIRS to ascertain prefrontal cortical increases and decreases in persons diagnosed with PTSD. Participants will be randomised to either the experimental condition (PE) or a comparative control condition (supportive counselling). Participants will be assessed at baseline, post-intervention, and at 12 and 24-week follow-ups using the same measures and imaging. • Recruit and assess university students using standard clinical measures and fNIRS for PTSD. • Assign enrolled students to either PE (experimental condition) or supportive counselling (control condition) for a minimum of 8 sessions. • Assess students at the end of treatment and at 12 and 24-week follow-ups using the same clinical measures and fNIRS for any changes in PTSD.