# Whole Brain Connectivity and Connectomics of Mindfulness-based Cognitive Therapy for PTSD

> **NIH NIH K23** · OHIO STATE UNIVERSITY · 2021 · $186,635

## Abstract

Project Summary
The candidate is a clinical psychologist and neuroscientist with a strong interest in the phenomenology,
affective neurocircuitry, and effective treatment of posttraumatic stress disorder (PTSD). PTSD is highly
prevalent (7% in males, 12% in females), chronic and highly debilitating. One in every five veterans deployed
to Afghanistan and Iraq have clinically significant PTSD symptoms. Empirically supported treatment (ESTs) for
PTSD using trauma exposure have very large effect sizes in RCTs; however, recent work finds high rates of
refusal and early drop-out among veterans (30-50%). We previously reported deficits in large scale distributed
neural networks in PTSD, including increased connectivity between Default Mode Network (DMN) and
Salience Network (SN), and we present pilot data that PTSD avoidant symptoms are linked to decreased DMN
connectivity with Central Executive Network (CEN). We also reported a mindfulness-based intervention for
PTSD decreased avoidance and increased connectivity between DMN and CEN. This K23 training program
will allow the candidate to learn and apply the powerful whole-brain connectomic and dynamic connectivity
methodologies needed to study the alterations in large scale distributed neural networks underlying PTSD and
therapeutic mechanisms. Our hypotheses are H1: Decreased DMN-CEN and increased DMN-SN underlie
emotional / behavioral avoidance associated with poor clinical acceptability and outcomes in PTSD patients,
H2: Mindfulness-based Cognitive Therapy (MBCT) targets the same DMN-CEN connectivity linked with PTSD
avoidance, and H3: MBCT-induced increased DMN-CEN connectivity mediates improvement in PTSD
avoidance, emotional / behavioral avoidance, and improved outcomes. The aims are to: 1.) test if behavioral
and emotional avoidance in PTSD are associated with decreased DMN-CEN connectivity, 2.) identify
effects of MBCT on DMN-CEN using powerful connectomics analyses, and 3.) explore mediation
relationships between DMN-CEN connectivity and behavioral and emotional engagement in
subsequent therapy and clinical outcomes. fMRI with N=60 combat PTSD patients with rsFC using
dynamic causal modeling, and contextual processing paradigms, will test association with avoidance
symptoms and laboratory measures of emotional avoidance. An RCT (N=30 MBCT, N=30 control) with pre-
post fMRI and group x time interaction analyses will identify effects of MBCT on connectivity among and
between DMN, CEN, and SN. Mediation analyses will test neural targets and longitudinal measures of
emotional engagement. This study will be the first targeting functional neural networks underlying avoidance
behaviors in PTSD treatment, and may lead to additional strategies to help the ~50% PTSD patients who do
not fully engage with existing ESTs, and elucidate neural mechanisms associated with a novel potential
component of PTSD treatment (mindfulness training). It will also provide the candidate advanced training and
pilot data for...

## Key facts

- **NIH application ID:** 10469876
- **Project number:** 7K23MH112852-05
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** ANTHONY P KING
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $186,635
- **Award type:** 7
- **Project period:** 2018-04-16 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10469876

## Citation

> US National Institutes of Health, RePORTER application 10469876, Whole Brain Connectivity and Connectomics of Mindfulness-based Cognitive Therapy for PTSD (7K23MH112852-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10469876. Licensed CC0.

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