Trauma-focused psychotherapy response in youth with posttraumatic stress disorder is associated with changes in insula volume

Randomized controlled trials have shown efficacy of trauma-focused psychotherapies in youth with posttraumatic stress disorder (PTSD), but little is known about the relationship between treatment response and alternations brain structures associated PTSD. In this study, we longitudinally examined association pre-to posttreatment changes structural magnetic resonance imaging (MRI) scans using a voxel-based morphometry approach. We analyzed MRI 35 patients (ages 8–18 years, 21 female) PTSD (80%) or partial (20%) before after eight weekly sessions psychotherapy. severity was assessed Clinician-Administered scale for Children Adolescents to divide participants into responders non-responders. Group by time interaction analysis showed significant differences grey-matter volume bilateral insula due reductions over non-responders compared responders. Despite group interaction, there were no at baseline follow-up. As typical development increase, these longitudinal findings suggest that non-response atypical neurodevelopment insula, which may underlie persistence youth. The absence responders, while need replication, successful psychotherapy not directly normalize abnormalities