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Distinctively different human neurobiological responses after trauma exposure and implications for posttraumatic stress disorder subty**

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Abstract

Trauma elicits various adaptive and maladaptive responses among all exposed people. There may be distinctively different patterns of adaptation/maladaptation or types according to neurobiological predisposition. The present study aims to dissect the heterogeneity of posttraumatic conditions in order to identify clinically meaningful subtypes in recently traumatized individuals and evaluate their neurobiological correlates and long-term prognosis. We implemented a data-driven classification approach in both discovery (n = 480) and replication (n = 220) datasets of trauma-exposed and trauma-unexposed individuals based on the clinical data across a wide range of assessments. Subtype-specific patterns of functional connectivity in higher-order cortical networks, longitudinal clinical outcomes, and changes in functional connectivity were also evaluated. We identified four distinct and replicable subtypes for trauma-exposed individuals according to posttraumatic stress symptoms. Each subtype was distinct in clinical characteristics, brain functional organization, and long-term trajectories for posttraumatic symptoms. These findings help enhance current understanding of mechanisms underlying the human-specific heterogeneous responses to trauma. Furthermore, this study contributes data towards the development of improved interventions, including targeting of subtype-specific characteristics, for trauma-exposed individuals and those with PTSD.

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Fig. 1: Proposed subtypes for recently traumatized individuals and their symptom characteristics.
Fig. 2: Trauma subtype-specific functional connectivity alterations at time 1 assessment.
Fig. 3: Subtype-specific trajectories of traditional symptoms of PTSD.
Fig. 4: Subtype-specific trajectories of dimensional symptoms and functional connectivity.

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Funding

This study was partly supported by the National Research Foundation of Korea grants funded by the Ministry of Science and ICT (2020M3E5D9080555 to IKL) and funded by the Ministry of Education (2020R1A6A1A03043528 to IKL). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Authors and Affiliations

  1. Ewha Brain Institute, Ewha Womans University, Seoul, South Korea

    Suji Lee, Sujung Yoon, Eun Namgung, Tammy D. Kim, Hae** Hong, Eunji Ha, Rye Young Kim, Yumi Song, Hyangwon Lee, Chaewon Suh & In Kyoon Lyoo

  2. Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea

    Sujung Yoon, Yumi Song, Hyangwon Lee, Chaewon Suh & In Kyoon Lyoo

  3. Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea

    Rye Young Kim & In Kyoon Lyoo

  4. Department of Psychiatry, University of Utah, Salt Lake City, UT, USA

    In Kyoon Lyoo

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  1. Suji Lee
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Contributions

SY and IKL. conceptualized and designed the study. SL, EN, TDK, HH, EH, RYK, YS, HL, and CS performed the research and participated in data acquisition. SL, SY, EN, TDK, HH, EH, RYK, YS, HL, CS, and IKL analyzed the data and interpreted the results. SL, SY, and IKL drafted the manuscript. All authors revised and reviewed the manuscript.

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Correspondence to In Kyoon Lyoo.

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Lee, S., Yoon, S., Namgung, E. et al. Distinctively different human neurobiological responses after trauma exposure and implications for posttraumatic stress disorder subty**. Mol Psychiatry 28, 2964–2974 (2023). https://doi.org/10.1038/s41380-023-01995-3

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