Brian Schulkin Thesis

Moreover, sleep disturbance is a core feature of PTSD [6] and a predictor of worse global functionality [7], yet sleep improvement is typically elusive after completion of PTSD-specific behavioral therapies [8, 9].While SSRI and other medication prescriptions are common, the overall evidence for the efficacy of psychopharmacological agents for individuals with PTSD is generally considered to be modest at best [1, 10].Participants with one or more neurological, cardiovascular, or psychophysiological conditions have been enrolled through clinician referrals and informal networks, producing a relatively open sampling frame that can support the advance of transdiagnostic clinical neuroscience research [15].

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Furthermore, the BHAM encourages new thinking in the domain of therapeutic strategy.

A thesis of the model is that relative symmetry in the activity of bilateral cerebral hemispheric regions responsible for management of the autonomic nervous system (i.e.

We hypothesized that use of the intervention would be associated with decreased levels of symptomatology, decreased temporal lobe high frequency electrical asymmetry, and improvements in parasympathetic measures of autonomic cardiovascular regulation.

Temporal lobe asymmetry was chosen because of predictions associated with the BHAM, and a high frequency range of electrical activity was chosen in consideration of potential associations between trauma, sleep disturbance, and increased activity in this range [27, 28].

The objective of this pilot study was to explore the use of a closed-loop, allostatic, acoustic stimulation neurotechnology for individuals with self-reported symptoms of post-traumatic stress, as a potential means to impact symptomatology, temporal lobe high frequency asymmetry, heart rate variability (HRV), and baroreflex sensitivity (BRS).

From a cohort of individuals participating in a naturalistic study to evaluate use of allostatic neurotechnology for diverse clinical conditions, a subset was identified who reported high scores on the Posttraumatic Stress Disorder Checklist (PCL).

Changes in temporal lobe high frequency asymmetry were analyzed from baseline assessment through the first four sessions, and for the last four sessions.

Nineteen individuals (mean age 47, 11 women) were enrolled, and the majority also reported symptom scores that exceeded inventory thresholds for depression.

Expert consensus statements in the last decade have held that psychotherapies for posttraumatic stress disorder (PTSD), based on controlled re-exposure to the traumatic event, are the most evidence-based treatment [1, 2].

However there are persisting concerns about this modality due to high rates of non-response and dropout [3–5].


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