Trauma Recovery via EEG and Actigraphy Tracking (TREAT): Biomarkers of Written Exposure Therapy in PTSD - Project Summary/Abstract Post-traumatic stress disorder, or PTSD, is a mental health condition that develops following exposure to traumatic events. In the United States, it affects approximately 5-10% of the general population. Although multiple treatments are available, a significant gap persists in the current understanding of the underlying mechanisms and objective predictors (i.e., treatment-related biomarkers) of the treatments for PTSD. Our study aims to develop a framework, called “Trauma Recovery via EEG and Actigraphy Tracking” or TREAT, to address this gap. TREAT utilizes advanced neurophysiology and imaging technologies, including conventional, portable, and dry EEG, as well as actigraphy-based sleep pattern monitoring, to track the physiological and electrophysiological brain-based changes modulated by Written Exposure Therapy (WET), a robust and scalable treatment paradigm. Comparing pre- versus post-treatment EEG and sleep data, Aim1 will identify clinically relevant biomarkers of WET. This aim is to pinpoint the key EEG channels that are most responsive to WET, thereby providing insight into the spatial effect of WET in PTSD. It will also pinpoint key EEG and sleep biomarkers associated with symptom reduction, providing objective measures to track WET outcomes. Aim2 will longitudinally track neurophysiological and sleep-related markers to identify a critical time point when the shift in EEG/sleep markers begins during WET. Creating a temporal map of the WET effect on EEG and sleep enables clinicians to optimize treatment duration and intensity for each individual patient in the future. Finally, Aim3 will provide models that predict WET outcome only based on baseline EEG and sleep markers, supporting personalized treatment selection and avoiding ineffective interventions in the future. This aim will determine which baseline EEG channels, EEG biomarkers, and sleep markers predict treatment outcomes prior to the initiation of therapy. Finally, it will identify subgroups of patients (i.e., biotypes) characterized by distinct EEG and sleep profiles at baseline, which will enable the prediction of treatment response and advance personalized intervention strategies. By drawing on expertise from clinicians, therapists, biostatisticians, engineers, and computational neuroscientists, this project will establish TREAT as a comprehensive biomarker identification framework for PTSD treatment and potentially for other neuropsychiatric conditions.
