Allison L. Thompson, Ph.D.

All Publications

• Amygdala and Insula Connectivity Changes Following Psychotherapy for Posttraumatic Stress Disorder: A Randomized Clinical Trial. Biological psychiatry Fonzo, G. A., Goodkind, M. S., Oathes, D. J., Zaiko, Y. V., Harvey, M., Peng, K. K., Weiss, M. E., Thompson, A. L., Zack, S. E., Lindley, S. E., Arnow, B. A., Jo, B., Rothbaum, B. O., Etkin, A. 2020

  Abstract

  BACKGROUND: Exposure-based psychotherapy is a first-line treatment for posttraumatic stress disorder (PTSD), but its mechanisms are poorly understood. Functional brain connectivity is a promising metric for identifying treatment mechanisms and biosignatures of therapeutic response. To this end, we assessed amygdala and insula treatment-related connectivity changes and their relationship to PTSD symptom improvements.METHODS: Individuals with a primary PTSD diagnosis (N= 66) participated in a randomized clinical trial of prolonged exposure therapy (n= 36) versus treatment waiting list (n= 30). Task-free functional magnetic resonance imaging was completed prior to randomization and 1 month following cessation of treatment/waiting list. Whole-brain blood oxygenation level-dependent responses were acquired. Intrinsic connectivity was assessed by subregion in the amygdala and insula, limbic structures key to the disorder pathophysiology. Dynamic causal modeling assessed evidence for effective connectivity changes in select nodes informed by intrinsic connectivity findings.RESULTS: The amygdala and insula displayed widespread patterns of primarily subregion-uniform intrinsic connectivity change, including increased connectivity between the amygdala and insula; increased connectivity of both regions with the ventral prefrontal cortex and frontopolar and sensory cortices; and decreased connectivity of both regions with the left frontoparietal nodes of the executive control network. Larger decreases in amygdala-frontal connectivity and insula-parietal connectivity were associated with larger PTSD symptom reductions. Dynamic causal modeling evidence suggested that treatment decreased left frontal inhibition of the left amygdala, and larger decreases were associated with larger symptom reductions.CONCLUSIONS: PTSD psychotherapy adaptively attenuates functional interactions between frontoparietal and limbic brain circuitry at rest, which may reflect a potential mechanism or biosignature of recovery.

  View details for DOI 10.1016/j.biopsych.2020.11.021

  View details for PubMedID 33516458

• Intrinsic Brain Connectivity Moderators of Psychotherapy Response and Changes in PTSD: A Combined Connectomic, Network Level, and Seeded Connectivity Approach Fonzo, G., Goodkind, M., Oathes, D., Zaiko, Y., Harvey, M., Peng, K., Weiss, E., Thompson, A., Zack, S., Rothbaum, B., Etkin, A. ELSEVIER SCIENCE INC. 2019: S111–S112

  View details for DOI 10.1016/j.biopsych.2019.03.280

  View details for Web of Science ID 000472661000267

• Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder SCIENCE TRANSLATIONAL MEDICINE Etkin, A., Maron-Katz, A., Wu, W., Fonzo, G. A., Huemer, J., Vertes, P. E., Patenaude, B., Richiardi, J., Goodkind, M. S., Keller, C. J., Ramos-Cejudo, J., Zaiko, Y., Peng, K. K., Shpigel, E., Longwell, P., Toll, R. T., Thompson, A., Zack, S., Gonzalez, B., Edelstein, R., Chen, J., Akingbade, I., Weiss, E., Hart, R., Mann, S., Durkin, K., Baete, S. H., Boada, F. E., Genfi, A., Autea, J., Newman, J., Oathes, D. J., Lindley, S. E., Abu-Amara, D., Arnow, B. A., Crossley, N., Hallmayer, J., Fossati, S., Rothbaum, B. O., Marmar, C. R., Bullmore, E. T., O'Hara, R. 2019; 11 (486)

  View details for DOI 10.1126/scitranslmed.aal3236

  View details for Web of Science ID 000463186500002

• Using fMRI connectivity to define a treatment-resistant form of post-traumatic stress disorder. Science translational medicine Etkin, A., Maron-Katz, A., Wu, W., Fonzo, G. A., Huemer, J., Vertes, P. E., Patenaude, B., Richiardi, J., Goodkind, M. S., Keller, C. J., Ramos-Cejudo, J., Zaiko, Y. V., Peng, K. K., Shpigel, E., Longwell, P., Toll, R. T., Thompson, A., Zack, S., Gonzalez, B., Edelstein, R., Chen, J., Akingbade, I., Weiss, E., Hart, R., Mann, S., Durkin, K., Baete, S. H., Boada, F. E., Genfi, A., Autea, J., Newman, J., Oathes, D. J., Lindley, S. E., Abu-Amara, D., Arnow, B. A., Crossley, N., Hallmayer, J., Fossati, S., Rothbaum, B. O., Marmar, C. R., Bullmore, E. T., O'Hara, R. 2019; 11 (486)

  Abstract

  A mechanistic understanding of the pathology of psychiatric disorders has been hampered by extensive heterogeneity in biology, symptoms, and behavior within diagnostic categories that are defined subjectively. We investigated whether leveraging individual differences in information-processing impairments in patients with post-traumatic stress disorder (PTSD) could reveal phenotypes within the disorder. We found that a subgroup of patients with PTSD from two independent cohorts displayed both aberrant functional connectivity within the ventral attention network (VAN) as revealed by functional magnetic resonance imaging (fMRI) neuroimaging and impaired verbal memory on a word list learning task. This combined phenotype was not associated with differences in symptoms or comorbidities, but nonetheless could be used to predict a poor response to psychotherapy, the best-validated treatment for PTSD. Using concurrent focal noninvasive transcranial magnetic stimulation and electroencephalography, we then identified alterations in neural signal flow in the VAN that were evoked by direct stimulation of that network. These alterations were associated with individual differences in functional fMRI connectivity within the VAN. Our findings define specific neurobiological mechanisms in a subgroup of patients with PTSD that could contribute to the poor response to psychotherapy.

  View details for PubMedID 30944165

• Students of Color STUDENT MENTAL HEALTH: A GUIDE FOR PSYCHIATRISTS, PSYCHOLOGISTS, AND LEADERS SERVING IN HIGHER EDUCATION Ryu, D., Thompson, A. L., Roberts, L. W. 2018: 399-409

  View details for Web of Science ID 000552225100027

• Mood and Anxiety Disorders STUDENT MENTAL HEALTH: A GUIDE FOR PSYCHIATRISTS, PSYCHOLOGISTS, AND LEADERS SERVING IN HIGHER EDUCATION Thompson, A. L., Ryu, D., Roberts, L. W. 2018: 185-195

  View details for Web of Science ID 000552225100014

• PTSD Psychotherapy Outcome Predicted by Brain Activation During Emotional Reactivity and Regulation AMERICAN JOURNAL OF PSYCHIATRY Fonzo, G. A., Goodkind, M. S., Oathes, D. J., Zaiko, Y. V., Harvey, M., Peng, K. K., Weiss, M., Thompson, A. L., Zack, S. E., Lindley, S. E., Arnow, B. A., Jo, B., Gross, J. J., Rothbaum, B. O., Etkin, A. 2017; 174 (12): 1163–74

  View details for DOI 10.1176/appi.ajp.2017.16091072

  View details for Web of Science ID 000417355900010

• Selective Effects of Psychotherapy on Frontopolar Cortical Function in PTSD. The American journal of psychiatry Fonzo, G. A., Goodkind, M. S., Oathes, D. J., Zaiko, Y. V., Harvey, M., Peng, K. K., Weiss, M. E., Thompson, A. L., Zack, S. E., Mills-Finnerty, C. E., Rosenberg, B. M., Edelstein, R., Wright, R. N., Kole, C. A., Lindley, S. E., Arnow, B. A., Jo, B., Gross, J. J., Rothbaum, B. O., Etkin, A. 2017; 174 (12): 1175-1184

  Abstract

  Exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD), but a comprehensive, emotion-focused perspective on how psychotherapy affects brain function is lacking. The authors assessed changes in brain function after prolonged exposure therapy across three emotional reactivity and regulation paradigms.Individuals with PTSD underwent functional MRI (fMRI) at rest and while completing three tasks assessing emotional reactivity and regulation. Individuals were then randomly assigned to immediate prolonged exposure treatment (N=36) or a waiting list condition (N=30) and underwent a second scan approximately 4 weeks after the last treatment session or a comparable waiting period, respectively.Treatment-specific changes were observed only during cognitive reappraisal of negative images. Psychotherapy increased lateral frontopolar cortex activity and connectivity with the ventromedial prefrontal cortex/ventral striatum. Greater increases in frontopolar activation were associated with improvement in hyperarousal symptoms and psychological well-being. The frontopolar cortex also displayed a greater variety of temporal resting-state signal pattern changes after treatment. Concurrent transcranial magnetic stimulation and fMRI in healthy participants demonstrated that the lateral frontopolar cortex exerts downstream influence on the ventromedial prefrontal cortex/ventral striatum.Changes in frontopolar function during deliberate regulation of negative affect is one key mechanism of adaptive psychotherapeutic change in PTSD. Given that frontopolar connectivity with ventromedial regions during emotion regulation is enhanced by psychotherapy and that the frontopolar cortex exerts downstream influence on ventromedial regions in healthy individuals, these findings inform a novel conceptualization of how psychotherapy works, and they identify a promising target for stimulation-based therapeutics.

  View details for DOI 10.1176/appi.ajp.2017.16091073

  View details for PubMedID 28715907

  View details for PubMedCentralID PMC5711612

• PTSD Psychotherapy Outcome Predicted by Brain Activation During Emotional Reactivity and Regulation. The American journal of psychiatry Fonzo, G. A., Goodkind, M. S., Oathes, D. J., Zaiko, Y. V., Harvey, M., Peng, K. K., Weiss, M. E., Thompson, A. L., Zack, S. E., Lindley, S. E., Arnow, B. A., Jo, B., Gross, J. J., Rothbaum, B. O., Etkin, A. 2017; 174 (12): 1163-1174

  Abstract

  Exposure therapy is an effective treatment for posttraumatic stress disorder (PTSD), but many patients do not respond. Brain functions governing treatment outcome are not well characterized. The authors examined brain systems relevant to emotional reactivity and regulation, constructs that are thought to be central to PTSD and exposure therapy effects, to identify the functional traits of individuals most likely to benefit from treatment.Individuals with PTSD underwent functional MRI (fMRI) while completing three tasks assessing emotional reactivity and regulation. Participants were then randomly assigned to immediate prolonged exposure treatment (N=36) or a waiting list condition (N=30). A random subset of the prolonged exposure group (N=17) underwent single-pulse transcranial magnetic stimulation (TMS) concurrent with fMRI to examine whether predictive activation patterns reflect causal influence within circuits. Linear mixed-effects modeling in line with the intent-to-treat principle was used to examine how baseline brain function moderated the effect of treatment on PTSD symptoms.At baseline, individuals with larger treatment-related symptom reductions (compared with the waiting list condition) demonstrated 1) greater dorsal prefrontal activation and 2) less left amygdala activation, both during emotion reactivity; 3) better inhibition of the left amygdala induced by single TMS pulses to the right dorsolateral prefrontal cortex; and 4) greater ventromedial prefrontal/ventral striatal activation during emotional conflict regulation. Reappraisal-related activation was not a significant moderator of the treatment effect.Capacity to benefit from prolonged exposure in PTSD is gated by the degree to which prefrontal resources are spontaneously engaged when superficially processing threat and adaptively mitigating emotional interference, but not when deliberately reducing negative emotionality.

  View details for DOI 10.1176/appi.ajp.2017.16091072

  View details for PubMedID 28715908

  View details for PubMedCentralID PMC5711543

• Selective Effects of Psychotherapy on Frontopolar Cortical Function in PTSD AMERICAN JOURNAL OF PSYCHIATRY Fonzo, G. A., Goodkind, M. S., Oathes, D. J., Zaiko, Y. V., Harvey, M., Peng, K. K., Weiss, M., Thompson, A. L., Zack, S. E., Mills-Finnerty, C. E., Rosenberg, B. M., Edelstein, R., Wright, R. N., Kole, C. A., Lindley, S. E., Arnow, B. A., Jo, B., Gross, J. J., Rothbaum, B. O., Etkin, A. 2017; 174 (12): 1175–84

  View details for DOI 10.1176/appi.ajp.2017.16091073

  View details for Web of Science ID 000417355900011

• Reorganization of Resting Connectivity Patterns Following Psychotherapy for Posttraumatic Stress Disorder Fonzo, G., Goodkind, M., Oathes, D., Zaiko, Y., Harvey, M., Peng, K., Weiss, E., Thompson, A., Zack, S., Mills-Finnerty, C., Rosenberg, B., Edelstein, R., Wright, R., Kole, C., Rothbaum, B., Etkin, A. NATURE PUBLISHING GROUP. 2017: S122–S123

  View details for Web of Science ID 000416846301019

• The Effects of Psychotherapy on Amygdalar Subregional Functional Connectivity in PTSD Fonzo, G., Goodkind, M., Oathes, D., Zaiko, Y., Harvey, M., Peng, K., Weiss, E., Thompson, A., Zack, S., Mills-Finnerty, C., Rosenberg, B., Edelstein, R., Wright, R., Kole, C., Rothbaum, B., Etkin, A. ELSEVIER SCIENCE INC. 2017: S236–S237

  View details for DOI 10.1016/j.biopsych.2017.02.455

  View details for Web of Science ID 000400348700582

• Brain Mechanisms and Predictors of Response to Prolonged Exposure Therapy in PTSD Fonzo, G., Goodkind, M., Oathes, D., Zaiko, Y., Harvey, M., Peng, K., Weiss, E., Mills-Finnerty, C., Thompson, A., Zack, S., Lindley, S., Arnow, B., Jo, B., Gross, J., Rothbaum, B., Etkin, A. NATURE PUBLISHING GROUP. 2016: S291–S292

  View details for Web of Science ID 000440365600493

• Neural Mechanisms of Psychotherapy for PTSD: Emotional Reactivity and Regulation Fonzo, G., Goodkind, M., Oathes, D., Zaiko, Y., Harvey, M., Peng, K., Weiss, E., Thompson, A., Zack, S., Arnow, B., Rothbaum, B., Etkin, A. NATURE PUBLISHING GROUP. 2015: S278–S279

  View details for Web of Science ID 000366597700483

• Mobile phone text messaging to promote healthy behaviors and weight loss maintenance: a feasibility study HEALTH INFORMATICS JOURNAL Gerber, B. S., Stolley, M. R., Thompson, A. L., Sharp, L. K., Fitzgibbon, M. L. 2009; 15 (1): 17-25

  Abstract

  There is a need to investigate newer strategies pertaining to the maintenance of healthy behaviors and weight. We investigated the feasibility of mobile phone text messaging to enable ongoing communication with African-American women participating in a weight management program. Ninety-five African-American women participated in this pilot study and received regularly scheduled text messages. Forty-two of these women chose to create 165 personal text messages that included tips on healthy eating and physical activity, as well as reminders to drink water and expressions of encouragement. A commercially available client-based application transmitted these personal messages and general health messages at least three times per week. The software transmitted over 4500 text messages during the first 4 months with 114 returned as undeliverable. Participants expressed generally positive attitudes toward incoming text messages, with only one participant declining to continue after enrollment. This study demonstrated early feasibility and acceptability of text messaging as a method for promoting healthy behaviors for weight maintenance.

  View details for DOI 10.1177/1460458208099865

  View details for Web of Science ID 000276058600002

  View details for PubMedID 19218309

  View details for PubMedCentralID PMC2730665