Criticality is associated with future psychotherapy response in patients with post-traumatic stress disorder – A pilot study

This study assessed whether brain criticality (a factor in optimizing information processing) is related to future response to treatment including EMDR therapy, hypothesizing that treatment responders’ brains function closer to criticality.

Article Abstract 

“Background: Trauma-focused psychotherapy is treatment of choice for post-traumatic stress disorder (PTSD). However, about half of patients do not respond. Recently, there is increased interest in brain criticality, which assesses the phase transition between order and disorder in brain activity. Operating close to this borderline is theorized to facilitate optimal information processing. We studied if brain criticality is related to future response to treatment, hypothesizing that treatment responders’ brains function closer to criticality.

Methods: Functional magnetic resonance imaging resting-state scans were acquired from 46 male veterans with PTSD around the start of treatment. Psychotherapy consisted of trauma-focused cognitive behavioral therapy, eye movement desensitization and reprocessing, or a combination thereof. Treatment response was assessed using the Clinician-Administered PTSD Scale, and criticality was assessed using an Ising temperature approach for seven canonical brain networks (ie, the visual, somatomotor, dorsal attention, ventral attention, limbic, frontoparietal and default mode networks) to measure distance to criticality.

Results: The brains of prospective treatment responders were closer to criticality than nonresponders (P = 0.017), while no significant interaction effect between group and brain network was observed (P = 0.486). In addition, average criticality across networks correlated with future treatment response (P = 0.028).

Conclusion: These results show that the brains of prospective PTSD psychotherapy treatment responders operate closer to criticality than nonresponders, and this occurs across the entire brain instead of in separate canonical brain networks. These results suggest that effective psychotherapy is mediated by brains operating closer to criticality.”

—Description from publisher 

Article Access 

Open Access 

van Lutterveld, R., Sterk, M., Spitoni, C., Kennis, M., van Rooij, S. J. H., & Geuze, E. (2025). Criticality is associated with future psychotherapy response in patients with post-traumatic stress disorder – A pilot study. Chronic Stress, 9. https://doi.org/10.1177/247054702413112

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Date
January 12, 2025

Creator(s)
Remko van Lutterveld, Myrthe Sterk, Cristian Spitoni Altman

Contributor(s)
Mitzy Kennis, Sanne J. H. van Rooij, Elbert Geuze

Topics
PTSD

Client Population
Military/Veterans

Practice & Methods
Neurobiology

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Publisher
SageJournals

Rights
Copyright © The Authors 2025

APA Citation
van Lutterveld, R., Sterk, M., Spitoni, C., Kennis, M., van Rooij, S. J. H., & Geuze, E. (2025). Criticality is associated with future psychotherapy response in patients with post-traumatic stress disorder - A pilot study. Chronic Stress, 9. https://doi.org/10.1177/247054702413112

Audience
EMDR Therapists

Language
English

Content Type
Article, Peer-Reviewed

Access Type
External Resource, Open Access

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