Utility of P300 ERP in monitoring post-trauma mental health: A longitudinal study in military personnel returning from combat deployment

Chao Wang; Paul Rapp; David Darmon; Amy Trongnetrpunya; Michelle E Costanzo; Dominic E Nathan; Christopher J Cellucci; Michael J Roy; David Keyser

doi:10.1016/j.jpsychires.2018.02.027

Utility of P300 ERP in monitoring post-trauma mental health: A longitudinal study in military personnel returning from combat deployment

J Psychiatr Res. 2018 Jun:101:5-13. doi: 10.1016/j.jpsychires.2018.02.027. Epub 2018 Mar 1.

Authors

Chao Wang¹, Paul Rapp², David Darmon³, Amy Trongnetrpunya³, Michelle E Costanzo⁴, Dominic E Nathan³, Christopher J Cellucci⁵, Michael J Roy⁶, David Keyser²

Affiliations

¹ Traumatic Injury Research Program, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation, Bethesda, MD, USA. Electronic address: cwang@bhsai.org.
² Traumatic Injury Research Program, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
³ Traumatic Injury Research Program, Department of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Henry M. Jackson Foundation, Bethesda, MD, USA.
⁴ Henry M. Jackson Foundation, Bethesda, MD, USA; Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
⁵ Aquinas LLC, Berwyn, PA, USA.
⁶ Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA; Center for Neuroscience and Regenerative Medicine, Bethesda, MD, USA.

PMID: 29522937
DOI: 10.1016/j.jpsychires.2018.02.027

Abstract

Military service members (SMs) returning from combat are at high risk of developing neuropsychiatric conditions such as posttraumatic stress disorder (PTSD) and major depression. Symptom dynamics following reintegration into civilian life may be magnified over time such that some SMs present with delayed onset and may not reach a diagnostic threshold for months to years. Monitoring the trajectory of mental health in the aftermath of combat trauma can therefore be particularly important in enhancing diagnosis. In this study, we investigated the possible utility of the P300 event-related potential (ERP) as an objective marker for monitoring post-trauma mental health. SMs recently returned from a combat deployment were recruited to undergo a baseline assessment, with subsequent follow-up assessment at 6 or 12 months later. At each assessment, ERPs were recorded using a conventional visual oddball task and a set of psychological scores assessing PTSD, depression, and psychosocial functioning were obtained. We observed that the individuals with overall improved psychological scores at follow-up had increased P300 amplitude and shortened P300 latency, and the individuals with overall worsened psychological scores at follow-up had prolonged P300 latency. The degree of change in aggregate psychological score was significantly correlated with the magnitude of change in P300 amplitude (r = -0.72, p < 0.0001) and latency (r = 0.42, p = 0.0201). These findings suggest that the P300 may be utilized as a quantitative biomarker for tracking the changes of mental health longitudinally. It may offer clinicians an objective tool for the assessment of the dynamics of mental health following trauma, and perhaps also for monitoring recovery during treatment.

Keywords: Biomarker; Combat trauma; Depression; ERP; PTSD.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Biomarkers
Combat Disorders / diagnosis*
Combat Disorders / physiopathology
Electroencephalography
Event-Related Potentials, P300 / physiology*
Female
Humans
Longitudinal Studies
Male
Military Personnel*
Stress Disorders, Post-Traumatic / diagnosis*
Stress Disorders, Post-Traumatic / physiopathology
Young Adult

Substances

Biomarkers