2025
Modeling decision-making under uncertainty with qualitative outcomes.
Korem N, Duek O, Jia R, Wertheimer E, Metviner S, Grubb M, Levy I. Modeling decision-making under uncertainty with qualitative outcomes. PLOS Computational Biology 2025, 21: e1012440. PMID: 40029903, PMCID: PMC11918403, DOI: 10.1371/journal.pcbi.1012440.Peer-Reviewed Original ResearchConnectome-Based Predictive Modeling of PTSD Development Among Recent Trauma Survivors
Ben-Zion Z, Simon A, Rosenblatt M, Korem N, Duek O, Liberzon I, Shalev A, Hendler T, Levy I, Harpaz-Rotem I, Scheinost D. Connectome-Based Predictive Modeling of PTSD Development Among Recent Trauma Survivors. JAMA Network Open 2025, 8: e250331. PMID: 40063028, PMCID: PMC11894499, DOI: 10.1001/jamanetworkopen.2025.0331.Peer-Reviewed Original ResearchConceptsConnectome-based predictive modelingPosttraumatic stress disorderClinician-Administered PTSD Scale for DSM-5Months post-traumaFunctional magnetic resonance imagingTrauma survivorsDSM-5Post-traumaPosttraumatic stress disorder symptom clustersPosttraumatic stress disorder symptom severityPosttraumatic stress disorder symptom trajectoriesPosttraumatic stress disorder severityTask-based fMRI dataAnterior default modePredictive of symptomsFollow-up assessmentDevelopment of effective personalized treatmentsComprehensive clinical assessmentClinician-AdministeredNeurobiological indicesPosttraumatic psychopathologyHyperarousal symptomsCentral executiveTrauma exposureSalience networkMEMORY RELATED STRUCTURAL AND FUNCTIONAL NEURAL CHANGES FOLLOWING A SINGLE INFUSION OF KETAMINE IN PTSD
Harpaz-Rotem *, Duek O, Korem N, Krystal J. MEMORY RELATED STRUCTURAL AND FUNCTIONAL NEURAL CHANGES FOLLOWING A SINGLE INFUSION OF KETAMINE IN PTSD. The International Journal Of Neuropsychopharmacology 2025, 28: i38-i38. PMCID: PMC11814760, DOI: 10.1093/ijnp/pyae059.066.Peer-Reviewed Original ResearchPost-retrieval extinctionInfusion of ketamineIntravenous infusion of ketamineTrauma memoriesTraumatic memoriesFear responsesSs' responsesAssociated with decreased connectivityAmygdala-vmPFC connectivityTrauma-focused psychotherapyTreatment of PTSDNMDA receptor antagonistPre-post treatmentAmygdala activationLower amygdalaReconsolidation windowUncinate fasciculusAssessed before treatmentKetamine administrationMemory learningNaturalistic stimuliLabile stateAmygdalaPTSDExtinction process
2024
Post-treatment alterations in white matter integrity in PTSD: Effects on symptoms and functional connectivity a secondary analysis of an RCT
Korem N, Duek O, Ben-Zion Z, Spiller T, Gordon C, Amen S, Levy I, Harpaz-Rotem I. Post-treatment alterations in white matter integrity in PTSD: Effects on symptoms and functional connectivity a secondary analysis of an RCT. Psychiatry Research Neuroimaging 2024, 343: 111864. PMID: 39111111, DOI: 10.1016/j.pscychresns.2024.111864.Peer-Reviewed Original ResearchReduced resting-state functional connectivityPost-traumatic stress disorderPost-traumatic stress disorder symptomsFunctional connectivityPost-treatment changesReducing PTSD symptom severityFollow-up changesResting-state functional connectivityIntensive exposure therapyExposure-based psychotherapyVentromedial prefrontal cortexPTSD symptom severityReduced structural connectivityFunctional connectivity patternsPost-treatmentWhite matter integrityPrefrontal cortexExposure therapyPTSD symptomsStress disorderSymptom severityUncinate fasciculusLimbic systemSecondary analysisAssociated with sustained changes351. High-Threshold-Low-Tolerance: A Model for the Emotionality Paradox in PTSD
Korem N, Duek O, Spiller T, Ben-Zion Z, Levy I, Harpaz-Rotem I. 351. High-Threshold-Low-Tolerance: A Model for the Emotionality Paradox in PTSD. Biological Psychiatry 2024, 95: s243. DOI: 10.1016/j.biopsych.2024.02.850.Peer-Reviewed Original ResearchEmotional State Transitions in Trauma-Exposed Individuals With and Without Posttraumatic Stress Disorder
Korem N, Duek O, Spiller T, Ben-Zion Z, Levy I, Harpaz-Rotem I. Emotional State Transitions in Trauma-Exposed Individuals With and Without Posttraumatic Stress Disorder. JAMA Network Open 2024, 7: e246813. PMID: 38625701, PMCID: PMC11022112, DOI: 10.1001/jamanetworkopen.2024.6813.Peer-Reviewed Original ResearchPosttraumatic stress disorderTrauma-exposed individualsEmotional numbing symptomsTrauma-exposed controlsNegative emotional statesNumbing symptomsEmotional numbingDSM-5Valence ratingsStress disorderEmotional statesTrauma-exposed control groupPTSD experiencesPosttraumatic stress disorder symptomsPosttraumatic Stress Disorder ChecklistDSM-5 criteriaAge-related associationsStimulus valencePCL-5Emotional responsesEmotional state transitionEmotional transitionSymptomsParticipantsDisorders
2023
Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study
Danböck S, Duek O, Ben-Zion Z, Korem N, Amen S, Kelmendi B, Wilhelm F, Levy I, Harpaz-Rotem I. Effects of a dissociative drug on fronto-limbic resting-state functional connectivity in individuals with posttraumatic stress disorder: a randomized controlled pilot study. Psychopharmacology 2023, 241: 243-252. PMID: 37872291, PMCID: PMC10806226, DOI: 10.1007/s00213-023-06479-4.Peer-Reviewed Original ResearchResting-state functional connectivityPosttraumatic stress disorderFunctional magnetic resonance imagingMedial prefrontal cortexMPFC subregionsAnterior medial PFCFunctional connectivityStress disorderAspartate glutamate receptor antagonistPilot studyNon-competitive N-methylGlutamate receptor antagonistsEffects of ketamineDissociative drugsMagnetic resonance imagingIntravenous drug infusionReceptor antagonistSubanesthetic doseDrug infusionCorrelative findingsKetamineResonance imagingTransient decreaseDrug midazolamAmygdalaStructural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review
Ben-Zion Z, Korem N, Fine N, Katz S, Siddhanta M, Funaro M, Duek O, Spiller T, Danböck S, Levy I, Harpaz-Rotem I. Structural Neuroimaging of Hippocampus and Amygdala Subregions in Posttraumatic Stress Disorder: A Scoping Review. Biological Psychiatry Global Open Science 2023, 4: 120-134. PMID: 38298789, PMCID: PMC10829655, DOI: 10.1016/j.bpsgos.2023.07.001.Peer-Reviewed Original ResearchPost-traumatic stress disorderAmygdala subregionsStress disorderKey limbic regionsEtiology of PTSDPosttraumatic stress disorderDentate gyrusLimbic regionsSubiculum volumeSubregion volumesHippocampal subregionsDisorder pathogenesisStructural neuroimagingAutomatic segmentation softwareAmygdalar subregionsHippocampusNucleus volumeScoping ReviewPathogenesisCurrent literatureDisordersSegmentation softwareMethodological limitationsPost-traumatic psychopathologyReviewCorrelates of avoidance coping in trauma-exposed U.S. military veterans: Results from the National Health and Resilience in Veterans Study
Korem N, Ben-Zion Z, Spiller T, Duek O, Harpaz-Rotem I, Pietrzak R. Correlates of avoidance coping in trauma-exposed U.S. military veterans: Results from the National Health and Resilience in Veterans Study. Journal Of Affective Disorders 2023, 339: 89-97. PMID: 37437721, DOI: 10.1016/j.jad.2023.07.036.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderAvoidance copingTraumatic eventsU.S. military veteransEmotional stabilityNegative affect symptomsEmotional neglectSexual abuseAffect symptomsMilitary veteransAvoidant coping strategiesGreater emotional stabilityPhysical health outcomesPsychosocial risk factorsConsolidated memoryStress disorderCoping strategiesAdverse childhood experiencesStressful experiencesCopingVeterans StudyChildhood experiencesStrong feelingsNetwork analytic approachConscientiousnessLong term structural and functional neural changes following a single infusion of Ketamine in PTSD
Duek O, Korem N, Li Y, Kelmendi B, Amen S, Gordon C, Milne M, Krystal J, Levy I, Harpaz-Rotem I. Long term structural and functional neural changes following a single infusion of Ketamine in PTSD. Neuropsychopharmacology 2023, 48: 1648-1658. PMID: 37270621, PMCID: PMC10517133, DOI: 10.1038/s41386-023-01606-3.Peer-Reviewed Original ResearchConceptsKetamine recipientsSingle infusionMain study outcomeTiming of administrationEnd of treatmentNMDA receptor antagonistFunctional neural changesFrequency of administrationSignificant clinical implicationsTrauma-focused psychotherapyBrief exposure therapyAmygdala-vmPFC connectivityPost-retrieval extinctionKetamine doseKetamine administrationReceptor antagonistTrauma scriptsNeural changesClinical implicationsDecreased connectivityExposure therapyKetamineTrauma memoriesStudy outcomesUncinate fasciculusUnderlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials
Zilcha-Mano S, Duek O, Suarez-Jimenez B, Zhu X, Lazarov A, Helpman L, Korem N, Malka M, Harpaz-Rotem I, Neria Y. Underlying Hippocampal Mechanism of Posttraumatic Stress Disorder Treatment Outcome: Evidence From Two Clinical Trials. Biological Psychiatry Global Open Science 2023, 3: 867-874. PMID: 37881552, PMCID: PMC10593870, DOI: 10.1016/j.bpsgos.2023.01.005.Peer-Reviewed Original ResearchPosttraumatic stress disorderRight hippocampal volumeHippocampal volumeSymptom reductionPosttreatment magnetic resonance imagingPosttraumatic stress disorder treatment outcomeLarger hippocampal volumesDisorder treatment outcomesPTSD symptom reductionMagnetic resonance imagingGreater PTSD symptom reductionBetter prognosisClinical trialsTreatment outcomesDepressive symptomsTherapeutic outcomesPTSD treatmentResonance imagingTreatment studiesClinical targetsStress disorderPTSD symptomsSmall sample sizeHippocampal mechanismsTreatment
2022
Longitudinal volumetric evaluation of hippocampus and amygdala subregions in recent trauma survivors
Ben-Zion Z, Korem N, Spiller TR, Duek O, Keynan JN, Admon R, Harpaz-Rotem I, Liberzon I, Shalev AY, Hendler T. Longitudinal volumetric evaluation of hippocampus and amygdala subregions in recent trauma survivors. Molecular Psychiatry 2022, 28: 657-667. PMID: 36280750, PMCID: PMC9918676, DOI: 10.1038/s41380-022-01842-x.Peer-Reviewed Original ResearchConceptsEmergency departmentAmygdala subregionsPTSD diagnosisGeneral hospital emergency departmentLeft amygdala volumeHospital emergency departmentRight hippocampus volumeCA1 hippocampal subregionRecent trauma survivorsTrauma survivorsCivilian trauma survivorsED admissionEligible participantsHippocampus volumeAmygdala volumeHippocampal subregionsVulnerability traitsDisorder pathogenesisClinical InterviewModerate evidenceHippocampus subregionsTrauma exposureStructural MRIRobust evidenceLower initial volumeDelirium screening in an acute care setting with a machine learning classifier based on routinely collected nursing data: A model development study
Spiller TR, Tufan E, Petry H, Böttger S, Fuchs S, Duek O, Ben-Zion Z, Korem N, Harpaz-Rotem I, von Känel R, Ernst J. Delirium screening in an acute care setting with a machine learning classifier based on routinely collected nursing data: A model development study. Journal Of Psychiatric Research 2022, 156: 194-199. PMID: 36252349, DOI: 10.1016/j.jpsychires.2022.10.018.Peer-Reviewed Original ResearchConceptsDelirium Observation ScaleAcute care settingNursing dataCare settingsSingle tertiary teaching hospitalPatients 18 yearsTertiary teaching hospitalDelirium prediction modelSuch screening programsDelirium screeningAcute careMean ageTeaching hospitalInclusion criteriaScreening programDeliriumPatientsClinical practiceTotal scoreDemographic characteristicsCharacteristic curveScreening procedureModel development studiesRiskAdditional measuresEmotional numbing in PTSD is associated with lower amygdala reactivity to pain
Korem N, Duek O, Ben-Zion Z, Kaczkurkin AN, Lissek S, Orederu T, Schiller D, Harpaz-Rotem I, Levy I. Emotional numbing in PTSD is associated with lower amygdala reactivity to pain. Neuropsychopharmacology 2022, 47: 1913-1921. PMID: 35945274, PMCID: PMC9485255, DOI: 10.1038/s41386-022-01405-2.Peer-Reviewed Original ResearchConceptsPosttraumatic stress disorderAmygdala reactivityLower amygdala reactivityHigher pain responseLower amygdala activationAltered pain perceptionAmygdala activationProcessing of painAmygdala responseEmotional numbingPain correlateMild painPain processingPain thresholdPain responsePain perceptionPainControl groupPTSD groupStress disorderRobust reductionAmygdala activityCombat controlsAmygdalaEmotional numbing symptoms
2021
Cannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study
Korem N, Duek O, Xu K, Harpaz-Rotem I, Pietrzak RH. Cannabinoid Receptor 1 rs1049353 Variant, Childhood Abuse, and the Heterogeneity of PTSD Symptoms: Results From the National Health and Resilience in Veterans Study. Chronic Stress 2021, 5: 24705470211011075. PMID: 33997583, PMCID: PMC8107935, DOI: 10.1177/24705470211011075.Peer-Reviewed Original ResearchPosttraumatic stress disorderOverall PTSD symptomsAnxious arousal symptomsPTSD symptomsNational HealthChildhood abuseVeterans StudySymptom clustersArousal symptomsAllele carrier statusArousal symptom clustersMultivariable analysisEndocannabinoid systemAllele carriersPTSD symptom clustersGene-environment studiesGreater severityG homozygotesU.S. veteransSymptomsStress disorderCarrier statusReceptor geneDisordersSignificant main effect
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