Using biomarkers to show change in a treatment for trauma-related nightmares

What is it about?

Post-traumatic nightmares and insomnia are troubling symptoms that often remain after therapy. Many recommended PTSD therapies use “exposure,” which is believed to work by heightening the patient’s distress by talking or writing about the trauma in session, enabling the patient to change how they think and feel about the trauma. Understanding exposure as a mechanism of therapeutic change can be advanced by using biological markers of distress in session, as well as change in symptoms over time. Our aim in this pilot study was to determine whether several biological markers, including heart rate, electrodermal activity, and molecular markers in blood samples could feasibly be integrated into a clinical trial as evidence of in-session trauma activation as well as response to treatment. Our findings show that participants complied with collection of heart rate and electrodermal activity through a wristband device, that blood samples were collected within a pre-specified set time-frame, and that heart rate and electrodermal activity could reliably be isolated both during treatment sessions to show stress and at night to identify the physiological markers associated with the occurrence of nightmares.

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Why is it important?

This study provided evidence that integrating biomarker sample and data collection into a clinical trial is not only feasible, but it is essential to expanding scientific understanding of the biological mechanisms underlying trauma-related nightmares.