Network Neuroscience and Translational Medicine: A Case for Abandoning Case Controlled Studies of Posttraumatic Stress Disorder

Translational network neuroscience and network models have the potential to change fundamentally our understanding of the nature of mental illness. Network neuroscience suggests that mental pathology-linked systems such as emotion regulation derive from the synchronized activation of multiple, sometimes regionally disparate areas of the brain. While the methods to actualize this understanding are emerging, case (e.g., those who meet criteria for a disorder) control (e.g., “healthy” participants) methods continue to dominate the literature. The purpose of this paper is to articulate why the field of translational and network neuroscience should largely abandon case control methods to actualize this potential. The perspective is articulated by using recent research on posttraumatic stress disorder (PTSD) to illustrate the issue in replication of network neuroscience and thus the difficulty translating the research to application. I argue that the heterogeneity of diagnoses such as PTSD - just in the presentation of meeting diagnostic criteria - combined with the complexity of human brain systems suggests that a mental disorder cannot be directly mapped to any one individual region or even multiple regions. However, symptoms and symptom sets might more reliably be links to activation patterns. Fine grained (symptom level), well-developed (psychometrically sound), continuous measures of symptom expression and intensity will be critical to actualize the potential of network neuroscience for mental disorders like PTSD.