Mapping the Neurobiological Mechanisms of Trauma Interventions: A Scoping Review of Large-Scale Brain Network Perspectives (2020–2025)

Summary

This scoping review maps neurobiological evidence for psychological and pharmacologically-assisted PTSD interventions published between 2020 and 2025. Using the triple-network model (default mode, salience, and central executive networks), the review synthesizes findings across cognitive behavioral/exposure therapies, somatic/mindfulness-based approaches, imagery rescripting, EMDR, and MDMA-assisted and ketamine-assisted psychotherapy. A mechanism-based classification is developed based on each intervention's primary network target and dominant pathway of effect, such as top-down regulation, bottom-up modulation, or multi-network integration. The review is conducted within a participatory framework involving researchers with lived trauma experience in data interpretation and validation of ecological validity.

Study at a glance

Abstract

This scoping review aims to systematically map the neurobiological evidence for psychological and pharmacologically-assisted interventions for post-traumatic stress disorder (PTSD) published between 2020 and 2025. Grounded in the triple-network model (default mode network, salience network, and central executive network), the review will synthesize findings across a range of intervention types, including cognitive behavioral/exposure therapies, somatic/mindfulness-based approaches, imagery rescripting, EMDR, and targeted pharmacological augmentations such as MDMA-assisted and ketamine-assisted psychotherapy. A mechanism-based classification will be developed based on each intervention's primary network target and dominant pathway of effect (e.g., top-down regulation, bottom-up modulation, or multi-network integration). The review is conducted within a participatory framework, involving researchers with lived trauma experience in data interpretation and validation of ecological validity.