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13 - Structural imaging of post-traumatic stress disorder

from Section III - Anxiety Disorders

Published online by Cambridge University Press:  10 January 2011

By
Mark W. Gilbertson
Edited by
Martha E. Shenton  and
Bruce I. Turetsky
Mark W. Gilbertson
Affiliation:
Mental Health/Research Service Manchester VA Medical Center Manchester, NH, USA
Martha E. Shenton
Affiliation:
VA Boston Healthcare System and Brigham and Women's Hospital, Harvard Medical School
Bruce I. Turetsky
Affiliation:
University of Pennsylvania
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Summary

Post-traumatic stress disorder (PTSD) includes a constellation of disabling behavioral and emotional symptoms that occur in a proportion of individuals exposed to severe psychological trauma. PTSD can be a chronic and debilitating condition in which intrusive memories, hypervigilence, heightened physiological reactivity to reminders of the traumatic event, and avoidance can lead to significant social and occupational impairment. Understanding the neurobiology of this disorder has not only served as validation of PTSD as a diagnostic entity, but may ultimately be critical to the development of more effective therapeutic interventions.

Neuroimaging studies of structural brain abnormalities in PTSD have largely emerged in the context of two principal lines of evidence in the literature. First, early animal research provided compelling evidence that exposure to severe and chronic stress, a process that may be mediated by the neurotoxic impact of elevated corticosteroids, can damage the hippocampal formation, namely, CA3 neuronal cell loss, diminished neuronal regeneration, atrophy of dendritric branching, and reduced levels of brain-derived neurotrophic factor (Gould et al., 1997; Margarinos et al., 1996; McEwen, 1995; Sapolsky et al., 1990; Smith et al., 1995; Uno et al., 1989). As a result, the initial neuroanatomical investigations of PTSD centered largely upon the morphology of the hippocampus. Second, an improved understanding in recent years of the neurocircuitry underlying conditioned fear acquisition and extinction in animals has identified a number of specific brain regions of interest (Herry et al., 2008; Maren, 2005) that are potentially relevant to an understanding of the symptomatology of PTSD (Rauch et al., 2006).

Type
Chapter
Information
Understanding Neuropsychiatric Disorders
Insights from Neuroimaging
 , pp. 205 - 213
Publisher: Cambridge University Press
Print publication year: 2010

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References

Abe, O, Yamasue, H, Kasai, K, et al. 2006. Voxel-based diffusion tensor analysis reveals aberrant anterior cingulum integrity in posttraumatic stress disorder due to terrorism. Psychiatry Res Neuroimag 146, 231–42.Google Scholar
Araki, T, Kasai, K, Yamasue, H, et al. 2005. Association between lower P300 amplitude and smaller anterior cingulated cortex volume in patients with posttraumatic stress disorder: a study of victims of Tokyo subway sarin attack. NeuroImage 25, 43–50.Google Scholar
Bonne, O, Brandes, D, Gilboa, A, et al. 2001. Longitudinal MRI study of hippocampal volume in trauma survivors with PTSD. Am J Psychiatry 158, 1248–51.Google Scholar
Bonne, O, Vythilingam, M, Inagaki, M, et al. 2008. Reduced posterior hippocampal volume in posttraumatic stress disorder. J Clin Psychiatry 69, 1087–91.
Bossini, L, Tavanti, M, Calossi, S, et al. 2008. Magnetic resonance imaging volumes of the hippocampus in drug-naïve patients with post-traumatic stress disorder without comorbidity conditions. J Psychiatric Res 42, 752–62.Google Scholar
Bremner, J A, Narayan, M, Anderson, E R. 2000. Hippocampal volume reduction in major depression. Am J Psychiatry 157, 115–27.Google Scholar
Bremner, J A, Randall, P, Scott, T M, et al. 1995. MRI-based measurements of hippocampal volume in combat-related posttraumatic stress disorder. Am J Psychiatry 152, 973–8.Google Scholar
Bremner, J D, Randall, P, Vermetten, E, et al. 1997. Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse – A preliminary report. Biol Psychiatry 41, 23–32.Google Scholar
Bremner, J D, Vythilingam, M, Vermetten, E, et al. 2003. MRI and PET study of deficits in hippocampal structure and function in women with childhood sexual abuse and posttraumatic stress disorder. Am J Psychiatry 160, 924–32.Google Scholar
Canive, J M, Lewine, J D, Orrison, W W, et al. 1997. MRI reveals gross structural abnormalities in PTSD. Ann N Y Acad Sci 821, 512–5.Google Scholar
Carrion, V G, Weems, C F, Eliez, S, et al. 2001. Attenuation of frontal asymmetry in pediatric posttraumatic stress disorder. Biol Psychiatry 50, 943–51.Google Scholar
Carrion, V G, Weems, C F and Reiss, A L. 2007. Stress predicts brain changes in children: A pilot longitudinal study on youth stress, posttraumatic stress disorder, and the hippocampus. Pediatrics 119, 509–16.Google Scholar
Chen, S, Xia, W, Li, L, et al. 2006. Gray matter density reduction in the insula in fire survivors with posttraumatic stress disorder: A voxel-based morphometric study. Psychiatry Res Neuroimag 146, 65–72.Google Scholar
Corbo, V, Clément, M H, Armony, J L, et al. 2005. Size versus shape differences: Contrasting voxel-based and volumetric analyses of the anterior cingulate cortex in individuals with acute posttraumatic stress disorder. Biol Psychiatry 58, 119–24.Google Scholar
Crusio, W E, Schwegler, H and Abeelen, J H F. 1989. Behavioral responses to novelty and structural variation of the hippocampus in mice. II. Multivariate genetic analysis. Behav Brain Res 32, 81–8.Google Scholar
Bellis, M D, Hall, J, Boring, A M, et al. 2001. A pilot longitudinal study of hippocampal volumes in pediatric maltreatment-related posttraumatic stress disorder. Biol Psychiatry 50, 305–09.Google Scholar
Bellis, M D and Keshavan, M S. 2003. Sex differences in brain maturation in maltreatment-related pediatric posttraumatic stress disorder. Neurosci Biobehav Rev 27, 103–17.Google Scholar
Bellis, M D, Keshavan, M S, Clark, D B, et al. 1999. Developmental traumatology part II: Brain development. Biol Psychiatry 45, 1271–84.Google Scholar
Bellis, M D, Keshavan, M S, Frustaci, K, et al. 2002b. Superior temporal gyrus volumes in maltreated children and adolescents with PTSD. Biol Psychiatry 51, 544–52.Google Scholar
Bellis, M D, Keshavan, M S, Shifflett, H, et al. 2002a. Brain structures in pediatric maltreatment-related posttraumatic stress disorder: A sociodemographically matched study. Biol Psychiatry 52, 1066–78.Google Scholar
Bellis, M D and Kuchibhatla, M. 2006. Cerebellar volumes in pediatric maltreatment-related posttraumatic stress disorder. Biol Psychiatry 60, 697–703.Google Scholar
Emdad, R, Bonekamp, D, Sondergaard, H P, et al. 2006. Morphometric and psychometric comparisons between non-substance-abusing patients with posttraumatic stress disorder and normal controls. Psychother Psychosom 75, 122–32.Google Scholar
Fennema-Notestine, C, Stein, M B, Kennedy, C M, et al. 2002. Brain morphometry in female victims of intimate partner violence with and without posttraumatic stress disorder. Biol Psychiatry 51, 1089–101.Google Scholar
Freeman, T W, Cardwell, D, Karson, C N and Komoroski, R A. 1998. In vivo proton magnetic resonance spectroscopy of the medial temporal lobes of subjects with combat-related posttraumatic stress disorder. Magn Reson Med 40, 66–71.Google Scholar
Freeman, T, Kimbrell, T, Booe, L, et al. 2006. Evidence of resilience: Neuroimaging in former prisoners of war. Psychiatry Res Neuroimag 146, 59–64.Google Scholar
Geuze, E, Westenberg, H G M, Heinecke, A, et al. 2008. Thinner prefrontal cortex in veterans with posttraumatic stress disorder. NeuroImage 41, 675–81.Google Scholar
Gilbertson, M W, Shenton, M E, Ciszewski, A, et al. 2002. Smaller hippocampal volume predicts pathologic vulnerability to psychological trauma. Nature Neurosci 5, 1242–7.Google Scholar
Golier, J A, Yehuda, R, DeSanti, S, et al. 2005. Absence of hippocampal volume differences in survivors of the Nazi Holocaust with and without posttraumatic stress disorder. Psychiatry Res Neuroimag 139, 53–64.Google Scholar
Gould, E, McEwen, B S, Tanapat, P, et al. 1997. Neurogenesis in the dentate gyrus of the adult tree shrew is regulated by psychosocial stress and NMDA receptor activation. J Neurosci 17, 2492–8.Google Scholar
Gurvits, T V, Shenton, M E, Hokama, H, et al. 1996. Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder. Biol Psychiatry 40, 1091–9.Google Scholar
Hakamata, Y, Matsuoka, Y, Inagaki, M, et al. 2007. Structure of orbitofrontal cortex and its longitudinal course in cancer-related post-traumatic stress disorder. Neurosci Res 59, 383–9.Google Scholar
Ham, B J, Chey, J, Yoon, S J, et al. 2007. Decreased N-acetyl-aspartate levels in anterior cingulate and hippocampus in subjects with post-traumatic stress disorder: A proton magnetic resonance spectroscopy study. Eur J Neurosci 25, 324–9.Google Scholar
Hedges, D W, Allen, A, Tate, D F, et al. 2003. Reduced hippocampal volume in alcohol and substance naïve Vietnam combat veterans with posttraumatic stress disorder. Cognit Behav Neurol 16, 219–24.Google Scholar
Herry, C, Ciocchi, S, Senn, V, et al. 2008. Switching on and off fear by distinct neuronal circuits. Nature 454, 589–90.Google Scholar
Hull, A M. 2002. Neuroimaging findings in post-traumatic stress disorder. Br J Psychiatry 181, 102–10.Google Scholar
Jackowski, A P, Douglas-Palumberi, H, Jackowski, M, et al. 2008. Corpus callosum in maltreated children with posttraumatic stress disorder: A diffusion tensor imaging study. Psychiatry Res Neuroimag 162, 256–61.Google Scholar
Jatzko, A, Rothenhöfer, S, Schmitt, A, et al. 2006. Hippocampal volume in chronic posttraumatic stress disorder (PTSD): MRI study using two different evaluation methods. J Affect Disord 94, 121–6.Google Scholar
Karl, A, Schaefer, M, Malta, L S, et al. 2006. A meta-analysis of structural brain abnormalities in PTSD. Neurosci Biobehav Rev 30, 1004–31.Google Scholar
Kasai, K, Yamasue, H, Gilbertson, M W, et al. 2008. Evidence for acquired pregenual anterior cingulate gray matter loss from a twin study of combat-related posttraumatic stress disorder. Biol Psychiatry 63, 550–6.Google Scholar
Kim, M J, Lyoo, I K, Kim, S J, et al. 2005. Disrupted white matter tract integrity of anterior cingulate in trauma survivors. Neuroreport 16, 1049–53.Google Scholar
Kim, S J, Jeong, D U, Sim, M E, et al. 2006. Asymmetrically altered integrity of cingulum bundle in posttraumatic stress disorder. Neuropsychobiology 54, 120–5.Google Scholar
Kitayama, N, Brummer, M, Hertz, L, et al. 2007. Morphologic alterations in the corpus callosum in abuse-related posttraumatic stress disorder: A preliminary study. J Nerv Mental Disord 195, 1027–9.Google Scholar
Kitayama, N, Quinn, S and Bremner, J D. 2006. Smaller volume of anterior cingulate cortex in abuse-related posttraumatic stress disorder. J Affect Disord 90, 171–4.Google Scholar
Kitayama, N, Vaccarino, V, Kutner, M, et al. 2005. Magnetic resonance imaging (MRI) measurement of hippocampal volume in posttraumatic stress disorder: A meta-analysis. J Affect Disord 88, 79–86.Google Scholar
Laakso, M P, Vaurio, O, Savolainen, L, et al. 2000. A volumetric MRI study of the hippocampus in type 1 and 2 alcoholism. Behav Brain Res 109, 177–86.Google Scholar
Letizia, B, Maricla, T, Sara, C, et al. 2008. Magnetic resonance imaging volumes of the hippocampus in drug-naïve patients with post-traumatic stress disorder without comorbidity conditions. J Psychiatric Res 42, 752–62.Google Scholar
Levitt, J J, Chen, Q C, May, F S, et al. 2006. Volume of cerebellar vermis in monozygotic twins discordant for combat exposure: Lack of relationship to posttraumatic stress disorder. Psychiatry Res Neuroimag 148, 143–9.Google Scholar
Li, L, Chen, S, Liu, J, et al. 2006. Magnetic resonance imaging and magnetic resonance spectroscopy study of deficits in hippocampal structure in fire victims with recent-onset posttraumatic stress disorder. Can J Psychiatry 51, 431–7.Google Scholar
Lindauer, R J L, Vlieger, E J, Jalink, M, et al. 2004. Smaller hippocampal volume in Dutch police officers with posttraumatic stress disorder. Biol Psychiatry 56, 356–63.Google Scholar
Mahmutyazicioğlu, K, Konuk, N, Ozdemir, H, et al. 2005. Evaluation of the hippocampus and the anterior cingulate gyrus by proton MR spectroscopy in patients with post-traumatic stress disorder. Diagn Interven Radiol 11, 125–9.Google Scholar
Maren, S. 2005. Building and burying fear memories in the brain. Neuroscientist 11, 89–99.Google Scholar
Margarinos, A M, McEwen, B S, Flugge, G and Fuchs, E. 1996. Chronic psychosocial stress causes apical dendritic atrophy of hippocampal CA3 pyramidal neurons in subordinate tree shrews. J Neurosci 16, 3534–40.Google Scholar
Matsuoka, Y, Yamawaki, S, Inagaki, M, et al. 2003. A volumetric study of amygdala in cancer survivors with instrusive recollections. Biol Psychiatry 54, 736–43.Google Scholar
May, F S, Chen, Q C, Gilbertson, M W, et al. 2004. Cavum septum pellucidum in monozygotic twins discordant for combat exposure: Relationship to posttraumatic stress disorder. Biol Psychiatry 55, 656–8.Google Scholar
McEwen, B S. 1995. Stressful experience, brain, and emotions: developmental, genetic, and hormonal influences. In Gazzaniga, M S (ed.) The Cognitive Neurosciences. Cambridge, MA: MIT Press, pp. 1117–35.
Mohanakrishnan Menon, P, Nasrallah, H A, Lyons, J A, et al. 2003. Single-voxel proton MR spectroscopy of right versus left hippocampi in PTSD. Psychiatry Res Neuroimag 123, 101–08.Google Scholar
Mohanakrishnan Menon, P, Nasrallah, H A, Reeves, R R and Ali, J A. 2004. Hippocampal dysfunction in gulf war syndrome: A proton MR spectroscopy study. Brain Res 1009, 189–94.Google Scholar
Myslobodsky, M S, Glicksohn, J, Singer, J, et al. 1995. Changes of brain anatomy in patients with posttraumatic stress disorder: A pilot magnetic resonance imaging study. Psychiatry Res 58, 259–64.Google Scholar
Nakano, T, Wenner, M, Inagaki, M, et al. 2002. Relationship between distressing cancer-related recollections and hippocampal volume in cancer survivors. Am J Psychiatry 159, 2087–93.Google Scholar
Pavić, L, Gregurek, R, Radoš, M, et al. 2007. Smaller right hippocampus in war veterans with posttraumatic stress disorder. Psychiatry Res Neuroimag 154, 191–8.Google Scholar
Pederson, C L, Maurer, S H, Kaminski, P L, et al. 2004. Hippocampal volume and memory performance in a community-based sample of women with posttraumatic stress disorder secondary to child abuse. J Traumat Stress 17, 37–40.Google Scholar
Pitman, R K, Shin, L M and Rauch, S L. 2001. Investigating the pathogenesis of posttraumatic stress disorder with neuroimaging. J Clin Psychiatry 62, 47–54.Google Scholar
Rauch, S L, Shin, L M and Phelps, E A. 2006. Neurocircuitry models of posttraumatic stress disorder and extinction: Human neuroimaging research – Past, present, and future. Biol Psychiatry 60, 376–82.Google Scholar
Rauch, S L, Shin, L M, Segal, E, et al. 2003. Selectively reduced regional cortical volumes in post-traumatic stress disorder. NeuroReport 14, 913–6.Google Scholar
Richert, K A, Carrion, V G, Karchemskiy, A and Reiss, A L. 2006. Regional differences of the prefrontal cortex in pediatric PTSD: An MRI study. Depress Anxiety 23, 17–25.Google Scholar
Sapolsky, R M, Uno, H, Rebert, C S and Finch, C E. 1990. Hippocampal damage associated with prolonged glucocorticoid exposure in primates. J Neurosci 10, 2897–902.Google Scholar
Schuff, N, Neylan, T C, Fox-Bosetti, S, et al. 2008. Abnormal N-acetylaspartate in hippocampus and anterior cingulate in posttraumatic stress disorder. Psychiatry Res 162, 147–57.Google Scholar
Schuff, N, Neylan, T C, Lenoci, M A, et al. 2001. Decreased hippocampal N-acetylaspartate in the absence of atrophy in posttraumatic stress disorder. Biol Psychiatry 50, 952–9.Google Scholar
Schwegler, H and Lipp, H P. 1983. Hereditary covariations of neuronal circuitry and behavior: Correlations between the proportions of hippocampal synaptic fields in the regio inferior and two-way avoidance in mice and rats. Behav Brain Res 7, 1–38.Google Scholar
Shin, L M, Shin, P S, Heckers, S, et al. 2004. Hippocampal function in posttraumatic stress disorder. Hippocampus 14, 292–300.Google Scholar
Smith, M A, Makino, S, Kvetnansky, R and Post, R M. 1995. Stress and glucocorticoids affect the expression of brain-derived neurotrophic factor and neurotorphin-3 mRNAs in the hippocampus. J Neurosci 15, 1768–77.Google Scholar
Smith, M E. 2005. Bilateral hippocampal volume reduction in adults with post-traumatic stress disorder: A meta-analysis of structural MRI studies. Hippocampus 15, 798–807.Google Scholar
Stein, M B, Koverola, C, Hanna, C, et al. 1997. Hippocampal volume in women victimized by childhood sexual abuse. Psychol Med 27, 951–9.Google Scholar
Thomas, L A and Bellis, M D. 2004. Pituitary volumes in pediatric maltreatment-related posttraumatic stress disorder. Biol Psychiatry 55, 752–8.Google Scholar
Tupler, L A and Bellis, M D. 2006. Segmented hippocampal volume in children and adolescents with posttraumatic stress disorder. Biol Psychiatry 59, 523–9.Google Scholar
Villarreal, G, Hamilton, D A, Graham, D P, et al. 2004. Reduced area of the corpus callosum in posttraumatic stress disorder. Psychiatry Res Neuroimag 131, 227–35.Google Scholar
Villarreal, G, Hamilton, D A, Petropoulos, H, et al. 2002a. Reduced hippocampal volume and total white matter volume in posttraumatic stress disorder. Biol Psychiatry 52, 119–25.Google Scholar
Villarreal, G, Petropoulos, H, Hamilton, D A, et al. 2002b. Proton magnetic resonance spectroscopy of the hippocampus and occipital white matter in PTSD: Preliminary results. Can J Psychiatry 47, 666–70.Google Scholar
Vythilingam, M, Luckenbaugh, D A, Lam, T, et al. 2005. Smaller head of the hippocampus in Gulf War-related posttraumatic stress disorder. Psychiatry Res Neuroimag 139, 89–99.Google Scholar
Wignall, E L, Dickson, J M, Vaughn, P, et al. 2004. Smaller hippocampal volume in patients with recent-onset posttraumatic stress disorder. Biol Psychiatry 56, 832–6.Google Scholar
Winter, H and Irle, E. 2004. Hippocampal volume in adult burn patients with and without posttraumatic stress disorder. Am J Psychiatry 16, 2194–200.Google Scholar
Woodward, S H, Kaloupek, D G, Streeter, C C, et al. 2006a. Hippocampal volume, PTSD, and alcoholism in combat veterans. Am J Psychiatry 163, 674–81.Google Scholar
Woodward, S H, Kaloupek, D G, Streeter, C C, et al. 2006b. Decreased anterior cingulate volume in combat-related PTSD. Biol Psychiatry 59, 582–7.Google Scholar
Woon, F L and Hedges, D W. 2008. Hippocampal and amygdala volumes in children and adults with childhood maltreatment-related posttraumatic stress disorder: A meta-analysis. Hippocampus 18, 729–36.Google Scholar
Uno, H, Tarara, R, Else, J G, et al. 1989. Hippocampal damage associated with prolonged and fetal stress in primates. J Neurosci 9, 1705–11. Google Scholar
Yamasue, H, Kasai, K, Iwanami, A, et al. 2003. Voxel-based analysis of MRI reveals anterior cingulate gray-matter volume reduction in posttraumatic stress disorder due to terrorism. Proc Natl Acad Sci 100, 9039–43.Google Scholar
Yehuda, R, Golier, J A, Tischler, L, et al. 2007. Hippocampal volume in aging combat veterans with and without post-traumatic stress disorder: Relation to risk and resilience factors. J Psychiatric Res 41, 435–45.Google Scholar

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