Amygdala volume changes in posttraumatic stress disorder in a large case-controlled veterans group.
Amygdala volume changes in posttraumatic stress disorder in a large case-controlled veterans group.
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DOI：
10.1001/archgenpsychiatry.2012.50
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发表时间：
2012-11
影响因子：
--
通讯作者：
Mid-Atlantic MIRECC Workgroup
中科院分区：
文献类型：
--
作者：
Morey RA;Gold AL;LaBar KS;Beall SK;Brown VM;Haswell CC;Nasser JD;Wagner HR;McCarthy G;Mid-Atlantic MIRECC Workgroup
创伤后应激障碍（PTSD）的海马体积较小，但相对较少的PTSD杏仁核体积的研究产生了模棱两可的结果。评估一个大型队列的近期退伍军人，与创伤后应激障碍和创伤暴露的控制，有足够的权力，以明确评估创伤后应激障碍的影响，在杏仁核和海马体的体积变化，以及疾病的持续时间，创伤负荷和抑郁症状的贡献。病例对照设计，包括结构MRI和临床诊断评估。对酒精使用、抑郁和药物使用的重要潜在混淆进行了统计学控制。达勒姆VA医疗中心位于北卡罗来纳州（美国）中部，靠近主要军事基地。非卧床患者（n=200），从2001年9月11日之后服役的军人和退伍军人登记处招募，包括当前PTSD组（n=99）和无PTSD的创伤暴露对照组（n=101）。杏仁核和海马体积计算自动分割的高分辨率结构MRI在3特斯拉。与非PTSD组相比，PTSD组左杏仁核（p = .002）、右杏仁核（p = .01）和左海马（p = .02）的体积较小，但右海马（p = .25）没有。杏仁核体积与PTSD慢性化、创伤负荷或抑郁症状的严重程度无关。这些结果为较小的杏仁核体积与PTSD之间的关联提供了明确的证据。创伤负荷或疾病慢性化与杏仁核体积之间缺乏相关性表明，较小的杏仁核代表了发展PTSD的脆弱性，或者与杏仁核体积缺乏剂量反应关系。我们的研究结果可能会引发新的动力，研究杏仁核的结构差异，其遗传决定因素，环境调节剂，以及它反映PTSD内在脆弱性的可能性。
Smaller hippocampal volumes are well established in posttraumatic stress disorder (PTSD), but the relatively few studies of amygdala volume in PTSD have produced equivocal results. To assess a large cohort of recent military veterans, with PTSD and trauma-exposed controls, with sufficient power to definitively assess the effect of PTSD on volumetric changes in the amygdala and hippocampus, as well as the contribution of illness duration, trauma load, and depressive symptoms. Case-controlled design with structural MRI and clinical diagnostic assessments. Important potential confounds of alcohol use, depression, and medication use were statistically controlled. Durham VA Medical Center located in central North Carolina (USA) in proximity to major military bases. Ambulatory patients (n=200), recruited from a registry of military service members and veterans serving after 11-September 2001, consisting of a group with current PTSD (n=99) and trauma-exposed comparison group without PTSD (n=101). Amygdala and hippocampus volumes computed from automated segmentation of high-resolution structural MRI acquired at 3 Tesla. Smaller volume was demonstrated in the PTSD compared to non-PTSD groups for the left amygdala (p = .002), right amygdala (p = .01), and left hippocampus (p = .02), but not for the right hippocampus (p = .25). Amygdala volumes were not associated with PTSD chronicity, trauma load, or severity of depressive symptoms. These results provide clear evidence of an association between smaller amygdala volume and PTSD. The lack of correlation between trauma load or illness chronicity and amygdala volume suggests that either a smaller amygdala represents a vulnerability to developing PTSD, or the lack of a dose-response relationship with amygdala volume. Our results may trigger a renewed impetus for investigating structural differences in the amygdala, its genetic determinants, its environmental modulators, and the possibility that it reflects an intrinsic vulnerability to PTSD.
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影响因子：
5.3
作者：
Anglada-Figueroa, D;Quirk, GJ
通讯作者：
Quirk, GJ
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作者：
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作者：
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Ryan, ND
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作者：
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通讯作者：
Egan, GF
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作者：
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通讯作者：
Pitman, RK