Post-traumatic stress symptoms correlate with smaller subgenual cingulate, caudate, and insula volumes in unmedicated combat veterans.
Post-traumatic stress symptoms correlate with smaller subgenual cingulate, caudate, and insula volumes in unmedicated combat veterans.
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DOI：
10.1016/j.pscychresns.2012.02.005
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发表时间：
2012-08
影响因子：
11.3
通讯作者：
Germain A
中科院分区：
文献类型：
--
作者：
Herringa R;Phillips M;Almeida J;Insana S;Germain A
先前的研究已经检查了PTSD和对照组之间脑容量的差异。共同的发现包括较小的海马和内侧前额叶皮质体积在创伤后应激障碍。然而，创伤后应激障碍（PTSS）存在于一个频谱上，并且神经变化可能发生在PTSD的诊断阈值之外。我们研究了PTSS和灰质之间的关系在战斗暴露的美国退伍军人。结构脑MRI获得了28名战斗退伍军人从持久行动和伊拉克自由。PTSS采用临床医生管理PTSD量表（CAPS）进行评估。13名受试者符合PTSD标准。受试者未接受药物治疗，且无重大共病精神疾病。使用基于体素的形态测量法分析图像，并对总CAPS评分和创伤负荷进行回归。随后通过PTSD与非PTSD的诊断来分析图像。CAPS评分与膝下扣带回（sgACC）、尾状核、下丘脑、小脑和左颞中回（MTG）呈负相关。组间对比显示，PTSD组的sgACC、尾状核、下丘脑、左丘脑、左MTG和右MFG较小。PTSS与边缘系统结构异常有关，边缘系统结构异常可能是PTSD病理生理学的基础。这些异常存在于PTSS的连续体上，超出了PTSD的诊断。
Prior studies have examined differences in brain volume between PTSD and control subjects. Convergent findings include smaller hippocampus and medial prefrontal cortex volumes in PTSD. However, post-traumatic stress symptoms (PTSS) exist on a spectrum, and neural changes may occur beyond the diagnostic threshold of PTSD. We examined the relationship between PTSS and gray matter among combat-exposed U.S. military veterans. Structural brain MRI was obtained on 28 combat veterans from Operations Enduring and Iraqi Freedom. PTSS were assessed using the Clinician-Administered PTSD Scale (CAPS). Thirteen subjects met criteria for PTSD. Subjects were unmedicated, and free of major comorbid psychiatric disorders. Images were analyzed using voxel-based morphometry, and regressed against the total CAPS score and trauma load. Images were subsequently analyzed by diagnosis of PTSD vs. non-PTSD. CAPS scores were inversely correlated with subgenual cingulate (sgACC), caudate, hypothalamus, insula, and left middle temporal gyrus (MTG). Group contrast revealed smaller sgACC, caudate, hypothalamus, left insula, left MTG, and right MFG in the PTSD group. PTSS are associated with abnormalities in limbic structures that may underlie the pathophysiology of PTSD. These abnormalities exist on a continuum with PTSS, beyond a diagnosis of PTSD.