Posttraumatic stress symptom persistence across 24 years: association with brain structures
Posttraumatic stress symptom persistence across 24 years: association with brain structures
复制标题
DOI：
10.1007/s11682-019-00059-x
复制
发表时间：
2020-08-01
影响因子：
3.2
通讯作者：
Kremen, William S.
中科院分区：
文献类型：
--
作者：
Franz, Carol E.;Hatton, Sean N.;Kremen, William S.
众所周知，创伤后应激障碍（PTSD）持续存在，引发早期医疗合并症，并加速衰老。虽然已经发现PTSD诊断与多个脑区体积较小有关，但创伤后应激（PTS）症状及其与脑形态测量学的关系很少在长时间内进行评估。我们预测，持续24年的PTS症状与中老年海马、杏仁核、前扣带体积和海马占用（HOC =海马体积/[海马体积+下侧脑室体积]）呈负相关。探索性分析检查了前额叶区域。我们评估了247名平均年龄为38岁（第一次）和62岁（第二次）的男性的PTS症状。所有人都在时间1之前受到过创伤。在时间2使用3t结构磁共振成像评估脑容量。症状随时间相关（r = 0.46p < 0.0001）。随着时间的推移，较高的PTS症状和时间1时的症状均与海马、杏仁核、吻侧额叶中回（MFG）和内侧眶额皮质（OFC）体积降低以及时间2时较低的HOC比率相关。从时间1到时间2，PTS症状增加与海马体积减小有关。在排除PTSD诊断阈值以上的个体后，海马、吻侧MFG和内侧OFC的结果仍然显著。即使在亚诊断阈值水平，创伤暴露后数十年PTS症状仍存在，与调节应激反应和适应的大脑区域高度相关的结构缺陷并行。
Posttraumatic stress disorder (PTSD) is known to persist, eliciting early medical co-morbidity, and accelerated aging. Although PTSD diagnosis has been found to be associated with smaller volume in multiple brain regions, posttraumatic stress (PTS) symptoms and their associations with brain morphometry are rarely assessed over long periods of time. We predicted that persistent PTS symptoms across similar to 24 years would be inversely associated with hippocampal, amygdala, anterior cingulate volumes, and hippocampal occupancy (HOC = hippocampal volume/[hippocampal volume + inferior lateral ventricle volume]) in late middle age. Exploratory analyses examined prefrontal regions. We assessed PTS symptoms in 247 men at average ages 38 (time 1) and 62 (time 2). All were trauma-exposed prior to time 1. Brain volumes were assessed at time 2 using 3 T structural magnetic resonance imaging. Symptoms were correlated over time (r = 0.46p < .0001). Higher PTS symptoms averaged over time and symptoms at time 1 were both associated with lower hippocampal, amygdala, rostral middle frontal gyrus (MFG), and medial orbitofrontal cortex (OFC) volumes, and a lower HOC ratio at time 2. Increased PTS symptomatology from time 1 to time 2 was associated with smaller hippocampal volume. Results for hippocampal, rostral MFG and medial OFC remained significant after omitting individuals above the threshold for PTSD diagnosis. Even at sub-diagnostic threshold levels, PTS symptoms were present decades after trauma exposure in parallel with highly correlated structural deficits in brain regions regulating stress responsivity and adaptation.