Hippocampal volume differences in Gulf War veterans with current versus lifetime posttraumatic stress disorder symptoms.
Hippocampal volume differences in Gulf War veterans with current versus lifetime posttraumatic stress disorder symptoms.
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DOI：
10.1016/j.biopsych.2010.09.044
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发表时间：
2011-03-15
影响因子：
10.6
通讯作者：
Neylan TC
中科院分区：
文献类型：
--
作者：
Apfel BA;Ross J;Hlavin J;Meyerhoff DJ;Metzler TJ;Marmar CR;Weiner MW;Schuff N;Neylan TC
海马体积减少在创伤后应激障碍（PTSD）和抑郁症中有描述。然而，目前尚不清楚它是否是PTSD发展的风险因素或PTSD的后果。我们试图确定创伤后应激障碍和抑郁症状对海马体积的影响。临床和磁共振成像数据收集在一个横断面研究的244海湾战争退伍军人。测量指标包括终生和当前临床医生管理的PTSD量表、汉密尔顿抑郁量表、生活压力源检查表和终生饮酒史。磁共振成像数据采集与1.5 T扫描仪和分析与自动和半自动图像处理技术。82名退伍军人患有终生创伤后应激障碍，44名患有当前创伤后应激障碍，38名患有当前抑郁症。在线性回归分析中，目前的PTSD症状（标准化系数β =-0.25，p = 0.03），但无论是终生的PTSD症状还是目前的抑郁症，都与海马体积较小有关。性别、年龄、早期生活创伤史、教育、终生和当前饮酒、当前大麻使用和抗抑郁药治疗没有独立影响。与缓解的PTSD患者相比，慢性PTSD患者的海马体平均较小。当前而不是终生PTSD症状严重程度解释海马大小的发现提出了两种可能性：小海马是缺乏从PTSD恢复的风险因素（特质），或者一旦PTSD症状缓解并且患者恢复（状态），PTSD对海马体积的影响是可逆的。
Decreased hippocampal volume is described in posttraumatic stress disorder (PTSD) and depression. However, it is not known whether it is a risk factor for the development of PTSD or a consequence of PTSD. We sought to determine the effects of PTSD and depressive symptoms on hippocampal volume. Clinical and magnetic resonance imaging data were collected in a cross sectional study of 244 Gulf War veterans. Measures included lifetime and current Clinician Administered PTSD Scale, Hamilton Depression Scale, Life Stressor Checklist, and Lifetime Drinking History. Magnetic resonance imaging data were acquired with a 1.5-T scanner and analyzed with automated and semiautomated image processing techniques. Eighty-two veterans had lifetime PTSD, 44 had current PTSD, and 38 had current depression. In the linear regression analysis, current PTSD symptoms (standardized coefficient β = −.25, p = .03) but neither lifetime PTSD symptoms nor current depression were associated with smaller hippocampal volume. Gender, age, history of early life trauma, education, lifetime and current alcohol use, current marijuana use, and treatment with antidepressants did not have independent effects. Participants with chronic PTSD had, on average, a smaller hippocampus compared with those with remitted PTSD. The finding that current but not lifetime PTSD symptom severity explains hippocampal size raises two possibilities: either a small hippocampus is a risk factor for lack of recovery from PTSD (trait) or PTSD effects on hippocampal volume are reversible once PTSD symptoms remit and the patient recovers (state).