Prospective MRI Study of Hippocampal Volume in PTSD-II

描述(由申请人提供)：最近的动物和人体研究表明 这种精神压力可能会损害大脑。减少的海马体体积 在几项创伤后应激障碍的横断面研究中报道。最好的情况是，这种现象 应该进行前瞻性的研究，通过测量相同的大脑结构 在创伤性事件之前或紧随其后的个人，以及再次 在疾病发展后的一段时间内。皮埃尔·S的前瞻性研究 年在哈大沙大学医院进行的创伤后应激障碍的海马体体积研究 耶路撒冷，以色列(提议的项目代表了一个竞争对手 (续)发现患上创伤后应激障碍的创伤幸存者 来自那些没有考虑到他们的海马体体积的人一周 在创伤性事件发生六个月后。这些数据驳斥了一个“弱点” 假说，根据该假说，较小的海马体代表一个危险因素 创伤暴露后的创伤后应激障碍。然而，这些数据并不能确凿地反驳 “习得”假说，因为对海马体的损伤可能不止于 需要六个月的时间来开发。本研究的主要目的是延长随访时间。 通过重新评估四年的海马体体积来评估先前研究的周期 之后，将这些测量结果与一周后获得的结果进行比较。 此外，拟议的研究将评估前额叶的体积 脑叶，这是一个大脑区域，负责调节注意力和执行认知 发现创伤后应激障碍患者的功能受损。前额叶结构异常 已经在其他精神障碍中被报道，但还没有被研究 关于创伤后应激障碍。这项研究将评估创伤后四年的磁力 一周和六个月受试者的脑部磁共振图像 图像已经可用。这些图像将受到体积测量 布里格姆妇产科S医院的海马区和前额叶分析 在波士顿由美国联合派，这一领域的领先者。将对数据进行测试 关于海马体的“习得”假说和“脆弱性” 前额叶的假说。显示先前存在的神经解剖学风险 患有创伤后应激障碍的个体的因素或进行性脑损伤可能 对理解这种疾病有重要的意义， 旨在防止其转变为慢性、 坚持不懈的条件。

DESCRIPTION (provided by applicant): Recent animal and human studies suggest that mental stress may damage the brain. Reduced hippocampal volume has been reported in several cross-sectional studies of PTSD. Optimally, this phenomenon should be studied prospectively, by measuring brain structures in the same individuals prior to, or immediately following, the traumatic event, and again some time after the development of the disorder. The PI?s prospective study of hippocampal volume in PTSD performed at Hadassah University Hospital in Jerusalem, Israel (of which the proposed project represents a competing continuation) found that trauma survivors who developed PTSD did not differ from those who do not with regard to the volume of their hippocampi one week and six months after the traumatic event. These data refute a "vulnerability" hypothesis, according to which smaller hippocampi represent a risk factor for PTSD upon traumatic exposure. However, these data do not definitively refute an "acquisition" hypothesis, because damage to the hippocampus may take more than six months to develop. The main goal of this study is to extend the follow-up period of the previous study by re-evaluating hippocampal volume four years later and comparing these measurements with those obtained at one week. Additionally, the proposed study will evaluate the volume of the prefrontal lobe, which is a brain area that mediates attention and executive cognitive functions found to be impaired in PTSD. Prefrontal structural abnormalities have been reported in other mental disorders but have not yet been studied with regard to PTSD. The study will evaluate four-year post-trauma magnetic resonance (MR) images of the brain in subjects for whom one-week and six-month images are already available. These images will be subjected to volumetric analyses of hippocampus and prefrontal lobe at the Brigham and Women?s Hospital in Boston by the US co-PI, a leader in this field. The data will be tested regarding the "acquisition" hypothesis for hippocampus, and the "vulnerability" hypotheses for prefrontal lobe. Demonstrating pre-existing neuroanatomic risk factors, or progressive damage to the brain, in individuals with PTSD could have important implications for understanding the disorder, and for interventions aimed at preventing its transformation into a chronic, unremitting condition.