Articlegold2017

The Association of PTSD Symptom Severity With Localized Hippocampus and Amygdala Abnormalities

Teddy J. Akiki · Christopher L. Averill · Kristen M. Wrocklage · Brian C. Schweinsburg · James Cobb Scott · Brenda L. Martini +4 more

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Posttraumatic Stress Disorder Research Memory and Neural Mechanisms Traumatic Brain Injury Research

Abstract

BACKGROUND: The hippocampus and amygdala have been repeatedly implicated in the psychopathology of posttraumatic stress disorder (PTSD). While numerous structural neuroimaging studies examined these two structures in PTSD, these analyses have largely been limited to volumetric measures. Recent advances in vertex-based neuroimaging methods have made it possible to identify specific locations of subtle morphometric changes within a structure of interest. METHODS: In this cross-sectional study, we used high-resolution magnetic resonance imaging to examine the relationship between PTSD symptomatology, as measured using the Clinician Administered PTSD Scale for the DSM-IV (CAPS), and structural shape of the hippocampus and amygdala using vertex-wise shape analyses in a group of combat-exposed US Veterans (N = 69). RESULTS: Following correction for multiple comparisons and controlling for age and cranial volume, we found that participants with more severe PTSD symptoms showed an indentation in the anterior half of the right hippocampus and an indentation in the dorsal region of the right amygdala (corresponding to the centromedial amygdala). Post hoc analysis using stepwise regression suggest that among PTSD symptom clusters, arousal symptoms explain most of the variance in the hippocampal abnormality, whereas re-experiencing symptoms explain most of the variance in the amygdala abnormality. CONCLUSION: The results provide evidence of localized abnormalities in the anterior hippocampus and centromedial amygdala in combat-exposed US Veterans suffering from PTSD symptoms. This novel finding provides a more fine-grained analysis of structural abnormalities in PTSD and may be informative for understanding the neurobiology of the disorder.

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2005Lifetime Prevalence and Age-of-Onset Distributions of DSM-IV Disorders in the National Comorbidity Survey Replication 1996Beck Depression Inventory–II 1995The development of a Clinician-Administered PTSD Scale 2006Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research.2009The Neurocircuitry of Fear, Stress, and Anxiety Disorders 2012Biological studies of post-traumatic stress disorder 1989Clinical evaluation of a measure to assess combat exposure.2006A meta-analysis of structural brain abnormalities in PTSD

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