Longitudinal MRI study of hippocampal volume in trauma survivors with PTSD.

OBJECTIVE The authors prospectively explored whether a reduction in the volume of the hippocampus occurs in recent trauma survivors who develop posttraumatic stress disorder (PTSD). METHOD Thirty-seven survivors of traumatic events were assessed within a week of the traumatic event and 6 months later. The assessment included magnetic resonance imaging of the brain (including 124 coronal slices of 1.5-mm thickness), psychometric testing, and structured clinical interviews. The Clinician-Administered PTSD Scale conferred PTSD diagnoses at 6 months. RESULTS Ten subjects (27%) had PTSD at 6 months. The subjects with PTSD did not differ from those without PTSD in hippocampal volume (right or left) at 1 week or 6 months. There was no reduction in hippocampal volume in the PTSD subjects between 1 week and 6 months. CONCLUSIONS Smaller hippocampal volume is not a necessary risk factor for developing PTSD and does not occur within 6 months of expressing the disorder. This brain abnormality might occur in individuals with chronic or complicated PTSD.

[1]  R. Kikinis,et al.  Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder , 1996, Biological Psychiatry.

[2]  A. Taylor,et al.  The impact of severity of physical injury and perception of life threat in the development of post-traumatic stress disorder in motor vehicle accident victims. , 1995, Behaviour research and therapy.

[3]  Lynda A. King,et al.  The civilian version of the Mississippi PTSD Scale: A psychometric evaluation , 1995, Journal of traumatic stress.

[4]  S. Orr,et al.  Prospective study of posttraumatic stress disorder and depression following trauma. , 1998, The American journal of psychiatry.

[5]  M. Keshavan,et al.  A.E. Bennett Research Award. Developmental traumatology. Part II: Brain development. , 1999, Biological psychiatry.

[6]  B. McEwen Stress and the Aging Hippocampus , 1999, Frontiers in Neuroendocrinology.

[7]  J. Vasterling,et al.  Attention and memory dysfunction in posttraumatic stress disorder. , 1998, Neuropsychology.

[8]  B. Turetsky,et al.  Temporolimbic volume reductions in schizophrenia. , 2000, Archives of general psychiatry.

[9]  R. Sapolsky,et al.  Hippocampal damage associated with prolonged and fatal stress in primates , 1989, The Journal of neuroscience : the official journal of the Society for Neuroscience.

[10]  Bruce S. McEwen,et al.  Repeated stress causes reversible impairments of spatial memory performance , 1994, Brain Research.

[11]  B. J. Casey,et al.  Developmental traumatology part II: brain development∗ ∗ See accompanying Editorial, in this issue. , 1999, Biological Psychiatry.

[12]  R. Bronen,et al.  Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse—a preliminary report , 1997, Biological Psychiatry.

[13]  B. McEwen,et al.  Chronic Psychosocial Stress Causes Apical Dendritic Atrophy of Hippocampal CA3 Pyramidal Neurons in Subordinate Tree Shrews , 1996, The Journal of Neuroscience.

[14]  B. McEwen Stress and hippocampal plasticity. , 1999, Annual review of neuroscience.

[15]  B. McEwen,et al.  Stress Effects on Morphology and Function of the Hippocampus a , 1997, Annals of the New York Academy of Sciences.

[16]  T. Keane,et al.  Mississippi Scale for Combat-Related Posttraumatic Stress Disorder: three studies in reliability and validity. , 1988, Journal of consulting and clinical psychology.

[17]  E. Fuchs,et al.  Stress, glucocorticoids and structural plasticity of the hippocampus , 1998, Neuroscience & Biobehavioral Reviews.

[18]  B. Stamm Measurement of stress, trauma, and adaptation , 1996 .

[19]  S. Southwick,et al.  MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. , 1995, The American journal of psychiatry.

[20]  J. Vasterling,et al.  Memory and attention in combat-related post-traumatic stress disorder (PTSD) , 1993 .

[21]  D. Charney,et al.  The development of a Clinician-Administered PTSD Scale , 1995, Journal of traumatic stress.

[22]  D. Hommer,et al.  Hippocampal volume in patients with alcohol dependence. , 1999, Archives of general psychiatry.

[23]  M. Stein,et al.  Hippocampal volume in women victimized by childhood sexual abuse , 1997, Psychological Medicine.

[24]  S. Orr,et al.  Lower precombat intelligence is a risk factor for posttraumatic stress disorder. , 1998, Journal of consulting and clinical psychology.

[25]  James R MacFall,et al.  Hippocampal volume in geriatric depression , 2000, Biological Psychiatry.

[26]  M. LeMay,et al.  Abnormalities of the left temporal lobe and thought disorder in schizophrenia. A quantitative magnetic resonance imaging study. , 1992, The New England journal of medicine.