Yamasue H, Kasai K, Iwanami A, Ohtani T, Yamada H, Abe O, Kuroki N, Fukuda R, Tochigi M, Furukawa S, Sadamatsu M, Sasaki T, Aoki S, Ohtomo K, Asukai N, Kato N
Department of Neuropsychiatry and Radiology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Proc Natl Acad Sci U S A. 2003 Jul 22;100(15):9039-43. doi: 10.1073/pnas.1530467100. Epub 2003 Jul 9.
MRI studies using the manual tracing method have shown a smaller-than-normal hippocampal volume in patients with posttraumatic stress disorder (PTSD). However, these studies have yielded inconsistent results, and brain structures other than the hippocampus have not been well investigated. A recently developed, fully automated method called voxel-based morphometry enables an exploration of structural changes throughout the brain by applying statistical parametric mapping to high-resolution MRI. Here we first used this technology in patients with PTSD. Participants were 9 victims of the Tokyo subway sarin attack with PTSD and 16 matched victims of the same traumatic event without PTSD. The voxel-based morphometry showed a significant gray-matter volume reduction in the left anterior cingulate cortex (ACC) in trauma survivors with PTSD compared with those without PTSD. The severity of the disorder was negatively correlated with the gray-matter volume of the left ACC in PTSD subjects. There were no significant differences in other gray-matter regions or any of the white-matter regions between two groups. The present study demonstrates evidence for structural abnormalities of ACC in patients with PTSD. Together with previous functional neuroimaging studies showing a dysfunction of this region, the present findings provide further support for the important role of ACC, which is pivotally involved in attention, emotional regulation, and conditioned fear, in the pathology of PTSD.
使用手动追踪法的MRI研究表明，创伤后应激障碍（PTSD）患者的海马体体积小于正常水平。然而，这些研究结果并不一致，并且海马体以外的脑结构尚未得到充分研究。一种最近开发的名为基于体素的形态测量学的全自动方法，通过将统计参数映射应用于高分辨率MRI，能够探索全脑的结构变化。在此，我们首次将这项技术应用于PTSD患者。参与者包括9名患有PTSD的东京地铁沙林袭击受害者以及16名匹配的同一创伤事件受害者，后者未患PTSD。基于体素的形态测量学显示，与未患PTSD的创伤幸存者相比，患有PTSD的创伤幸存者左侧前扣带回皮质（ACC）灰质体积显著减少。在PTSD受试者中，该障碍的严重程度与左侧ACC的灰质体积呈负相关。两组之间在其他灰质区域或任何白质区域均无显著差异。本研究证明了PTSD患者ACC存在结构异常的证据。结合先前显示该区域功能障碍的功能性神经影像学研究，本研究结果进一步支持了ACC在PTSD病理学中所起的重要作用，ACC在注意力、情绪调节和条件性恐惧中起关键作用。
