Emdad Reza, Bonekamp David, Sondergaard Hans Peter, Bjorklund Tomas, Agartz Ingrid, Ingvar Martin, Theorell Tores
Karolinska Institute, and National Institute for Psychosocial Medicine, Stockholm, Sweden.
Psychother Psychosom. 2006;75(2):122-32. doi: 10.1159/000090897.
Hippocampal decrease in size in response to posttraumatic stress disorder (PTSD) is still a subject of controversy. The aims of this study were to: (1) confirm previous hippocampus findings in PTSD patients compared to controls, using ethnically similar study groups where alcohol and drug abuse were non-existent; (2) test influence of disease duration as well as depression scores on possible morphological changes; (3) test whether the voxel-based morphometry (VBM) data confirm the group differences seen in the region of interest (ROI) analysis, and (4) test the associations between the cognitive test scores and the morphological changes.
VBM and ROI-based analysis were applied in 23 patients and 17 healthy controls. Culture-neutral cognitive tests were used.
The ROI-based method showed significantly decreased gray matter volumes for global hippocampal volume, as in a separate analysis of left and right sides in the PTSD group. Total volume of the hippocampus was significantly decreased on the left side, as in the global assessment. A multiple regression VBM model showed significant voxel clusters for group affiliation in the right hippocampus, modelling lowering of gray matter associated with the PTSD group. Disease duration was shown to be negatively correlated to bilateral hippocampal volume and high depression score to bilateral gray matter parahippocampal volume. No significant correlations were found between hippocampal or parahippocampal volumes and cognitive functions.
The present and previous studies showed that morphologic differences do not appear to be due to drug or alcohol abuse. The VBM data partially confirm the group differences seen in the ROI-based method in the medial temporal lobe. The fact that the significantly lower score on the short-term memory test in the PTSD group is not correlated to hippocampal volume may suggest a more general basis for such memory impairment.
创伤后应激障碍（PTSD）患者海马体体积减小仍是一个存在争议的话题。本研究的目的是：（1）在不存在酒精和药物滥用的种族相似研究组中，与对照组相比，确认PTSD患者先前的海马体研究结果；（2）测试疾病持续时间以及抑郁评分对可能的形态学变化的影响；（3）测试基于体素的形态计量学（VBM）数据是否证实了在感兴趣区域（ROI）分析中看到的组间差异，以及（4）测试认知测试分数与形态学变化之间的关联。
对23名患者和17名健康对照者应用了VBM和基于ROI的分析。使用了与文化无关的认知测试。
基于ROI的方法显示，PTSD组的整体海马体体积灰质体积显著减少，左侧和右侧的单独分析也是如此。如整体评估所示，左侧海马体的总体积显著减少。多元回归VBM模型显示右侧海马体中存在与组归属相关的显著体素簇，模拟了与PTSD组相关的灰质降低。疾病持续时间与双侧海马体体积呈负相关，高抑郁评分与双侧海马旁灰质体积呈负相关。未发现海马体或海马旁体积与认知功能之间存在显著相关性。
目前和先前的研究表明，形态学差异似乎不是由药物或酒精滥用引起的。VBM数据部分证实了基于ROI的方法在颞叶内侧观察到的组间差异。PTSD组在短期记忆测试中得分显著较低与海马体体积无关这一事实可能表明这种记忆损害有更普遍的基础。
