Jatzko A, Rothenhöfer S, Schmitt A, Gaser C, Demirakca T, Weber-Fahr W, Wessa M, Magnotta V, Braus D F
Central Institute of Mental Health, Faculty for Clinical Medicine Mannheim, University of Heidelberg, Germany.
J Affect Disord. 2006 Aug;94(1-3):121-6. doi: 10.1016/j.jad.2006.03.010. Epub 2006 May 15.
The hippocampus is discussed as one of the key regions in the pathogenesis of Posttraumatic Stress Disorder (PTSD). MRI results concerning the volume of the hippocampus are, however, inconsistent. This may be due to the heterogeneity of patients' traumata or postprocessing of the imaging data. To overcome these problems, the present study investigates volume changes in well-characterized chronic PTSD patients in comparison to controls using two different evaluation methods.
15 patients with chronic PTSD, traumatized at the same air show plane crash in 1988 (Ramstein, Germany), and 15 matched healthy controls participated in this study. All patients suffered from significant impairment by the PTSD; none had a history of drug or alcohol abuse. Hippocampus volume changes were processed by a semi-automated standard procedure performed with BRAINS2 as well as the voxel based morphometry (VBM) using SPM2.
No differences in total brain grey or white matter were detected between patients and controls. No differences in total hippocampal volume or in right and left parts were seen, even when hippocampal volumes were corrected by total brain volume or correlated with clinical data. Finally, no significant differences were detected between patients and controls in hippocampal regions using VBM.
This is the first study examining long-term changes in hippocampal volumes in chronic PTSD patients compared to matched controls using two different evaluation methods. Neither conventional volumetry nor VBM could detect any differences in the volume and structure. This supports the hypothesis that previously described hippocampal volume reduction is not necessarily due to PTSD or at least that, after 15 years, volume changes have been restored or have not yet developed.
海马体被认为是创伤后应激障碍（PTSD）发病机制中的关键区域之一。然而，关于海马体体积的MRI结果并不一致。这可能是由于患者创伤的异质性或成像数据的后处理。为了克服这些问题，本研究使用两种不同的评估方法，调查了特征明确的慢性PTSD患者与对照组相比的体积变化。
15名慢性PTSD患者参与了本研究，他们于1988年在同一次航展飞机失事中（德国拉姆施泰因）受到创伤，另有15名匹配的健康对照。所有患者均因PTSD而有明显损伤；均无药物或酒精滥用史。海马体体积变化通过使用BRAINS2执行的半自动标准程序以及使用SPM2的基于体素的形态计量学（VBM）进行处理。
患者与对照组之间未检测到全脑灰质或白质的差异。即使海马体体积通过全脑体积校正或与临床数据相关，也未发现总海马体体积或左右部分存在差异。最后，使用VBM在患者与对照组的海马体区域未检测到显著差异。
这是第一项使用两种不同评估方法，比较慢性PTSD患者与匹配对照组海马体体积长期变化 的研究。传统体积测量法和VBM均未检测到体积和结构上的任何差异。这支持了以下假设，即先前描述的海马体体积减小不一定是由PTSD导致的，或者至少在15年后，体积变化已经恢复或尚未出现。
