Bossini Letizia, Tavanti Maricla, Calossi Sara, Lombardelli Alessia, Polizzotto Nicola Riccardo, Galli Rosita, Vatti Gianpaolo, Pieraccini Fulvio, Castrogiovanni Paolo
Department of Neuroscience, University of Siena School of Medicine, Viale Bracci 1, 53100 Siena, Italy.
J Psychiatr Res. 2008 Jul;42(9):752-62. doi: 10.1016/j.jpsychires.2007.08.004. Epub 2007 Sep 24.
Most brain imaging studies have showed smaller hippocampal volume in adults with chronic PTSD; however, some other studies have not replicated this finding. Most of these investigations included subjects with other psychiatric comorbidities, such as major depression or alcohol abuse. The prevalence of psychiatric comorbidities in PTSD is generally high and this makes it difficult, if not impossible, to disentangle the contribution of other disorders to hippocampal volume. Therefore, the main goal of the current study is to compare hippocampal volumes of healthy subjects and drug-naïve patients with PTSD caused by different types of mixed civilian traumas (i.e. car accident, physical abuse, sudden death of a family member, assault or robbery, natural disaster and traumatic abortion) and without comorbidity conditions. Magnetic resonance imaging (MRI) was used to measure the hippocampi, total cerebrum, gray matter, white matter and cerebrospinal fluid volumes in 34 patients with single diagnosis of PTSD, and 34 case-matched non-PTSD comparison subjects. The patients with single diagnosis of PTSD had an 11.8% smaller left hippocampus (p<0.001) and an 8.7% smaller right hippocampus (p=0.003) than the healthy controls. The results were controlled for the total brain volume and for gray matter volumes. Subjects with PTSD also displayed lower overall gray matter volume (p=0.006). There were no significant correlations between hippocampal volumes and illness duration or severity of PTSD. The findings indicate the presence of smaller hippocampal volumes in drug-naïve patients with single diagnosis of PTSD, compared with healthy subjects.
大多数脑成像研究表明，患有慢性创伤后应激障碍（PTSD）的成年人海马体体积较小；然而，其他一些研究并未重复这一发现。这些研究大多纳入了患有其他精神疾病共病的受试者，如重度抑郁症或酒精滥用。PTSD患者中精神疾病共病的发生率普遍较高，这使得即便不是不可能，也很难厘清其他疾病对海马体体积的影响。因此，本研究的主要目的是比较健康受试者与未服用过药物、因不同类型的混合性平民创伤（即车祸、身体虐待、家庭成员猝死、袭击或抢劫、自然灾害和创伤性流产）导致PTSD且无共病情况的患者的海马体体积。采用磁共振成像（MRI）测量了34例单纯诊断为PTSD的患者以及34例匹配的非PTSD对照受试者的海马体、全脑、灰质、白质和脑脊液体积。单纯诊断为PTSD的患者左侧海马体比健康对照组小11.8%（p<0.001），右侧海马体小8.7%（p=0.003）。研究结果对全脑体积和灰质体积进行了校正。PTSD患者的总体灰质体积也较低（p=0.006）。海马体体积与PTSD的病程或严重程度之间无显著相关性。研究结果表明，与健康受试者相比，未服用过药物、单纯诊断为PTSD的患者海马体体积较小。
