San Francisco Veterans Affairs Medical Center, San Francisco, CA ,CA 94121 United States.
Psychiatry Res. 2011 Aug 30;193(2):93-100. doi: 10.1016/j.pscychresns.2011.01.013. Epub 2011 Jun 16.
The goal of this study was to determine whether posttraumatic stress disorder (PTSD) was associated with an increase in time-related decline in macrostructural brain volume and whether these changes were associated with accelerated cognitive decline. To quantify brain structure, three-dimensional T1-weighted MRI scans were performed at baseline and again after a minimum of 24months in 25 patients with PTSD (PTSD+) and 22 controls (PTSD-). Longitudinal changes in brain volume were measured using deformation morphometry. For the group as a whole, PTSD+ patients did not show significant ongoing brain atrophy compared to PTSD-. PTSD+ patients were then subgrouped into those with decreasing or increasing symptoms. We found little evidence for brain markers of accelerated atrophy in PTSD+ veterans whose symptoms improved over time, with only a small left parietal region showing greater ongoing tissue loss than PTSD-. PTSD patients whose symptoms increased over time showed accelerated atrophy throughout the brain, particularly brainstem and frontal and temporal lobes. Lastly, for the sample as a whole, greater rates of brain atrophy were associated with greater rates of decline in verbal memory and delayed facial recognition.
这项研究的目的是确定创伤后应激障碍（PTSD）是否与宏观结构脑体积的时间相关下降增加有关，以及这些变化是否与认知加速下降有关。为了定量脑部结构，对 25 名 PTSD（PTSD+）患者和 22 名对照（PTSD-）患者进行了三维 T1 加权 MRI 扫描，在基线时进行了一次，在至少 24 个月后又进行了一次。使用变形测量法测量脑容量的纵向变化。对于整个组，与 PTSD-相比，PTSD+患者没有显示出明显的持续脑萎缩。然后，将 PTSD+患者分为症状减轻或加重的亚组。我们发现，随着时间的推移症状改善的 PTSD+退伍军人几乎没有加速萎缩的脑部标志物的证据，只有一小部分左顶叶区域的持续组织损失大于 PTSD-。随着时间的推移症状增加的 PTSD 患者整个大脑都出现了加速萎缩，特别是脑干、额叶和颞叶。最后，对于整个样本，脑萎缩的速度越快，言语记忆和延迟面部识别的下降速度越快。
