Department of Psychiatry, Universitätsmedizin Charité, Chariteplatz 1, Berlin, Germany.
Depress Anxiety. 2013 Mar;30(3):207-16. doi: 10.1002/da.22044. Epub 2013 Jan 14.
Recent reviews and meta-analyses reported structural gray matter changes in patients suffering from adult-onset posttraumatic stress disorder (PTSD) and in subjects with and without PTSD who experienced childhood trauma. However, it remains unclear if such structural changes are also affecting the white matter. The aim of this systematic review is to provide a comprehensive overview of all empirical investigations measuring white matter integrity in populations affected by PTSD and/or childhood trauma. To this end, results from different methodological approaches were included. Twenty-five articles are reviewed of which 10 pertained to pediatric PTSD and the effects of childhood trauma measured during childhood, seven to the effects of childhood trauma measured during adulthood, and eight to adult-onset PTSD. Overall, reductions in white matter volume were reported more often than increases in these populations. However, the heterogeneity of the exact locations indicates only a weak overlap across published studies. In addition, a meta-analysis was carried out on seven whole-brain diffusion tensor imaging (DTI) studies in adults. Significant clusters of both increases and decreases were identified in various structures, most notably the cingulum and the superior longitudinal fasciculus. Future research directions are discussed.
近期的综述和荟萃分析报告了成年创伤后应激障碍（PTSD）患者以及经历过儿童期创伤但无 PTSD 的患者存在结构性灰质变化。然而，目前尚不清楚这些结构性变化是否也会影响白质。本系统综述的目的是全面概述所有测量 PTSD 人群和/或儿童期创伤对白质完整性影响的实证研究。为此，纳入了不同方法学方法的结果。共综述了 25 篇文章，其中 10 篇涉及儿科 PTSD 以及儿童期测量的儿童期创伤的影响，7 篇涉及成年期测量的儿童期创伤的影响，8 篇涉及成年期 PTSD。总体而言，这些人群中报告的白质体积减少比增加更为常见。然而，确切位置的异质性仅表明发表研究之间存在微弱重叠。此外，对 7 项成人全脑弥散张量成像（DTI）研究进行了荟萃分析。在各种结构中均发现了增加和减少的显著集群，尤其是扣带束和上纵束。讨论了未来的研究方向。
