Department of Neurosciences, University of Toledo, Toledo, Ohio.
Department of Psychology, University of Toledo, Toledo, Ohio.
Biol Psychiatry Cogn Neurosci Neuroimaging. 2018 Nov;3(11):968-975. doi: 10.1016/j.bpsc.2017.11.010. Epub 2017 Dec 8.
Smaller hippocampal volume is associated with more severe posttraumatic stress disorder (PTSD) symptoms years after traumatic experiences. Posttraumatic stress symptoms appear early following trauma, but the relationship between hippocampal volume and PTSD symptom severity during early posttrauma periods is not well understood. It is possible that the inverse relationship between hippocampal volume and PTSD symptom severity is already present soon after trauma. To test this possibility, we prospectively examined the association between hippocampal volumes and severity of PTSD symptoms within weeks to months after trauma due to a motor vehicle collision.
Structural magnetic resonance imaging scans of 44 survivors were collected about 2 weeks and again at 3 months after a motor vehicle collision to measure hippocampal volumes. The PTSD Checklist was used to evaluate PTSD symptoms at each scan time. Full (n = 5) or partial (n = 6) PTSD was evaluated using the Clinician-Administered PTSD Scale at 3 months.
Left hippocampal volumes at both time points negatively correlated with PTSD Checklist scores, and with subscores for re-experiencing symptoms at 3 months. Left hippocampal volumes at 3 months also negatively correlated with hyperarousal symptoms at 3 months. Finally, neither left nor right hippocampal volumes significantly changed between 2 weeks and 3 months posttrauma.
The results suggest that small hippocampal volume at early posttrauma weeks is associated with increased risk for PTSD development. Furthermore, the inverse relationship between hippocampal volume and PTSD symptoms at 3 months did not arise from posttrauma shifts in hippocampal volume between 2 weeks and 3 months after trauma.
创伤后数年,较小的海马体积与更严重的创伤后应激障碍(PTSD)症状相关。创伤后早期即出现 PTSD 症状,但海马体积与创伤后早期 PTSD 症状严重程度之间的关系尚不清楚。海马体积与 PTSD 症状严重程度之间的负相关关系可能在创伤后不久就已经存在。为了验证这一可能性,我们前瞻性地研究了由于机动车碰撞后数周至数月内海马体积与 PTSD 症状严重程度之间的关系。
对 44 名幸存者的结构磁共振成像扫描在机动车碰撞后约 2 周和 3 个月进行采集,以测量海马体积。创伤后 PTSD 检查表用于评估每次扫描时的 PTSD 症状。使用临床医生管理 PTSD 量表在 3 个月时评估完全(n=5)或部分(n=6)PTSD。
左海马体积在两个时间点与 PTSD 检查表评分以及 3 个月时的再体验症状评分呈负相关。3 个月时的左海马体积也与 3 个月时的过度警觉症状呈负相关。最后,左、右海马体积在创伤后 2 周和 3 个月之间均无明显变化。
结果表明,创伤后早期几周海马体积较小与 PTSD 发展风险增加有关。此外,3 个月时海马体积与 PTSD 症状之间的负相关关系并非源于创伤后 2 周至 3 个月期间海马体积的变化。