Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Department of Neurology, Columbia University Medical Center, USA.
Taub Institute for Research on Alzheimer's Disease and the Aging Brain, G.H. Sergievsky Center, Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, USA.
J Psychiatr Res. 2021 May;137:368-375. doi: 10.1016/j.jpsychires.2021.03.015. Epub 2021 Mar 17.
Posttraumatic Stress Disorder (PTSD) is an increasingly prevalent condition among older adults and may escalate further as the general population including veterans from recent conflicts grow older. Despite growing evidence of higher medical comorbidity, cognitive impairment and dementia, and disability in older individuals with PTSD, there are very few studies examining brain cortical structure in this population. Hence, we examined cortical volumes in a cross-sectional study of veterans and civilians aged ≥50 years, of both sexes and exposed to trauma (interpersonal, combat, non-interpersonal).
Cortical volumes were obtained from T1-weighted structural MRI and compared between individuals with PTSD and Trauma Exposed Healthy Controls (TEHC) adjusting for age, sex, estimated intracranial volume, depression severity, and time elapsed since trauma exposure.
The PTSD group (N = 55) had smaller right parahippocampal gyrus compared to TEHC (N = 36), corrected p(p) = 0.034, with an effect size of 0.75 (Cohen's d), with no significant group differences in other cortical areas.
These findings are different from the structural brain findings reported in studies in younger age groups (larger parahippocampal volume in PTSD patients), suggesting a possible significant change in brain structure as PTSD patients age. These results need replication in longitudinal studies across the age-span to test whether they are neuroanatomical markers representing disease vulnerability, trauma resilience or pathological neurodegeneration associated with cognitive impairment and dementia.
创伤后应激障碍（PTSD）在老年人中越来越普遍，随着包括最近冲突中的退伍军人在内的老年人口的增加，这种情况可能会进一步加剧。尽管越来越多的证据表明 PTSD 老年患者的合并症、认知障碍和痴呆症以及残疾的发生率更高，但很少有研究检查该人群的大脑皮质结构。因此，我们在一项横断面研究中检查了≥50 岁的退伍军人和平民的皮质体积，这些人都经历过创伤（人际、战斗、非人际）。
从 T1 加权结构 MRI 中获得皮质体积，并在调整年龄、性别、估计脑容量、抑郁严重程度和创伤暴露后时间的情况下，比较 PTSD 患者和创伤暴露健康对照组（TEHC）之间的个体皮质体积。
与 TEHC（N=36）相比，PTSD 组（N=55）的右侧海马旁回体积较小，校正后 p（p）=0.034，效应量为 0.75（Cohen's d），其他皮质区域无显著组间差异。
这些发现与在年轻年龄组中报告的结构脑发现不同（PTSD 患者的海马旁回体积更大），这表明随着 PTSD 患者年龄的增长，大脑结构可能发生显著变化。这些结果需要在整个年龄跨度的纵向研究中复制，以测试它们是否是代表疾病易感性、创伤弹性或与认知障碍和痴呆症相关的病理性神经退行性变的神经解剖学标志物。
