Structural alterations in lateral prefrontal, parietal and posterior midline regions of men with chronic posttraumatic stress disorder

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2011
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Stoppel, Christian
Kaufmann, Jörn
Tempelmann, Claus
Hinrichs, Hermann
Heinze, Hans-Jochen
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Journal of Psychiatry & Neuroscience. 2011, 36(3), pp. 176-186. ISSN 1180-4882. eISSN 1488-2434. Available under: doi: 10.1503/jpn.100010
Zusammenfassung

Background
So far, the neural network associated with posttraumatic stress disorder (PTSD) has been suggested to mainly involve the amygdala, hippocampus and medial prefrontal cortex. However, increasing evidence indicates that cortical regions extending beyond this network might also be implicated in the pathophysiology of PTSD. We aimed to investigate PTSD-related structural alterations in some of these regions.
Methods
We enrolled highly traumatized refugees with and without (traumatized controls) PTSD and non-traumatized controls in the study. To increase the validity of our results, we combined an automatic cortical parcellation technique and voxel-based morphometry.
Results
In all, 39 refugees (20 with and 19 without PTSD) and 13 controls participated in the study. Participants were middle-aged men who were free of psychoactive substances and consumed little to no alcohol. Patients with PTSD (and to a lesser extent traumatized controls) showed reduced volumes in the right inferior parietal cortex, the left rostral middle frontal cortex, the bilateral lateral orbitofrontal cortex and the bilateral isthmus of the cingulate. An influence of cumulative traumatic stress on the isthmus of the cingulate and the lateral orbitofrontal cortex indicated that, at least in these regions, structural alterations might be associated with repeated stress experiences. Voxel-based morphometry analyses produced largely consistent results, but because of a poorer signal-to-noise ratio, conventional statistics did not reach significance.
Limitations
Although we controlled for several important confounding variables (e.g., sex, alcohol abuse) with our particular sample, this might limit the generalizibility of our data. Moreover, high comorbidity of PTSD and major depression hinders a definite separation of these conditions in our findings. Finally, the results concerning the lateral orbitofrontal cortex should be interpreted with caution, as magnetic resonance imaging acquisition in this region is affected by a general signal loss.
Conclusion
Our results indicate that lateral prefrontal, parietal and posterior midline structures are implicated in the pathophysiology of PTSD. As these regions are particularly involved in episodic memory, emotional processing and executive control, this might have important implications for the understanding of PTSD symptoms.

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150 Psychologie
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ISO 690ECKART, Cindy, Christian STOPPEL, Jörn KAUFMANN, Claus TEMPELMANN, Hermann HINRICHS, Thomas ELBERT, Hans-Jochen HEINZE, Iris-Tatjana KOLASSA, 2011. Structural alterations in lateral prefrontal, parietal and posterior midline regions of men with chronic posttraumatic stress disorder. In: Journal of Psychiatry & Neuroscience. 2011, 36(3), pp. 176-186. ISSN 1180-4882. eISSN 1488-2434. Available under: doi: 10.1503/jpn.100010
BibTex
@article{Eckart2011-05Struc-18078,
  year={2011},
  doi={10.1503/jpn.100010},
  title={Structural alterations in lateral prefrontal, parietal and posterior midline regions of men with chronic posttraumatic stress disorder},
  number={3},
  volume={36},
  issn={1180-4882},
  journal={Journal of Psychiatry & Neuroscience},
  pages={176--186},
  author={Eckart, Cindy and Stoppel, Christian and Kaufmann, Jörn and Tempelmann, Claus and Hinrichs, Hermann and Elbert, Thomas and Heinze, Hans-Jochen and Kolassa, Iris-Tatjana}
}
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