Amygdala Nuclei Volume and Shape in Military Veterans With Posttraumatic Stress Disorder

Morey, Rajendra A.; Clarke, Emily; Haswell, Courtney C.; Phillips, Rachel; Clausen, Ashley; Mufford, Mary S.; Saygin, Zeynep M.; Workgroup, VA Mid-Atlantic Mirecc; Wagner, H. Ryan; LaBar, Kevin S.

doi:10.1016/j.bpsc.2019.11.016

Cited by 41 publications

(51 citation statements)

References 56 publications

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“…In this study, we found that the left Me, right hippocampal body and presubiculum were the only regions with significantly larger volumes in earthquake survivors who developed PTSD than in TCs. The finding of larger Me in PTSD group as compared with TCs is in line with a recent published amygdala subregion study (Morey et al, 2020). Interestingly, the volumes of these regions in both the PTSD patients and TCs were significantly smaller than those in HCs, suggesting that a traumatic event may cause volume loss in these regions in both groups.…”

Section: Discussionsupporting

confidence: 91%

“…In that study, no significant differences between patients with PTSD and TCs were found (Luo et al, 2017). As for subregional‐level volumetric analysis of the amygdala, one recent study reported smaller lateral and paralaminar nuclei but larger central, medial and cortical nuclei in military veterans with PTSD than in veterans without PTSD (Morey et al, 2020). Two other studies reported morphometric alterations corresponding to the basolateral subregion and the central amygdala (Akiki et al, 2017; Veer et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

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Alterations in hippocampal subfield and amygdala subregion volumes in posttraumatic subjects with and without posttraumatic stress disorder

Zhang

et al. 2021

Human Brain Mapping

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The hippocampus and amygdala are important structures in the posttraumatic stress disorder (PTSD); however, the exact relationship between these structures and stress or PTSD remains unclear. Moreover, they consist of several functionally distinct subfields/subregions that may serve different roles in the neuropathophysiology of PTSD. Here we present a subregional profile of the hippocampus and amygdala in 145 survivors of a major earthquake and 56 non‐traumatized healthy controls (HCs). We found that the bilateral hippocampus and left amygdala were significantly smaller in survivors than in HCs, and there was no difference between survivors with (n = 69) and without PTSD (trauma‐exposed controls [TCs], n = 76). Analyses revealed similar results in most subfields/subregions, except that the right hippocampal body (in a head‐body‐tail segmentation scheme), right presubiculum, and left amygdala medial nuclei (Me) were significantly larger in PTSD patients than in TCs but smaller than in HCs. Larger hippocampal body were associated with the time since trauma in PTSD patients. The volume of the right cortical nucleus (Co) was negatively correlated with the severity of symptoms in the PTSD group but positively correlated with the same measurement in the TC group. This correlation between symptom severity and Co volume was significantly different between the PTSD and TCs. Together, we demonstrated that generalized smaller volumes in the hippocampus and amygdala were more likely to be trauma‐related than PTSD‐specific, and their subfields/subregions were distinctively affected. Notably, larger left Me, right hippocampal body and presubiculum were PTSD‐specific; these could be preexisting factors for PTSD or reflect rapid posttraumatic reshaping.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Alterations in hippocampal subfield and amygdala subregion volumes in posttraumatic subjects with and without posttraumatic stress disorder

Zhang

et al. 2021

Human Brain Mapping

View full text Add to dashboard Cite

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“…Of note, limited evidence in human studies show distinct changes within amygdala subnuclei related to PTSD. Recent findings show smaller lateral, paralaminar, and superficial amygdala nuclei volumes, but larger bilateral central, medial, and cortical nuclei in patients with PTSD relative to traumaexposed individuals without PTSD (Morey et al, 2019;Stein et al, 2019;Veer et al, 2015). Similarly, PTSD symptom severity was associated with an indentation in the centromedial amygdala within a sample of combat-exposed veterans with PTSD (Akiki et al, 2017).…”

Section: Amygdalamentioning

confidence: 94%

Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review

Quiñones

Gallegos

Lin

et al. 2020

Cogn Affect Behav Neurosci

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Compelling evidence from animal and human research suggest a strong link between inflammation and posttraumatic stress disorder (PTSD). Furthermore, recent findings support compromised neurocognitive function as a key feature of PTSD, particularly with deficits in attention and processing speed, executive function, and memory. These cognitive domains are supported by brain structures and neural pathways that are disrupted in PTSD and which are implicated in fear learning and extinction processes. The disruption of these supporting structures potentially results from their interaction with inflammation. Thus, the converging evidence supports a model of inflammatory dysregulation and cognitive dysfunction as combined mechanisms underpinning PTSD symptomatology. In this review, we summarize evidence of dysregulated inflammation in PTSD and further explore how the neurobiological underpinnings of PTSD, in the context of fear learning and extinction acquisition and recall, may interact with inflammation. We then present evidence for cognitive dysfunction in PTSD, highlighting findings from human work. Potential therapeutic approaches utilizing novel pharmacological and behavioral interventions that target inflammation and cognition also are discussed.

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“…In animal models of chronic pain, the excitability of neurons in the amygdala rapidly increases in response to repeated pain stimuli (Ursin, 2014 and increased spinogenesis in basolateral regions of the amygdala when animals are exposed to sustained stress (Roozendaal et al, 2009). Studies of post-traumatic stress disorder in humans expand upon this indicating that both pain and fear-based learning can drive hypertrophy in these regions of the amygdala (Morey et al, 2020). The increased activity and hypertrophy of the amygdala divergently affects plasticity in other brain regions such as the PFC and hippocampus (Patel et al, 2018).…”

Section: Corticolimbic Plasticitymentioning

confidence: 99%

What Does CATS Have to Do With Cancer? The Cognitive Activation Theory of Stress (CATS) Forms the SURGE Model of Chronic Post-surgical Pain in Women With Breast Cancer

2021

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Chronic post-surgical pain (CPSP) represents a highly prevalent and significant clinical problem. Both major and minor surgeries entail risks of developing CPSP, and cancer-related surgery is no exception. As an example, more than 40% of women undergoing breast cancer surgery struggle with CPSP years after surgery. While we do not fully understand the pathophysiology of CPSP, we know it is multifaceted with biological, social, and psychological factors contributing. The aim of this review is to advocate for the role of response outcome expectancies in the development of CPSP following breast cancer surgery. We propose the Cognitive Activation Theory of Stress (CATS) as an applicable theoretical framework detailing the potential role of cortisol regulation, inflammation, and inflammatory-induced sickness behavior in CPSP. Drawing on learning theory and activation theory, CATS offers psychobiological explanations for the relationship between stress and health, where acquired expectancies are crucial in determining the stress response and health outcomes. Based on existing knowledge about risk factors for CPSP, and in line with the CATS position, we propose the SURGEry outcome expectancy (SURGE) model of CPSP. According to SURGE, expectancies impact stress physiology, inflammation, and fear-based learning influencing the development and persistence of CPSP. SURGE further proposes that generalized response outcome expectancies drive adaptive or maladaptive stress responses in the time around surgery, where coping dampens the stress response, while helplessness and hopelessness sustains it. A sustained stress response may contribute to central sensitization, alterations in functional brain networks and excessive fear-based learning. This sets the stage for a prolonged state of inflammatory-induced sickness behavior – potentially driving and maintaining CPSP. Finally, as psychological factors are modifiable, robust and potent predictors of CPSP, we suggest hypnosis as an effective intervention strategy targeting response outcome expectancies. We here argue that presurgical clinical hypnosis has the potential of preventing CPSP in women with breast cancer.

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Amygdala Nuclei Volume and Shape in Military Veterans With Posttraumatic Stress Disorder

Cited by 41 publications

References 56 publications

Alterations in hippocampal subfield and amygdala subregion volumes in posttraumatic subjects with and without posttraumatic stress disorder

Alterations in hippocampal subfield and amygdala subregion volumes in posttraumatic subjects with and without posttraumatic stress disorder

Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: an integrative review

What Does CATS Have to Do With Cancer? The Cognitive Activation Theory of Stress (CATS) Forms the SURGE Model of Chronic Post-surgical Pain in Women With Breast Cancer

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