Anatomical deficits in adult posttraumatic stress disorder: A meta-analysis of voxel-based morphometry studies

Meng, Yajing; Qiu, Changjian; Zhu, Hongru; Lama, Sunima; Lui, Su; Gong, Qiyong; Zhang, Wei

doi:10.1016/j.bbr.2014.05.021

Cited by 84 publications

(80 citation statements)

References 90 publications

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“…The pattern of observed network alterations largely overlapped with the salience, central executive, and default mode networks (96,97), as well as with the somatomotor, auditory, and visual networks (98) (Fig 5). We also found substantial alterations in brain function that are similar in many ways to those observed in patients with PTSD in individuals shortly after major traumatic experiences, highlighting the need for a meta-analysis, which revealed that PTSD symptom severity was negatively correlated with gray matter in the left anterior cingulate cortex and positively correlated with gray matter in the left insula (89). We have used DT imaging to investigate children with PTSD, and our findings suggest that pediatric PTSD is accompanied by a connectivity disequilibrium between the salience and default-mode networks, which is a finding of potential pathophysiologic importance (90).…”

Section: State Of the Art: Psychoradiologymentioning

confidence: 81%

Psychoradiology: The Frontier of Neuroimaging in Psychiatry

Lui¹,

et al. 2016

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Unlike neurologic conditions, such as brain tumors, dementia, and stroke, the neural mechanisms for all psychiatric disorders remain unclear. A large body of research obtained with structural and functional magnetic resonance imaging, positron emission tomography/single photon emission computed tomography, and optical imaging has demonstrated regional and illness-specific brain changes at the onset of psychiatric disorders and in individuals at risk for such disorders. Many studies have shown that psychiatric medications induce specific measurable changes in brain anatomy and function that are related to clinical outcomes. As a result, a new field of radiology, termed psychoradiology, seems primed to play a major clinical role in guiding diagnostic and treatment planning decisions in patients with psychiatric disorders. This article will present the state of the art in this area, as well as perspectives regarding preparations in the field of radiology for its evolution. Furthermore, this article will (a) give an overview of the imaging and analysis methods for psychoradiology; (b) review the most robust and important radiologic findings and their potential clinical value from studies of major psychiatric disorders, such as depression and schizophrenia; and (c) describe the main challenges and future directions in this field. An ongoing and iterative process of developing biologically based nomenclatures with which to delineate psychiatric disorders and translational research to predict and track response to different therapeutic drugs is laying the foundation for a shift in diagnostic practice in psychiatry from a psychologic symptom-based approach to an imaging-based approach over the next generation. This shift will require considerable innovations for the acquisition, analysis, and interpretation of brain images, all of which will undoubtedly require the active involvement of radiologists.q RSNA, 2016 Online supplemental material is available for this article.This copy is for personal use only. To order printed copies, contact reprints@rsna.org STATE OF THE ART: PsychoradiologyLui et al imaging study of schizophrenia with CT revealed bilaterally enlarged ventricles, which was an important con firmation of the neuropathology of the disorder (1). Since then, many psychiatry researchers have used brain imaging to elucidate the profile of brain abnormalities associated with different psychiatric disorders. This effort accelerated considerably in recent years because of the rapid and extensive growth and development in MR imaging, molecular imaging, and other diagnostic imaging techniques.Increased understanding of neurobiologic mechanisms of psychiatric disorders, increased technical capacities of human brain imaging, and many compelling demonstrations of differences between patients and control subjects in terms of brain anatomy and function provide the basis for the emergence of the clinical subspecialty of psychoradiology. Although clinical application of psychoradiology is not on the immediate horizon, th...

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Section: State Of the Art: Psychoradiologymentioning

confidence: 81%

Psychoradiology: The Frontier of Neuroimaging in Psychiatry

Lui¹,

et al. 2016

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“…PTSD patients showed volume reduction in medial prefrontal cortex, left hippocampus, left middle temporal gyrus and right superior frontal gyrus and left occipital cortex. In contrast, Meng et al [73] reported volume reduction in left anterior cingulate cortex, left insula and right parahippocampal gyrus in PTSD patients as compared to traumaexposed healthy subjects. Karl et al [52] reported that in addition to smaller hippocampal volumes in PTSD patients compared to controls, patients also had smaller left amygdala volumes.…”

Section: Chronic Stress In Humans: Post-traumatic Stress Disorder Andmentioning

confidence: 88%

Stress and laterality – The comparative perspective

Ocklenburg

Korte

Peterburs

et al. 2016

Physiology & Behavior

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“…The mPFC mask included ventromedial PFC, ACC (including subgenual, rostral, and dorsal regions), and dorsomedial PFC. The more dorsal regions of the mPFC were included in our search region, given evidence that GMV abnormalities may extend into these regions in adult PTSD (Meng et al, 2014). Multiple comparison correction was performed using Monte Carlo simulation (AFNI's 3dClustSim), which incorporates the estimated smoothness of the data to establish the likelihood of false positives of different cluster sizes (that is, cluster size thresholding).…”

Section: Discussionmentioning

confidence: 99%

Abnormal Structure of Fear Circuitry in Pediatric Post-Traumatic Stress Disorder

Keding

Herringa

2014

Neuropsychopharmacol

102

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Structural brain studies of adult post-traumatic stress disorder (PTSD) show reduced gray matter volume (GMV) in fear regulatory areas including the ventromedial prefrontal cortex (vmPFC) and hippocampus. Surprisingly, neither finding has been reported in pediatric PTSD. One possibility is that they represent age-dependent effects that are not fully apparent until adulthood. In addition, lowerresolution MRI and image processing in prior studies may have limited detection of such differences. Here we examine fear circuitry GMV, including age-related differences, using higher-resolution MRI in pediatric PTSD vs healthy youth. In a cross-sectional design, 3 T anatomical brain MRI was acquired in 27 medication-free youth with PTSD and 27 healthy non-traumatized youth of comparable age, sex, and IQ. Voxel-based morphometry was used to compare GMV in a priori regions including the medial prefrontal cortex and amygdala/hippocampus. Compared with healthy youth, PTSD youth had reduced GMV but no age-related differences in anterior vmPFC (BA 10/11, Z ¼ 4.5), which inversely correlated with PTSD duration. In contrast, although there was no overall group difference in hippocampal volume, a group Â age interaction (Z ¼ 3.6) was present in the right anterior hippocampus. Here, age positively predicted hippocampal volume in healthy youth but negatively predicted volume in PTSD youth. Within the PTSD group, re-experiencing symptoms inversely correlated with subgenual anterior cingulate cortex (sgACC, Z ¼ 3.7) and right anterior hippocampus (Z ¼ 3.5) GMV. Pediatric PTSD is associated with abnormal structure of the vmPFC and age-related differences in the hippocampus, regions important in the extinction and contextual gating of fear. Reduced anterior vmPFC volume may confer impaired recovery from illness, consistent with its role in the allocation of attentional resources. In contrast, individual differences in sgACC volume were associated with re-experiencing symptoms, consistent with the role of the sgACC in fear extinction. The negative relationship between age and hippocampal volume in youth with PTSD may suggest an ongoing neurotoxic process over development, which further contributes to illness expression. Future studies employing a longitudinal design would be merited to further explore these possibilities.

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Anatomical deficits in adult posttraumatic stress disorder: A meta-analysis of voxel-based morphometry studies

Cited by 84 publications

References 90 publications

Psychoradiology: The Frontier of Neuroimaging in Psychiatry

Psychoradiology: The Frontier of Neuroimaging in Psychiatry

Stress and laterality – The comparative perspective

Abnormal Structure of Fear Circuitry in Pediatric Post-Traumatic Stress Disorder

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