Smaller hippocampal volume as a vulnerability factor for the persistence of post-traumatic stress disorder

Rooij, Sanne J.H. van; Kennis, Mitzy; Sjouwerman, Rachel; Heuvel, Martijn P. van den; Kahn, René S.; Geuze, Elbert

doi:10.1017/s0033291715000707

Cited by 101 publications

(92 citation statements)

References 43 publications

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“…Our finding supports other studies that show that hippocampal differences persist (13,48) or show bilateral effects (50) after controlling for lifetime alcohol use or abuse, suggesting that reduced hippocampal volume in PTSD is not due to a confound with AUD.…”

Section: Discussionsupporting

confidence: 90%

“…This conclusion is based on observations of reduced hippocampal volume in trauma-exposed control subjects without PTSD relative to trauma-unexposed control subjects (46,47). In contrast, other magnetic resonance imaging studies did not detect group differences between trauma-exposed and healthy control subjects (48–50), suggesting that lower hippocampal volume is specifically related to the presence of a psychiatric disorder rather than exposure to trauma. These studies are consistent with the hypothesis that lower hippocampal volume is a heritable risk factor for developing PTSD as demonstrated in twin studies.…”

Section: Discussionmentioning

confidence: 61%

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Smaller Hippocampal Volume in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia

Logue

Rooij

Dennis

et al. 2018

Biological Psychiatry

351

217

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BACKGROUND Many studies report smaller hippocampal and amygdala volumes in posttraumatic stress disorder (PTSD), but findings have not always been consistent. Here, we present the results of a large-scale neuroimaging consortium study on PTSD conducted by the Psychiatric Genomics Consortium (PGC)–Enhancing Neuroimaging Genetics through Meta-Analysis (ENIGMA) PTSD Working Group. METHODS We analyzed neuroimaging and clinical data from 1868 subjects (794 PTSD patients) contributed by 16 cohorts, representing the largest neuroimaging study of PTSD to date. We assessed the volumes of eight subcortical structures (nucleus accumbens, amygdala, caudate, hippocampus, pallidum, putamen, thalamus, and lateral ventricle). We used a standardized image-analysis and quality-control pipeline established by the ENIGMA consortium. RESULTS In a meta-analysis of all samples, we found significantly smaller hippocampi in subjects with current PTSD compared with trauma-exposed control subjects (Cohen’s d = −0.17, p = .00054), and smaller amygdalae (d = −0.11, p = .025), although the amygdala finding did not survive a significance level that was Bonferroni corrected for multiple subcortical region comparisons (p < .0063). CONCLUSIONS Our study is not subject to the biases of meta-analyses of published data, and it represents an important milestone in an ongoing collaborative effort to examine the neurobiological underpinnings of PTSD and the brain’s response to trauma.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 61%

Smaller Hippocampal Volume in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia

Logue

Rooij

Dennis

et al. 2018

Biological Psychiatry

351

217

View full text Add to dashboard Cite

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“…Persistent PTSD patients are a specific subgroup of patients with distinct neurobiological characteristics (see also van Rooij et al 2015). While all patients within the study qualified as a "PTSD case", those who do not recover are distinct in their symptom presentation and concordantly have different brain functioning.…”

Section: Discussionmentioning

confidence: 99%

Predicting Treatment Outcome in PTSD: A Longitudinal Functional MRI Study on Trauma-Unrelated Emotional Processing

Rooij

Kennis

Vink

et al. 2015

Neuropsychopharmacol

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In about 30-50% of patients with posttraumatic stress disorder (PTSD), symptoms persist after treatment. Although neurobiological research has advanced our understanding of PTSD, little is known about the neurobiology underlying persistence of PTSD. Two functional MRI scans were collected from 72 war veterans with and without PTSD over a 6- to 8-month interval, during which PTSD patients received trauma-focused therapy. All participants performed a trauma-unrelated emotional processing task in the scanner. Based on post-treatment symptom severity, a distinction was made between remitted and persistent patients. Behavioral and imaging measures of trauma-unrelated emotional processing were compared between the three groups (remitted patients, N=21; persistent patients, N=22; and combat controls, N=25) with repeated-measures (pre- and post-treatment) analyses. Second, logistic regression was used to predict treatment outcome. Before and after treatment, persistent patients showed a higher dorsal anterior cingulate cortex (dACC) and insula response to negative pictures compared with remitted patients and combat controls. Before treatment, persistent patients showed increased amygdala activation in response to negative pictures compared with remitted patients. The remitted patients and combat controls did not differ on the behavioral or imaging measures. Finally, higher dACC, insula, and amygdala activation before treatment were significant predictors of symptom persistence. Our results highlight a pattern of brain activation that may predict poor response to PTSD treatment. These findings can contribute to the development of alternative or additional therapies. Further research is needed to elucidate the heterogeneity within PTSD and describe how differences in neural function are related to treatment outcome. Such approaches are critical for defining parameters to customize PTSD treatment and improve treatment response rates.

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“…But there was strictly unclear, whether the reduced hippocampal volume is a result of PTSD or, maybe, a risk factor. The findings of Van Rooij et al (2015) suggest that a smaller hippocampus is not the result of stress or trauma exposure, but a constitutional risk factor for the PTSD persistence [25]. Also in their study hippocampal volume has not been increased in patient with successful treatment [25].…”

Section: Molecular Basis Of Hippocampus Memory Functionmentioning

confidence: 68%

“…The findings of Van Rooij et al (2015) suggest that a smaller hippocampus is not the result of stress or trauma exposure, but a constitutional risk factor for the PTSD persistence [25]. Also in their study hippocampal volume has not been increased in patient with successful treatment [25]. As a counterweight, Zoladz and Diamond (2015) during their literature review found reports not only about smaller hippocampal volume and impaired hippocampus-dependent memory in patients with PTSD, but also multiple reports about absence of a hippocampal functioning global impairment in PTSD [27].…”

Section: Molecular Basis Of Hippocampus Memory Functionmentioning

confidence: 99%

Role of the hippocampus in memory functioning: modern view

Assonov

Bozhuk

2017

ZMJ

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The purpose of this review was to develop the comprehensive conception of the hippocampus role in the functioning of human memory, based on data obtained by analysis of the latest scientific literature on the topic and make recommendations for further ways of researches in this topic. The scientific literature of the last 5 years on the role of the hippocampus in memory functioning was analyzed.Based on the reviewed literature, we made the next conclusions: the hippocampus is an extremely important for memory structure with various connections for different types of memory; the hippocampus is affected by a variety of substances, most studied now are glucocorticosteroids, whose effect on memory differs depending on the start time of action; the hippocampus volume in mental disorders affecting memory is less than normal, which makes it an important diagnostic criterion; at the moment, various promising methods that can help in the therapy of PTSD, depression, phobias and other disorders associated with memory impairment and based on the knowledge of the hippocampus for the treatment of memory disorders are being developed. Based on these conclusions and data, which were analyzed, we offered the following recommendations: to implement the hippocampal function examination in the diagnostics of mental disorders, which are accompanied by a violation of its work; to use the size of the hippocampus as one of the prognostic factors for the severity of the memory-associated disorders and the therapy progress; to carefully investigate the difference in the effect of various psychotherapies and pharmacotherapies on the hippocampus to determine exactly which of the therapies is the most morphologically reasonable; to find out how significant the decrease in the hippocampal volume is for the memory functioning; to use pathogenetically and morphologically based methods to improve the function of the hippocampus in the treatment of disorders that are accompanied by memory problems.Роль гіпокампа в роботі пам'яті: сучасний поглядМета роботи -розробити всебічну концепцію ролі гіпокампа у функціонуванні пам'яті людини на основі даних, що отри-мані під час аналізу новітньої наукової літератури з цієї теми, а також виробити рекомендації для дальших досліджень у цій області. Аналізувалась наукова література останніх 5 років про роль гіпокампа у функціонуванні пам'яті.Висновки. Гіпокамп є дуже важливою структурою пам'яті зі зв'язками, які відрізняються для різних типів пам'яті. На гіпокамп впливають різні речовини, найбільш вивченими серед них нині є глюкокортикостероїди, дія яких на пам'ять відрізняється залежно від часу початку їхньої дії. Розмір гіпокампа при психічних розладах, що впливають на пам'ять, менше норми, що робить його важливим діагностичним критерієм. Зараз розробляються різні перспективні методи, що можуть допомогти в терапії посттравматичного стресового розладу, депресії, фобій та інших розладів, котрі пов'язані з погіршенням пам'яті та засновані на знанні гіпокампа для лікування розладів пам'яті. На підставі цих вис...

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Smaller hippocampal volume as a vulnerability factor for the persistence of post-traumatic stress disorder

Cited by 101 publications

References 43 publications

Smaller Hippocampal Volume in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia

Smaller Hippocampal Volume in Posttraumatic Stress Disorder: A Multisite ENIGMA-PGC Study: Subcortical Volumetry Results From Posttraumatic Stress Disorder Consortia

Predicting Treatment Outcome in PTSD: A Longitudinal Functional MRI Study on Trauma-Unrelated Emotional Processing

Role of the hippocampus in memory functioning: modern view

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