Gray Matter Correlates of Posttraumatic Stress Disorder: A Quantitative Meta-Analysis

doi:10.1016/j.biopsych.2012.06.029

Biological Psychiatry

Volume 73, Issue 1, 1 January 2013, Pages 70-74

https://doi.org/10.1016/j.biopsych.2012.06.029 Get rights and content

Background

Since the inception of the diagnosis posttraumatic stress disorder (PTSD), attempts have been undertaken to understand why only a subpopulation of individuals exposed to trauma develops PTSD. Cerebral gray matter reductions have been suggested to be a crucial pathobiological marker of PTSD. However, a quantitative meta-analysis of whole-brain voxel-based morphometry studies is lacking.

Methods

Here, we investigated concurrence across voxel-based morphometry studies in PTSD compared with trauma-exposed individuals without PTSD (all together nine studies with 319 subjects) by means of activation likelihood estimation.

Results

We identified brain regions of consistent gray matter reduction in anterior cingulate cortex, ventromedial prefrontal cortex, left temporal pole/middle temporal gyrus, and left hippocampus in PTSD patients compared with individuals exposed to trauma without PTSD.

Conclusions

This is the first quantitative whole-brain meta-analysis showing brain structure deficits in traumatized subjects with PTSD compared with trauma-exposed healthy control subjects. The gray matter deficit profile overlaps with brain networks of emotion processing, fear extinction, and emotion regulation known to be affected in PTSD. Although the data cannot clarify if this is a predisposition or a consequence of the disease, the results may facilitate the need to control for structural characteristics in future functional brain studies.

Section snippets

Selection of Studies

Studies were selected using a systematic search process. Peer-reviewed articles published in English until July 2011 were selected from the search results of two separate databases (PubMed, Web of Knowledge). Keyword searches were conducted using the following terms: 1) voxel-based morphometry <or> VBM <or> morphometry <or> volumetry; and 2) PTSD <or> posttraumatic stress disorder <or> trauma <or> stress. From the resulting papers, we selected those that reported structural differences by means

Results

The present meta-analysis consisted of nine published studies. Bryant et al. (24) reported a volume reduction in left anterior cingulate cortex (ACC) in PTSD patients who had encountered assault or motor vehicle collisions, on average, 6 years before scanning. Chen et al. (25) found less gray matter in left hippocampus, left ACC, and bilateral insular cortex in fire victims in their 30s for whom the traumatization took place, on average, 7 months before scanning. Similar results were reported

Discussion

Within the scope of the present quantitative meta-analysis, we aimed at investigating common structural reductions in neuroimaging studies comparing PTSD patients with trauma-exposed individuals that did not develop PTSD. Convergence was found in ACC, vmPFC, left TP/MTG, and left hippocampus.

The structure that has received, by far, the most attention in research on PTSD is the hippocampus. In line with several ROI-based meta-analyses on structural alterations (4, 12, 13, 14), we found gray

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Archival ReportGray Matter Correlates of Posttraumatic Stress Disorder: A Quantitative Meta-Analysis

Background

Methods

Results

Conclusions

Section snippets

Selection of Studies

Results

Discussion

Neurosci Biobehav Rev

Biol Psychiatry

Biol Psychiatry

J Affect Disord

Prog Neuropsychopharmacol Biol Psychiatry

Neuroimage

Psychiatry Res

Psychiatry Res

Neurosci Res

J Psychiatr Res

Psychiatry Res

Neurosci Biobehav Rev

Neuron

Biol Psychiatry

Neuron

Biol Psychiatry

Neuroimage

Trends Cogn Sci

Biol Psychiatry

Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication

Arch Gen Psychiatry

Diagnostic and Statistical Manual of Mental Disorders

Developing an agenda for translational studies of resilience and vulnerability following trauma exposure

Ann N Y Acad Sci

Traumatic stress, brain changes, and memory deficits: A critical note

J Nerv Ment Dis

MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder

Am J Psychiatry

Hippocampal volume in women victimized by childhood sexual abuse

Psychol Med

Hippocampal volume and memory performance in a community-based sample of women with posttraumatic stress disorder secondary to child abuse

J Trauma Stress

Archival Report
Gray Matter Correlates of Posttraumatic Stress Disorder: A Quantitative Meta-Analysis