Amygdala Volume Changes in Posttraumatic Stress Disorder in a Large Case-Controlled Veterans Group

作者：Morey Rajendra A^*; Gold Andrea L; LaBar Kevin S; Beall Shannon K; Brown Vanessa M; Haswell Courtney C; Nasser Jessica D; Wagner H Ryan; McCarthy Gregory

来源：Archives of General Psychiatry, 2012, 69(11): 1169-1178.

DOI：10.1001/archgenpsychiatry.2012.50

Context: Smaller hippocampal volumes are well established in posttraumatic stress disorder (PTSD), but the relatively few studies of amygdala volume in PTSD have produced equivocal results.
Objective: To assess a large cohort of recent military veterans with PTSD and trauma-exposed control subjects, with sufficient power to perform a definitive assessment of the effect of PTSD on volumetric changes in the amygdala and hippocampus and of the contribution of illness duration, trauma load, and depressive symptoms.
Design: Case-controlled design with structural magnetic resonance imaging and clinical diagnostic assessments. We controlled statistically for the important potential confounds of alcohol use, depression, and medication use.
Setting: Durham Veterans Affairs Medical Center, which is located in proximity to major military bases.
Patients: Ambulatory patients (n=200) recruited from a registry of military service members and veterans serving after September 11, 2001, including a group with current PTSD (n=99) and a trauma-exposed comparison group without PTSD (n=101).
Main Outcome Measure: Amygdala and hippocampal volumes computed from automated segmentation of high-resolution structural 3-T magnetic resonance imaging.
Results: Smaller volume was demonstrated in the PTSD group compared with the non-PTSD group for the left amygdala (P=.002), right amygdala (P=.01), and left hippocampus (P=.02) but not for the right hippocampus (P=.25). Amygdala volumes were not associated with PTSD chronicity, trauma load, or severity of depressive symptoms.
Conclusions: These results provide clear evidence of an association between a smaller amygdala volume and PTSD. The lack of correlation between trauma load or illness chronicity and amygdala volume suggests that a smaller amygdala represents a vulnerability to developing PTSD or the lack of a dose-response relationship with amygdala volume. Our results may trigger a renewed impetus for investigating structural differences in the amygdala, its genetic determinants, its environmental modulators, and the possibility that it reflects an intrinsic vulnerability to PTSD. Arch Gen Psychiatry. 2012;69(11):1169-1178

• 出版日期2012-11