Is the spatial distribution of brain lesions associated with closed-head injury in children predictive of subsequent development of posttraumatic stress disorder?
OBJECTIVE
To determine whether there is an association between the spatial distributions of lesions detected at magnetic resonance (MR) imaging of the brain in children, adolescents, and young adults after closed-head injury (CHI) and development of the reexperiencing symptoms of posttraumatic stress disorder (PTSD).


METHODS
Data obtained in 94 subjects without a history of PTSD as determined by parental interview were analyzed. MR images were obtained 3 months after CHI. Lesions were manually delineated and registered to the Talairach coordinate system. Mann-Whitney analysis of lesion distribution and PTSD status at 1 year (again, as determined by parental interview) was performed, consisting of an analysis of lesion distribution versus the major symptoms of PTSD: reexperiencing, hyperarousal, and avoidance.


RESULTS
Of the 94 subjects, 41 met the PTSD reexperiencing criterion and nine met all three PTSD criteria. Subjects who met the reexperiencing criterion had fewer lesions in limbic system structures (eg, the cingulum) on the right than did subjects who did not meet this criterion (Mann-Whitney, P =.003).


CONCLUSIONS
Lesions induced by CHI in the limbic system on the right may inhibit subsequent manifestation of PTSD reexperiencing symptoms in children, adolescents, and young adults.
Herskovits
Edward H
EH
Division of Neuroradiology, Johns Hopkins Medical Institutions, 600 N Wolfe St, Baltimore, MD 21287-7619, USA.
Gerring
Joan P
JP
Davatzikos
Christos
C
Bryan
R Nick
RN
D000293:Adolescent; D000328:Adult; D001921:Brain / Q000473:pathology*; D001930:Brain Injuries / Q000175:diagnosis / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D016489:Head Injuries, Closed / Q000150:complications* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology*
NASA Discipline Neuroscience; Non-NASA Center