title: Hippocampal volume in adult burn patients with and without posttraumatic stress disorder.
abstract: OBJECTIVE
  Increasing evidence suggests that posttraumatic stress disorder (PTSD) is associated with small hippocampal size. The authors compared trauma-exposed subjects with PTSD and trauma-exposed subjects without PTSD to clarify whether small hippocampal size is related to PTSD or to mere trauma exposure.
  
  
  METHODS
  Three-dimensional structural magnetic resonance imaging was used to assess hippocampal volumes in 30 men who had recently been exposed to a severe burn trauma and 15 matched healthy comparison subjects.
  
  
  RESULTS
  Relative to the comparison subjects, the trauma-exposed subjects with PTSD (N=15) as well as the trauma-exposed subjects without PTSD (N=15) had significantly smaller volumes of the right hippocampus (subjects with PTSD: -12%; subjects without PTSD: -13%). Larger total areas of burned body surface were significantly related to smaller left hippocampal volumes. Use of analgesic/sedative treatment with the N-methyl-d-aspartic acid (NMDA) antagonist ketamine was significantly related to larger right hippocampal volumes and to stronger PTSD symptoms.
  
  
  CONCLUSIONS
  PTSD is not a necessary condition for small hippocampal size in trauma-exposed individuals. Rather, the results provide evidence that smaller hippocampal size in trauma-exposed individuals is a result of traumatic stress. The posttraumatic application of NMDA antagonists may protect against hippocampal damage induced by traumatic stressors but increases the patient's risk of developing PTSD symptoms.
authors.affiliation: Department of Psychiatry and Psychotherapy, University of Göttingen, Von-Siebold-Str. 5, D-37075 Göttingen, FRG.
authors.forename: Hermann
authors.initials: H
authors.lastname: Winter
authors.forename: Eva
authors.initials: E
authors.lastname: Irle
mesh_terms: D000328:Adult; D000367:Age Factors; D000700:Analgesics / Q000627:therapeutic use; D001921:Brain / Q000033:anatomy & histology; D002056:Burns / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D006624:Hippocampus / Q000033:anatomy & histology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D021621:Imaging, Three-Dimensional; D008016:Life Change Events; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D015599:Trauma Severity Indices
chemical_list: D000700:Analgesics; D006993:Hypnotics and Sedatives