Regional cerebral blood flow during auditory recall in 47 subjects exposed to assaultive and non-assaultive trauma and developing or not posttraumatic stress disorder.
OBJECTIVE
Psychological trauma leads to posttraumatic stress disorder (PTSD) in susceptible subjects. The aim of this study was to investigate the differences in regional cerebral blood flow (rCBF) between two groups of subjects exposed to different types of traumatic stressor either developing or not developing PTSD.


METHODS
Twenty subjects developing (S) and 27 not developing (NS) PTSD after being exposed to either earlier person-under-the-train accident (NA) or being assaulted in the underground environment (A) were included in the study. 99mTc-HMPAO SPECT was performed and the uptake in 29 regions of the brain (VOIs), bilaterally, was assessed. rCBF distribution was compared, using analysis of variance (ANOVA), between groups (S/NS) and type (A/NA) during a situation involving an auditory evoked re-experiencing of the traumatic event. Discriminant analysis was applied to test the concordance between clinical diagnosis and SPECT findings.


RESULTS
In the general analyses significant differences were found between groups and types and there was a significant hemisphere x type interaction. S showed higher CBF than NS and so did A as compared to NA, particularly in the right hemisphere. Discriminant analysis correctly classified 66% of cases (p < 0001) in testing S/NS and 72% (p < 0001) in testing NA/A.


CONCLUSIONS
Under recall of their traumatic experience we found higher relative CBF distribution values in S as compared to NS. CBF was higher in the right hemisphere and particularly in assaulted subjects. These findings underscore the role upon trauma recall of both the right hemisphere and the nature of the stressing event.
Pagani
Marco
M
Section of Nuclear Medicine and Dept. of Radiology, Karolinska Hospital, Stockholm, Sweden. marcopagani2@yahoo.it
Högberg
Göran
G
Salmaso
Dario
D
Tärnell
Berit
B
Sanchez-Crespo
Alejandro
A
Soares
Joaquim
J
Aberg-Wistedt
Anna
A
Jacobsson
Hans
H
Hällström
Tore
T
Larsson
Stig A
SA
Sundin
Orian
O
D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D000704:Analysis of Variance; D001921:Brain / Q000000981:diagnostic imaging; D001931:Brain Mapping; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008297:Male; D011939:Mental Recall / Q000502:physiology*; D008875:Middle Aged; D012189:Retrospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology*; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods