Hippocampal volume in aging combat veterans with and without post-traumatic stress disorder: relation to risk and resilience factors.
OBJECTIVE
To examine whether there are post-traumatic stress disorder (PTSD) related differences in hippocampal volume in middle-aged and elderly veterans and to examine the relationship of neuroendocrine activity, memory performance, and measures of risk and resilience for PTSD to hippocampal volume in this cohort.


METHODS
Seventeen veterans with chronic PTSD and 16 veterans without chronic PTSD received an MRI scan followed by neuroendocrine assessment (24-h urinary cortisol excretion and the lysozyme IC(50-DEX), a measure of glucocorticoid receptor (GR) responsiveness), and cognitive testing.


RESULTS
Veterans with PTSD did not differ from those without PTSD in hippocampal volume, but they did show significantly lower urinary cortisol levels, and poorer memory performance on the Wechsler Logical Memory test and Digit Span test. Smaller left hippocampal volumes were observed in veterans who developed PTSD in response to their first reported traumatic exposure, compared to veterans who had first experienced a traumatic event to which they did not develop PTSD, prior to experiencing a subsequent event that led to PTSD. In contrast, the two neuroendocrine measures were associated with risk factors related to early trauma exposure.


CONCLUSIONS
Although hippocampal volume was not found to differ between subjects with and without PTSD, smaller hippocampal volumes in PTSD may be associated with specific risk and resilience factors. These may be distinct from vulnerability markers associated with increased responsiveness to glucocorticoids and/or other neuroendocrine measures that have been observed in combat-related PTSD.
Yehuda
Rachel
R
The Traumatic Stress Studies Program, Psychiatry Department, Mount Sinai School of Medicine, New York, NY, United States. Rachel.Yeuda@med.va.gov
Golier
Julia A
JA
Tischler
Lisa
L
Harvey
Philip D
PD
Newmark
Randall
R
Yang
Ren Kui
RK
Buchsbaum
Monte S
MS
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D002908:Chronic Disease; D005260:Female; D006624:Hippocampus / Q000033:anatomy & histology* / Q000503:physiopathology*; D006801:Humans; D006854:Hydrocortisone / Q000652:urine; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D014728:Veterans / Q000523:psychology*; D014857:Warfare; D014888:Wechsler Scales
D006854:Hydrocortisone