title: Abnormal N-acetylaspartate in hippocampus and anterior cingulate in posttraumatic stress disorder.
abstract: Magnetic resonance spectroscopic imaging (MRSI) studies suggest hippocampal abnormalities in posttraumatic stress disorder (PTSD), whereas findings of volume deficits in the hippocampus, as revealed with magnetic resonance imaging (MRI), have been inconsistent. Co-morbidities of PTSD, notably alcohol abuse, may have contributed to the inconsistency. The objective was to determine whether volumetric and metabolic abnormalities in the hippocampus and other brain regions are present in PTSD, independent of alcohol abuse. Four groups of subjects, PTSD patients with (n=28) and without (n=27) alcohol abuse and subjects negative for PTSD with (n=23) and without (n=26) alcohol abuse, were enrolled in this observational MRI and MRSI study of structural and metabolic brain abnormalities in PTSD. PTSD was associated with reduced N-acetylaspartate (NAA) in both the left and right hippocampus, though only when normalized to creatine levels in the absence of significant hippocampal volume reduction. Furthermore, PTSD was associated with reduced NAA in the right anterior cingulate cortex regardless of creatine. NAA appears to be a more sensitive marker for neuronal abnormality in PTSD than brain volume. The alteration in the anterior cingulate cortex in PTSD has implications for fear conditioning and extinction.
authors.affiliation: Center for Imaging of Neurodegenerative Diseases, DVA Medical Center, San Francisco, CA 94121, USA. norbert.schuff@ucsf.edu
authors.forename: Norbert
authors.initials: N
authors.lastname: Schuff
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
authors.forename: Sabrina
authors.initials: S
authors.lastname: Fox-Bosetti
authors.forename: Maryanne
authors.initials: M
authors.lastname: Lenoci
authors.forename: Kristin W
authors.initials: KW
authors.lastname: Samuelson
authors.forename: Colin
authors.initials: C
authors.lastname: Studholme
authors.forename: John
authors.initials: J
authors.lastname: Kornak
authors.forename: Charles R
authors.initials: CR
authors.lastname: Marmar
authors.forename: Michael W
authors.initials: MW
authors.lastname: Weiner
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000473:pathology / Q000503:physiopathology; D000465:Algorithms; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001284:Atrophy; D003130:Combat Disorders / Q000175:diagnosis / Q000503:physiopathology*; D015897:Comorbidity; D003214:Conditioning, Classical / Q000502:physiology; D003401:Creatine / Q000378:metabolism; D003865:Major Depressive Disorder / Q000473:pathology / Q000503:physiopathology; D004292:Dominance, Cerebral / Q000502:physiology; D004734:Energy Metabolism / Q000502:physiology*; D005108:Extinction, Psychological / Q000502:physiology; D005239:Fear / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008016:Life Change Events; D008279:Magnetic Resonance Imaging; D009682:Magnetic Resonance Spectroscopy; D008297:Male; D008875:Middle Aged; D009474:Neurons / Q000473:pathology / Q000502:physiology; D012984:Software; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000503:physiopathology*; D014728:Veterans
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine