title: Changes in brain anatomy during the course of posttraumatic stress disorder.
abstract: The goal of this study was to determine whether posttraumatic stress disorder (PTSD) was associated with an increase in time-related decline in macrostructural brain volume and whether these changes were associated with accelerated cognitive decline. To quantify brain structure, three-dimensional T1-weighted MRI scans were performed at baseline and again after a minimum of 24months in 25 patients with PTSD (PTSD+) and 22 controls (PTSD-). Longitudinal changes in brain volume were measured using deformation morphometry. For the group as a whole, PTSD+ patients did not show significant ongoing brain atrophy compared to PTSD-. PTSD+ patients were then subgrouped into those with decreasing or increasing symptoms. We found little evidence for brain markers of accelerated atrophy in PTSD+ veterans whose symptoms improved over time, with only a small left parietal region showing greater ongoing tissue loss than PTSD-. PTSD patients whose symptoms increased over time showed accelerated atrophy throughout the brain, particularly brainstem and frontal and temporal lobes. Lastly, for the sample as a whole, greater rates of brain atrophy were associated with greater rates of decline in verbal memory and delayed facial recognition.
authors.affiliation: San Francisco Veterans Affairs Medical Center, San Francisco, CA ,CA 94121 United States. valerie.cardenas-nicolson@ucsf.edu
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Cardenas
authors.forename: Kristin
authors.initials: K
authors.lastname: Samuelson
authors.forename: Maryann
authors.initials: M
authors.lastname: Lenoci
authors.forename: Colin
authors.initials: C
authors.lastname: Studholme
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Neylan
authors.forename: Charles R
authors.initials: CR
authors.lastname: Marmar
authors.forename: Norbert
authors.initials: N
authors.lastname: Schuff
authors.forename: Michael W
authors.initials: MW
authors.lastname: Weiner
mesh_terms: D000328:Adult; D001284:Atrophy; D001921:Brain / Q000473:pathology*; D001931:Brain Mapping; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013313:Stress Disorders, Post-Traumatic / Q000150:complications / Q000473:pathology*; D014728:Veterans