title: The neurobiological role of the dorsolateral prefrontal cortex in recovery from trauma. Longitudinal brain imaging study among survivors of the South Korean subway disaster.
abstract: BACKGROUND
  A multiwave longitudinal neuroimaging study in a cohort of direct survivors of a South Korean subway disaster, most of whom recovered from posttraumatic stress disorder 5 years after trauma, provided a unique opportunity to investigate the brain correlates of recovery from a severe psychological trauma.
  
  
  OBJECTIVE
  To investigate region-specific brain mobilization during successful recovery from posttraumatic stress disorder by assessing cortical thickness multiple times from early after trauma to recovery, and to examine whether a brain-derived neurotrophic factor gene polymorphism was associated with this brain mobilization.
  
  
  METHODS
  Five-year follow-up case-control study conducted from 2003-2007.
  
  
  METHODS
  Seoul National University and Hospital.
  
  
  METHODS
  Thirty psychologically traumatized disaster survivors and 36 age- and sex-matched control group members recruited from the disaster registry and local community, respectively, who contributed 156 high-resolution brain magnetic resonance images during 3 waves of assessments.
  
  
  METHODS
  Cerebral cortical thickness measured in high-resolution anatomic magnetic resonance images using a validated cortical thickness analysis tool and its prospective changes from early after trauma to recovery in trauma-exposed individuals and controls.
  
  
  RESULTS
  Trauma-exposed individuals had greater dorsolateral prefrontal cortical (DLPFC) thickness 1.42 years after trauma (right DLPFC, 5.4%; left superior frontal cortex, 5.8%; and left inferior frontal cortex, 5.3% [all clusters, P ≤ .01]) relative to controls. Thicknesses gradually normalized over time during recovery. We found a positive linear trend, with trauma-exposed individuals with a valine/valine genotype having the greatest DLPFC cortical thickness, followed by those with a methionine genotype and controls (P < .001 for trend). Greater DLPFC thickness was associated with greater posttraumatic stress disorder symptom reductions and better recovery.
  
  
  CONCLUSIONS
  The DLPFC region might play an important role in psychological recovery from a severely traumatic event in humans.
authors: Department of Psychiatry and Interdisciplinary Program in Neuroscience, Seoul National University College of Medicine and College of Natural Sciences, 28 Yongon-dong, Jongno-gu, 110-744 Seoul, South Korea. inkylyoo@gmail.com
authors: In Kyoon
authors: IK
authors: Lyoo
authors: Jieun E
authors: JE
authors: Kim
authors: Sujung J
authors: SJ
authors: Yoon
authors: Jaeuk
authors: J
authors: Hwang
authors: Sujin
authors: S
authors: Bae
authors: Dajung J
authors: DJ
authors: Kim
mesh_terms: D000059:Accidents; D000293:Adolescent; D000328:Adult; D019208:Brain-Derived Neurotrophic Factor / Q000235:genetics; D016022:Case-Control Studies; D004190:Disasters; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D017397:Prefrontal Cortex / Q000473:pathology / Q000503:physiopathology*; D011890:Railroads; D056910:Republic of Korea; D013313:Stress Disorders, Post-Traumatic / Q000235:genetics / Q000473:pathology / Q000503:physiopathology*; D017741:Survivors / Q000523:psychology; D055815:Young Adult
chemical_list: D019208:Brain-Derived Neurotrophic Factor