title: Decreased premotor cortex volume in victims of urban violence with posttraumatic stress disorder.
abstract: BACKGROUND
  Studies addressing posttraumatic stress disorder (PTSD) have demonstrated that PTSD patients exhibit structural abnormalities in brain regions that relate to stress regulation and fear responses, such as the hippocampus, amygdala, anterior cingulate cortex, and ventromedial prefrontal cortex. Premotor cortical areas are involved in preparing to respond to a threatening situation and in representing the peripersonal space. Urban violence is an important and pervasive cause of human suffering, especially in large urban centers in the developing world. Violent events, such as armed robbery, are very frequent in certain cities, and these episodes increase the risk of PTSD. Assaultive trauma is characterized by forceful invasion of the peripersonal space; therefore, could this traumatic event be associated with structural alteration of premotor areas in PTSD?
  
  
  RESULTS
  Structural magnetic resonance imaging scans were acquired from a sample of individuals that had been exposed to urban violence. This sample consisted of 16 PTSD patients and 16 age- and gender-matched controls. Psychometric questionnaires differentiated PTSD patients from trauma-exposed controls with regard to PTSD symptoms, affective, and resilience predispositions. Voxel-based morphometric analysis revealed that, compared with controls, the PTSD patients presented significant reductions in gray matter volume in the ventral premotor cortex and in the pregenual anterior cingulate cortex.
  
  
  CONCLUSIONS
  Volume reduction in the premotor cortex that is observed in victims of urban violence with PTSD may be associated with a disruption in the dynamical modulation of the safe space around the body. The finding that PTSD patients presented a smaller volume of pregenual anterior cingulate cortex is consistent with the results of other PTSD neuroimaging studies that investigated different types of traumatic events.
authors.affiliation: Instituto de Biofísica Carlos Chagas Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil. rochavr@biof.ufrj.br
authors.forename: Vanessa
authors.initials: V
authors.lastname: Rocha-Rego
authors.forename: Mirtes G
authors.initials: MG
authors.lastname: Pereira
authors.forename: Leticia
authors.initials: L
authors.lastname: Oliveira
authors.forename: Mauro V
authors.initials: MV
authors.lastname: Mendlowicz
authors.forename: Adriana
authors.initials: A
authors.lastname: Fiszman
authors.forename: Carla
authors.initials: C
authors.lastname: Marques-Portella
authors.forename: William
authors.initials: W
authors.lastname: Berger
authors.forename: Carlton
authors.initials: C
authors.lastname: Chu
authors.forename: Mateus
authors.initials: M
authors.lastname: Joffily
authors.forename: Jorge
authors.initials: J
authors.lastname: Moll
authors.forename: Jair J
authors.initials: JJ
authors.lastname: Mari
authors.forename: Ivan
authors.initials: I
authors.lastname: Figueira
authors.forename: Eliane
authors.initials: E
authors.lastname: Volchan
mesh_terms: D000328:Adult; D001921:Brain / Q000002:abnormalities; D001931:Brain Mapping / Q000379:methods; D005260:Female; D005625:Frontal Lobe / Q000503:physiopathology; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009044:Motor Cortex / Q000503:physiopathology*; D017397:Prefrontal Cortex / Q000503:physiopathology*; D013313:Stress Disorders, Post-Traumatic / Q000503:physiopathology*; D014505:Urban Population; D014754:Violence; D014947:Wounds and Injuries