title: Early adversity and combat exposure interact to influence anterior cingulate cortex volume in combat veterans.
abstract: OBJECTIVE
  Childhood and combat trauma have been observed to interact to influence amygdala volume in a sample of U.S. military veterans with and without PTSD. This interaction was assessed in a second, functionally-related fear system component, the pregenual and dorsal anterior cingulate cortex, using the same sample and modeling approach.
  
  
  METHODS
  Anterior cingulate cortical tissues (gray + white matter) were manually-delineated in 1.5 T MR images in 87 U.S. military veterans of the Vietnam and Persian Gulf wars. Hierarchical multiple regression modeling was used to assess associations between anterior cingulate volume and the following predictors, trauma prior to age 13, combat exposure, the interaction of early trauma and combat exposure, and PTSD diagnosis.
  
  
  RESULTS
  As previously observed in the amygdala, unique variance in anterior cingulate cortical volume was associated with both the diagnosis of PTSD and with the interaction of childhood and combat trauma. The pattern of the latter interaction indicated that veterans with childhood trauma exhibited a significant inverse linear relationship between combat trauma and anterior cingulate volume while those without childhood trauma did not. Such associations were not observed in hippocampal or total cerebral tissue volumes.
  
  
  CONCLUSIONS
  In the dorsal anterior cingulate cortex, as in the amygdala, early trauma may confer excess sensitivity to later combat trauma.
authors.affiliation: National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Menlo Park, CA, USA.
authors.forename: Steven H
authors.initials: SH
authors.lastname: Woodward
authors.forename: Janice R
authors.initials: JR
authors.lastname: Kuo
authors.forename: Marie
authors.initials: M
authors.lastname: Schaer
authors.forename: Danny G
authors.initials: DG
authors.lastname: Kaloupek
authors.forename: Stephan
authors.initials: S
authors.lastname: Eliez
keywords: Cingulate cortex; Combat disorders; Posttraumatic stress disorder; Stress, psychological