title: Analysis of the Metabolic and Structural Brain Changes in Patients With Torture-Related Post-Traumatic Stress Disorder (TR-PTSD) Using ¹⁸F-FDG PET and MRI.
abstract: Many people exposed to torture later suffer from torture-related post-traumatic stress disorder (TR-PTSD). The aim of this study was to analyze the morphologic and functional brain changes in patients with TR-PTSD using magnetic resonance imaging (MRI) and positron emission tomography (PET). This study evaluated 19 subjects. Thirteen subcortical brain structures were evaluated using FSL software. On the T1-weighted images, normalized brain volumes were measured using SIENAX software. The study compared the volume of the brain and 13 subcortical structures in 9 patients suffering from TR-PTSD after torture and 10 healthy volunteers (HV). Diffusion-weighted imaging (DWI) was performed in the transverse plane. In addition, the 18F-FDG PET data were evaluated to identify the activity of the elected regions. The mean left hippocampal volume for the TR-PTSD group was significantly lower than in the HV group (post hoc test (Bonferroni) P < 0.001). There was a significant difference between the gray matter volume of the patients with TR-PTSD and the HV group (post hoc test (Bonferroni) P < 0.001). The TR-PTSD group showed low significant expansion of the ventricles in contrast to the HV group (post hoc test (Bonferroni) P < 0.001). Diffusion-weighted imaging revealed significant differences in the right frontal lobe and the left occipital lobe between the TR-PTSD and HV group (post hoc test (Bonferroni) P < 0.001). Moderate hypometabolism was noted in the occipital lobe in 6 of the 9 patients with TR-PTSD, in the temporal lobe in 1 of the 9 patients, and in the caudate nucleus in 5 of the 9 patients. In 2 cases, additional hypometabolism was observed in the posterior cingulate cortex and in the parietal and frontal lobes. The findings from this study show that TR-PTSD might have a deleterious influence on a set of specific brain structures. This study also demonstrated that PET combined with MRI is sensitive in detecting possible metabolic and structural brain changes in TR-PTSD.
authors.affiliation: From the Institute of Radiology and Nuclear Medicine (SZ, RB, K Hittmair, JH), Hanusch Hospital; Institute of Nuclear Medicine with PET-Center (PK, SM), Wilhelminen Hospital, Teaching Hospital of Medical University of Vienna; Department of Social Psychiatry (TW), Medical University of Vienna, Vienna; and Department of Radiology (K Hergan), Paracelsus Medical University of Salzburg, Salzburg, Austria.
authors.forename: Shahin
authors.initials: S
authors.lastname: Zandieh
authors.forename: Reinhard
authors.initials: R
authors.lastname: Bernt
authors.forename: Peter
authors.initials: P
authors.lastname: Knoll
authors.forename: Thomas
authors.initials: T
authors.lastname: Wenzel
authors.forename: Karl
authors.initials: K
authors.lastname: Hittmair
authors.forename: Joerg
authors.initials: J
authors.lastname: Haller
authors.forename: Klaus
authors.initials: K
authors.lastname: Hergan
authors.forename: Siroos
authors.initials: S
authors.lastname: Mirzaei
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D049268:Positron-Emission Tomography; D013313:Stress Disorders, Post-Traumatic / Q000473:pathology*; D014104:Torture / Q000523:psychology*
chemical_list: D019788:Fluorodeoxyglucose F18