Abstract
IntroductionSmaller hippocampal volumes are one of the most consistent findings in neuroimaging studies of post‐traumatic stress disorder (PTSD). However, very few prospective studies have assessed changes in hippocampal gray matter prior to and following therapy for PTSD, and no neuroimaging studies to date have longitudinally assessed military populations.MethodsA pilot study was conducted, assessing patients with combat‐related PTSD with structural MRI. Participants were then assigned either to a treatment group or waiting‐list control group. After the treatment group received multimodal psychological therapy for approximately 6 weeks, both groups completed a second neuroimaging assessment.ResultsRegion‐of‐interest analysis was used to measure gray matter volume in the hippocampus and amygdala. There was a group by time interaction; the therapy group (n = 6) showed a significant increase in hippocampal volume and a nonsignificant trend toward an increase in amygdala volume following therapy, while no change was observed in the waiting‐list group (n = 9).ConclusionsThis study provides initial evidence for increases in gray matter volume in the hippocampus in response to therapy for combat‐related PTSD.
Highlights
Smaller hippocampal volumes are one of the most consistent findings in neuroimaging studies of post-traumatic stress disorder (PTSD)
Patients with combat-related PTSD were assessed with psychological questionnaires and structural magnetic resonance imaging (MRI) neuroimaging at two time points approximately 6 weeks apart
Individuals who underwent psychotherapy between the two assessments were compared with a waiting-list control group
Summary
Post-traumatic stress disorder (PTSD) is a complex and debilitating psychiatric disorder caused by exposure to traumatic events. In a study by Vermetten, Vythilingam, Southwick, Charney and Bremner (2003), long-term treatment with the antidepressant paroxetine was shown to increase hippocampal volume and improve memory, while in a study by Lindauer et al (2005), no increase in hippocampal volume was observed following psychotherapy It remains an open question if and how gray matter changes following psychological therapeutic intervention for combat-related PTSD. Regions were selected on a theoretical basis, as alterations in these areas are commonly observed in PTSD populations, and on a practical basis, as they are discrete and clearly defined anatomical regions To our knowledge, this is the first longitudinal study to compare patients with combat-related PTSD before and after therapy to a waiting-list control group. We hypothesized that the therapy group would show both improved symptom scores and increased gray matter following therapy compared with the control group
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