Abstract
Severe and chronic stress affects the hippocampus, especially during development. However, studies concerning structural alterations of the hippocampus yielded a rather inconsistent picture. Moreover, further anxiety-relevant brain regions, such as the insula, might be implicated in the pathophysiology of posttraumatic stress disorder (PTSD). We combined magnetic resonance (MR) volumetric and spectroscopic analyses of hippocampus and insula in highly traumatized refugees without a history of alcohol/substance abuse or other comorbid diseases. No PTSD-related difference was apparent in the volumes or neurometabolite levels of bilateral hippocampus or insula. However, an association between left hippocampal N-acetyl-aspartate (NAA) and adverse childhood experiences indicated a potential detrimental effect of the early environment on hippocampal integrity. Our results add to increasing evidence that PTSD-related, morphological alterations in the hippocampus are a consequence of early adversity or may result from other factors, such as extensive use of alcohol.
Highlights
Severe and chronic stress affects the hippocampus, especially during development
posttraumatic stress disorder (PTSD)-related alterations in this structure might in some cases be a consequence of early adversity or result from other factors, such as the extensive use of psychoactive drugs, including alcohol
Prev iou s work in the same sample, showed that PTSD-related structural alterations were present in frontal brain region s as well (Eckart et aI., 20 II)
Summary
Severe and chronic stress affects the hippocampus, especially during development. studies concerning structural alterations of the hippocampus yielded a rather inconsistent picture. Another possible methodological issue that has been discussed as a confounding factor in PTSD-related brain research is the hi gh occurrence of comorbid psychiatri c disorders that are associated with hippocampal volume reductions by them selves- as, for exa mple, borderline personality di sorder (Driessen et aI., 2000) or alcohol abuse (Agartz et aI., 1999; Woodward et aI., 2006). It still remains to be clarified whether these functi onal alterati ons are associated with macroscopic structural alterati ons in thi s region as well
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