Post-traumatic stress disorder in convalescent patients of severe acute respiratory syndrome: (1)H-MRS study

Abstract

To ascertain the metabolic changes in patients of severe acute respiratory syndrome (SARS) and SARS-related post-traumatic stress disorder (PTSD) and elucidate the relationship between PTSD, SARS and brain metabolism. A total of 58 convalescent SARS patients were evaluated by the scores of impact of event scale (IES), self-rating anxiety scale (SAS) and self-rating depression scale (SDS), etc. And 44 of them participated in (1)H-MRS study. There were 18 patients (M:F = 6:12) with SARS-related PTSD and 26 convalescent SARS patients without PTSD. And the procedures were repeated in 18 age, gender and education-matched normal control subjects. In all patients and controls, the regions of interest on magnetic resonance spectroscopy (MRS) were anterior cingulate gyrus (ACG), posterior cingulate gyrus (PCG), left anterior periventricular white matter (LAPWM) and left posterior periventricular white matter (LPPWM). And the correlations between MRS findings and the scores of SAS, SDS and IES were evaluated. In comparisons with the control subjects (n = 18) and convalescent SARS patients without PTSD (n = 26), the SARS-related PTSD group (n = 18) had significantly lower N-acetylaspartate/creatine (NAA/Cr) in 4 regions of interest while the NAA/Cr of the convalescent SARS patients was significantly lower than controls in 3 regions of interest (ACG, PCG and LAPWM). The ratios of NAA/Cr showed no close correlation with the scores of IES, SAS and SDS in convalescent SARS patients. The changes of brain metabolism in PTSD are caused by SARS. But their exact relationship awaits further explorations. SARS may also lead to the changes of brain metabolism.