TY - JOUR
T1 - Longitudinal volumetric evaluation of hippocampus and amygdala subregions in recent trauma survivors
AU - Ben-Zion, Ziv
AU - Korem, Nachshon
AU - Spiller, Tobias R.
AU - Duek, Or
AU - Keynan, Jackob Nimrod
AU - Admon, Roee
AU - Harpaz-Rotem, Ilan
AU - Liberzon, Israel
AU - Shalev, Arieh Y.
AU - Hendler, Talma
N1 - Funding Information:
The authors would like to thank our wonderful research team at Tel-Aviv Sourasky Medical Center—including Naomi Fine, Nili Green, Mor Halevi, Sheli Luvton, Yael Shavit, Olga Nevenchannaya, Iris Rashap, Efrat Routledge, and Ophir Leshets—for their significant contributions to participants, screening, enrollment, assessments, and follow-up. We extend our gratitude to all the participants of this study, who completed all the assessments at three different time points after experiencing a traumatic event, thus contributing to scientific research on post-traumatic psychopathology.
Funding Information:
This work was supported by award number R01-MH-103287 from the National Institute of Mental Health (NIMH) given to AYS (PI), IL, and TH (co-Investigators, subcontractors), and had undergone critical review by the NIMH Adult Psychopathology and Disorders of Aging study section.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2023/2
Y1 - 2023/2
N2 - The hippocampus and the amygdala play a central role in post-traumatic stress disorder (PTSD) pathogenesis. While alternations in volumes of both regions have been consistently observed in individuals with PTSD, it remains unknown whether these reflect pre-trauma vulnerability traits or acquired post-trauma consequences of the disorder. Here, we conducted a longitudinal panel study of adult civilian trauma survivors admitted to a general hospital emergency department (ED). One hundred eligible participants (mean age = 32.97 ± 10.97, n = 56 females) completed both clinical interviews and structural MRI scans at 1-, 6-, and 14-months after ED admission (alias T1, T2, and T3). While all participants met PTSD diagnosis at T1, only n = 29 still met PTSD diagnosis at T3 (a “non-Remission” Group), while n = 71 did not (a “Remission” Group). Bayesian multilevel modeling analysis showed robust evidence for smaller right hippocampus volume (P+ of ~0.014) and moderate evidence for larger left amygdala volume (P+ of ~0.870) at T1 in the “non-Remission” group, compared to the “Remission” group. Subregion analysis further demonstrated robust evidence for smaller volume in the subiculum and right CA1 hippocampal subregions (P+ of ~0.021–0.046) in the “non-Remission” group. No time-dependent volumetric changes (T1 to T2 to T3) were observed across all participants or between groups. Results support the “vulnerability trait” hypothesis, suggesting that lower initial volumes of specific hippocampus subregions are associated with non-remitting PTSD. The stable volume of all hippocampal and amygdala subregions does not support the idea of consequential, progressive, stress-related atrophy during the first critical year following trauma exposure.
AB - The hippocampus and the amygdala play a central role in post-traumatic stress disorder (PTSD) pathogenesis. While alternations in volumes of both regions have been consistently observed in individuals with PTSD, it remains unknown whether these reflect pre-trauma vulnerability traits or acquired post-trauma consequences of the disorder. Here, we conducted a longitudinal panel study of adult civilian trauma survivors admitted to a general hospital emergency department (ED). One hundred eligible participants (mean age = 32.97 ± 10.97, n = 56 females) completed both clinical interviews and structural MRI scans at 1-, 6-, and 14-months after ED admission (alias T1, T2, and T3). While all participants met PTSD diagnosis at T1, only n = 29 still met PTSD diagnosis at T3 (a “non-Remission” Group), while n = 71 did not (a “Remission” Group). Bayesian multilevel modeling analysis showed robust evidence for smaller right hippocampus volume (P+ of ~0.014) and moderate evidence for larger left amygdala volume (P+ of ~0.870) at T1 in the “non-Remission” group, compared to the “Remission” group. Subregion analysis further demonstrated robust evidence for smaller volume in the subiculum and right CA1 hippocampal subregions (P+ of ~0.021–0.046) in the “non-Remission” group. No time-dependent volumetric changes (T1 to T2 to T3) were observed across all participants or between groups. Results support the “vulnerability trait” hypothesis, suggesting that lower initial volumes of specific hippocampus subregions are associated with non-remitting PTSD. The stable volume of all hippocampal and amygdala subregions does not support the idea of consequential, progressive, stress-related atrophy during the first critical year following trauma exposure.
KW - Adult
KW - Female
KW - Humans
KW - Young Adult
KW - Bayes Theorem
KW - Hippocampus/diagnostic imaging
KW - Stress Disorders, Post-Traumatic/pathology
KW - Amygdala
KW - Magnetic Resonance Imaging/methods
KW - Survivors
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UR - http://www.scopus.com/inward/citedby.url?scp=85140611972&partnerID=8YFLogxK
U2 - 10.1038/s41380-022-01842-x
DO - 10.1038/s41380-022-01842-x
M3 - Article
C2 - 36280750
AN - SCOPUS:85140611972
VL - 28
SP - 657
EP - 667
JO - Molecular Psychiatry
JF - Molecular Psychiatry
SN - 1359-4184
IS - 2
ER -