Brain structural changes as vulnerability factors and acquired signs of post-earthquake stress

Abstract

Many survivors of severe disasters, even those without posttraumatic stress disorder (PTSD), need psychological support. To understand the pathogenesis of PTSD symptoms and prevent the development of PTSD, the critical issue is to distinguish neurological abnormalities as vulnerability factors from acquired signs of PTSD symptoms in the early stage of adaptation to the trauma in the normal population. The neurological underpinnings of PTSD have been well characterized, but the causal relationships with the traumatic event are still unclear. We examined 42 non-PTSD subjects to find brain morphometric changes related to the severity of PTSD symptoms in a longitudinal magnetic resonance imaging study extending through the Great East Japan Earthquake. We found that regional grey matter volume (rGMV) in the right ventral anterior cingulate cortex (ACC) before the earthquake, and decreased rGMV in the left orbitofrontal cortex (OFC) through the earthquake were negatively associated with PTSD symptoms. Our results indicate that subjects with smaller GMV in the ACC before the earthquake, and subjects with decreased GMV in the OFC through the earthquake were likely to have PTSD symptoms. As the ACC is involved in processing of fear and anxiety, our results indicate that these processing are related to vulnerability for PTSD symptoms. In addition, decreased OFC volume was induced by failing to extinct conditioned fear soon after the traumatic event. These findings provide a better understanding of posttraumatic responses in early stage of adaptation to the trauma and may contribute to the development of effective methods to prevent PTSD.

Early Cortical Thickness Change after Mild Traumatic Brain Injury following Motor Vehicle Collision

“…21,31 In our control group of injured survivors with a similar trauma, we were able to document comparable levels of body injuries and psychological distress, thus controlling for potentially important confounding factors, such as stress and pain. 46,47 Differences in cortical thickness findings between our study and a previous study that assessed cortical thickness 3 months after a blast injury may be attributed to differences in trauma types, post-trauma durations, or the nature of the control groups. 48 …”

Abnormal Structure of Fear Circuitry in Pediatric Post-Traumatic Stress Disorder

“…A twin study of adult PTSD suggests the former (Gilbertson et al, 2002), while leaving open the possibility of common developmental effects in the PTSD twin pairs. In contrast, reduced vmPFC volume appears to be an acquired trait that contributes to the emergence of PTSD in vulnerable adults (Kasai et al, 2008;Sekiguchi et al, 2013). In further evidence of their role in adult PTSD, both vmPFC (Herringa et al, 2012;Sekiguchi et al, 2013) and hippocampal volume (Apfel et al, 2011;Gilbertson et al, 2002;Karl et al, 2006) inversely correlate with PTSD severity.…”

“…In contrast, reduced vmPFC volume appears to be an acquired trait that contributes to the emergence of PTSD in vulnerable adults (Kasai et al, 2008;Sekiguchi et al, 2013). In further evidence of their role in adult PTSD, both vmPFC (Herringa et al, 2012;Sekiguchi et al, 2013) and hippocampal volume (Apfel et al, 2011;Gilbertson et al, 2002;Karl et al, 2006) inversely correlate with PTSD severity. Successful treatment may reverse hippocampal volume deficits (Levy-Gigi et al, 2013;Vermetten et al, 2003), but does not appear to affect vmPFC volume (Dickie et al, 2013;Levy-Gigi et al, 2013).…”

En integrert forståelse av subjektive lidelser i klinisk praksis

“…The encounter between the ideal and the reality, results in a balance between the individual's subjective expectations of life, and society's objective life demands. The individual's narrative script and behavioural patterns can be perceived as stress-vulnerability to the development of anxiety, substance dependency, eating disorders and post-traumatic stress disorder (PTSD) (18,19).…”