MRI to Help Identify Individuals Most at Risk of Developing Persistent PTSD After a Traumatic Event

The study intended to explore how structural changes or abnormalities in the brain are related to the time since the trauma, and the clinical severity. PTSD is triggered by a traumatic event that results in, or has the potential to inflict serious physical injury, and can include symptoms such as strong memories of the event, emotional numbness, bad dreams, intense worry or guilt, outbursts of anger, and avoidance of thoughts and situations reminiscent of the trauma.

The study was published in the March, 2016, online issue of the journal Radiology and included 67 PTSD patients, and 78 matching healthy survivors. All participants were scanned using a 3.0 T Magnetic Resonance Imaging (MRI) system. The individuals were first evaluated by trained earthquake support psychologists using the Clinician-Administered PTSD Scale (CAPS). Those patients whose CAPS score was ≥50 were then evaluated by a psychiatrist for the presence or absence of PTSD, and other psychiatric problems.

The results of the study show an early increase in cortical thickness of the gray matter in the brain, and could be used to identify those who are most at risk of developing persistent PTSD after a traumatic event. PTSD patients were found to have a greater cortical thickness in certain brain areas, and a reduced volume in others, compared to the control group. The researchers found that PTSD severity correlated positively with cortical thickness in the left precuneus brain region.

Senior author of the study, Qiyong Gong, MD, PhD, Huaxi MR Research Center, West China Hospital of Sichuan University (Chengdu, China), said, "It is particularly important to compare PTSD patients to similarly stressed individuals in order to learn about the specific brain alterations directly related to PTSD that occur above and beyond general stress responses. Our results indicated that PTSD patients had alterations in both gray matter and white matter in comparison with other individuals who experienced similar psychological trauma from the same earthquake. Importantly, early in the course of PTSD, gray matter changes were in the form of increased rather than decreased cortical thickness, as opposed to most reported observations from other studies of PTSD. This might result from a neuro-inflammatory or other process that could be related to endocrine changes or a functional compensation. The left precuneus is well known to be important in visual processing and is more active in PTSD patients during memory tasks. It's possible that changes in the precuneus may comprise a neural alteration related to visual flashback symptoms in PTSD."

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West China Hospital of Sichuan University