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, 100 (15), 9039-43

Voxel-based Analysis of MRI Reveals Anterior Cingulate Gray-Matter Volume Reduction in Posttraumatic Stress Disorder Due to Terrorism

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Voxel-based Analysis of MRI Reveals Anterior Cingulate Gray-Matter Volume Reduction in Posttraumatic Stress Disorder Due to Terrorism

H Yamasue et al. Proc Natl Acad Sci U S A.

Abstract

MRI studies using the manual tracing method have shown a smaller-than-normal hippocampal volume in patients with posttraumatic stress disorder (PTSD). However, these studies have yielded inconsistent results, and brain structures other than the hippocampus have not been well investigated. A recently developed, fully automated method called voxel-based morphometry enables an exploration of structural changes throughout the brain by applying statistical parametric mapping to high-resolution MRI. Here we first used this technology in patients with PTSD. Participants were 9 victims of the Tokyo subway sarin attack with PTSD and 16 matched victims of the same traumatic event without PTSD. The voxel-based morphometry showed a significant gray-matter volume reduction in the left anterior cingulate cortex (ACC) in trauma survivors with PTSD compared with those without PTSD. The severity of the disorder was negatively correlated with the gray-matter volume of the left ACC in PTSD subjects. There were no significant differences in other gray-matter regions or any of the white-matter regions between two groups. The present study demonstrates evidence for structural abnormalities of ACC in patients with PTSD. Together with previous functional neuroimaging studies showing a dysfunction of this region, the present findings provide further support for the important role of ACC, which is pivotally involved in attention, emotional regulation, and conditioned fear, in the pathology of PTSD.

Figures

Fig. 1.
Fig. 1.
Results of SPM analysis of MRI data. Statistical parametric map in three orthogonal projections shows voxels where less regional gray-matter densities emerged in the victims with PTSD compared with those without PTSD.
Fig. 2.
Fig. 2.
Regional differences between the victims with and without PTSD. Areas with significantly reduced gray-matter densities in the victims with PTSD compared with those without PTSD were rendered onto orthogonal slices of the normal template magnetic resonance images.
Fig. 3.
Fig. 3.
Left ACC volume correlations with PTSD symptoms measured by total score of CAPS.

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