Reduced area of the corpus callosum in posttraumatic stress disorder

https://doi.org/10.1016/j.pscychresns.2004.05.002Get rights and content

Abstract

Magnetic resonance imaging (MRI) studies have revealed decreases in the mid-sagittal area of the corpus callosum (CC) in pediatric posttraumatic stress disorder (PTSD), but at present no data are available in adult PTSD patients. We have previously reported decreased whole-brain white matter (WM) volume in adults with PTSD and now report corpus callosum area from the same sample. MRI was used to obtain whole-brain images in 12 adult patients with PTSD and 10 matched controls. Total parenchyma (white matter plus gray matter [GM]) volume, mid-sagittal area of the CC and seven sub-regions of this structure were calculated. In PTSD patients, the total CC area, absolute and normalized to total brain parenchyma, was smaller compared with control values. Several absolute and normalized CC sub-regions were also smaller in PTSD patients: genu (region 2), mid-body (region 5) and isthmus (region 6). There was also a trend for the anterior mid-body (area 4) to be smaller in PTSD patients. No differences were found in the rostrum (region 1), rostral body (region 3) or splenium (region 7). Adult patients with PTSD had decreased CC area after correcting for total brain tissue, indicating that these differences are not attributable to generalized white matter atrophy. These findings are similar to previous results in children with PTSD and suggest specific changes in the CC.

Introduction

Posttraumatic stress disorder (PTSD) is a common condition that develops in some individuals after exposure to psychological trauma. Neuroimaging studies are providing important information about the neurobiology of PTSD. Volumetric neuroimaging studies have focused on the hippocampus. Most studies of adults with chronic, severe PTSD report decreased hippocampal volumes Bremner et al., 1995, Bremner et al., 1997, Bremner et al., 2003, Gurvits et al., 1996, Stein et al., 1997, Villarreal et al., 2002, Gilbertson et al., 2002, although others did not Schuff et al., 2001, Fennema-Notestine et al., 2002, Bonne et al., 2001, Yamasue et al., 2003. Studies in pediatric PTSD have not replicated decreased hippocampal volume, but instead found smaller brain volumes De Bellis et al., 1999, Carrion et al., 2001, enlarged ventricles and decreased mid-sagittal area of the corpus callosum (CC) De Bellis et al., 1999, De Bellis et al., 2002. These findings suggest that early psychological trauma and PTSD cause impaired development or atrophy affecting the whole brain and, in particular, the CC. To our knowledge, the mid-sagittal area of the CC has not been measured in adults with PTSD. We previously reported decreased total white matter (WM) volume in adults with PTSD (Villarreal et al., 2002), and therefore we hypothesized that reductions in CC area may also be observed in an adult sample. Here, we report measures of the mid-sagittal area of the CC in the patient sample from our previous report.

Section snippets

Subjects

Patients were recruited from the University of New Mexico Health Sciences Center (UNM-HSC) psychiatric outpatient clinics. All participants signed an informed consent approved by the UNM Institutional Review Board (the Human Research Review Committee). Twelve subjects (10 women) with PTSD related to different types of traumas were recruited (see Table 1). Six had histories of childhood sexual abuse. Diagnoses were established with the Clinician Administered PTSD Scale (CAPS, Blake et al., 1995)

Results

Total absolute CC and NCC areas were significantly smaller in PTSD subjects (see Table 3). There were no differences in CC length between groups. There was a trend for a group effect for absolute CC sub-regions (F(1,20)=4.15, P=0.06) and a significant interaction effect (F(6, 120)=2.5, P=0.03). Post hoc comparisons revealed that regions 2, 5 and 6 were significantly smaller in PTSD subjects, with a trend for area 4 to be smaller (P=0.06). We also found an overall significant group effect for

Discussion

We found a decrease in total absolute and normalized CC and several sub-regions: 2 (genu), 4 (anterior mid-body, statistical trend), 5 (mid-body) and (6 isthmus) in adult subjects with chronic, severe PTSD. These findings are strikingly similar to what De Bellis et al., 1999, De Bellis et al., 2002 found in pediatric PTSD. This group found smaller total CC area, reduced sub-regions 2, 4, 5 and 6, and, in addition, reduced area 7 (spenium) in children with PTSD. Other findings from these

Acknowledgements

This work was supported in part by grants to GV from the dedicated funds of the University of New Mexico School of Medicine and from the Mental Illness and Neuroscience Discovery (MIND) Institute, Albuquerque NM and grants to WMB from the NIH (NS35708, NS39123, HD41237, RR15636) and from the MIND Institute.

This study was presented at the International Society for Traumatic Stress Studies, November 2002.

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