Summary: Researchers report patients with greater hippocampal volume responded better to treatments for PTSD.
Source: Columbia University Medical Center
A study has found that PTSD patients with a larger hippocampus, a region of the brain key to distinguishing between safety and threat, are more likely to respond to exposure-based therapy for posttraumatic stress disorder (PTSD).
The study, from researchers at Columbia University Medical Center (CUMC) and New York State Psychiatric Institute (NYSPI), was published online in Psychiatry Research: Neuroimaging on May 4, 2016.
Previous research has shown that having a smaller hippocampus is associated with increased risk of PTSD. In this study, the researchers examined the relationship between hippocampus volume, measured with MRI, and response to treatment in 50 participants with PTSD and 36 trauma-exposed healthy controls. The participants were evaluated at baseline and after 10 weeks, during which time the PTSD group had prolonged exposure therapy, a type of cognitive behavioral therapy that has been shown to help patients with PTSD discriminate between real and imagined trauma.
The study found that patients with PTSD who responded to treatment had greater hippocampal volume at the beginning of the study than non-responders to treatment.
The findings add to growing evidence that the hippocampus is key to distinguishing between cues that signal safety and those that signal threat.
“If replicated, these findings have important implications for screening and treating patients who have been exposed to trauma,” noted Yuval Neria, PhD, professor of medical psychology at CUMC, director of the PTSD Program at NYSPI, and senior author of the paper. “For example, new recruits for military service may be scanned before an assignment to determine whether they are capable of dealing with the expected stress and trauma. Having a smaller hippocampus may be a contraindication for prolonged exposure to trauma.”
First author Mikael Rubin, MA, a former project coordinator at NYSPI and currently a PhD student at University of Texas at Austin, added, “While we only studied response to prolonged exposure therapy, future research may help to determine if PTSD patients with a smaller hippocampus respond better to other treatments such as medication, either alone or in combination with psychotherapy.”
Funding: This work was supported by National Institute of Mental Health grants R01MH072833 and R01MH105355 (Dr. Neria, principal investigator).
The authors have declared no financial or other conflicts of interest.
Source: Rachel Yarmolinsky – Columbia University Medical Center
Image Source: This NeuroscienceNews.com image is in the public domain.
Original Research: Abstract for “Greater hippocampal volume is associated with PTSD treatment response” by Mikael Rubin, Erel Shvil, Santiago Papini, Binod T. Chhetry, Liat Helpman, John C. Markowitz, J. John Mann, and Yuval Neria in Psychiatry Research: Neuroimaging. Published online May 4 2016 doi:10.1016/j.pscychresns.2016.05.001
http://neurosciencenews.com/ptsd-treatment-hippocampal-volume-4237/ (accessed May 13, 2016).
Greater hippocampal volume is associated with PTSD treatment response
Previous research associates smaller hippocampal volume with posttraumatic stress disorder (PTSD). It is unclear, however, whether treatment affects hippocampal volume or vice versa. Seventy-six subjects, 40 PTSD patients and 36 matched trauma-exposed healthy resilient controls, underwent clinical assessments and magnetic resonance imaging (MRI) at baseline, and 10 weeks later, during which PTSD patients completed ten weeks of Prolonged Exposure (PE) treatment. The resilient controls and treatment responders (n=23) had greater baseline hippocampal volume than treatment non-responders (n=17) (p=0.012 and p=0.050, respectively), perhaps due to more robust fear-extinction capacity in both the initial phase after exposure to trauma and during treatment.
“Greater hippocampal volume is associated with PTSD treatment response” by Mikael Rubin, Erel Shvil, Santiago Papini, Binod T. Chhetry, Liat Helpman, John C. Markowitz, J. John Mann, and Yuval Neria in Psychiatry Research: Neuroimaging. Published online May 4 2016 doi:10.1016/j.pscychresns.2016.05.001