Proton Magnetic Resonance Spectroscopy of the Hippocampus and Occipital White Matter in PTSD: Preliminary Results

Abstract

French

Objective:

Previous proton magnetic resonance spectroscopy (¹H-MRS) studies in posttraumatic stress disorder (PTSD) report decreased hippocampal N-acetylaspartate (NAA), an indicator of neuronal integrity. However, other areas of the brain need to be explored. The objective of this study was to investigate the specificity of hippocampal NAA concentration changes in PTSD by also examining a control region, the occipital white matter (OWM).

Methods:

Eight patients with PTSD and 5 control subjects underwent single-voxel ¹H-MRS of the hippocampi and bilateral OWM. Absolute neurometabolite concentrations were determined.

Preliminary Results:

Trends toward reduced left hippocampal NAA and creatine (Cre) were found in the PTSD group. PTSD subjects also had reduced bilateral OWM Cre.

Conclusions:

The preliminary results of our study in civilians with PTSD replicate previous MRS studies and are consistent with decreased hippocampal neuronal integrity without effects in the OWM. Replication of our findings is needed.

Keywords

posttraumatic stress disorder magnetic resonance spectroscopy N-acetylaspartate hippocampus white matter

References

Bremner

Randall

Scott

Bronen

Seibyl

Southwick

, and others. MRI-based measurement of hippocampal volume in patients with combat-related posttraumatic stress disorder. Am J Psychiatry 1995;152:973–81.

Gurvits

Shenton

Hokama

Ohta

Lasko

Gilbertson

, and others. Magnetic resonance imaging study of hippocampal volume in chronic, combat-related posttraumatic stress disorder. Biol Psychiatry 1996;40:1091–9.

Bremner

Randall

Vermetten

Staib

Bronen

Mazure

, and others. Magnetic resonance imaging-based measurement of hippocampal volume in posttraumatic stress disorder related to childhood physical and sexual abuse—a preliminary report. Biol Psychiatry 1997;41:23–32.

Stein

Koverola

Hanna

Torchia

McClarty

Hippocampal volume in women victimized by childhood sexual abuse. Psychol Med 1997;27:951–9.

Schuff

Neylan

Lenoci

Weiss

Marmar

, and others. Decreased hippocampal N-acetylaspartate in the absence of atrophy in posttraumatic stress disorder. Biol Psychiatry 2001;50:952–9.

Pitman

: Hippocampal diminution in PTSD: More (or less?) than meets the eye. Hippocampus 2001;11(2):73–4.

Charles

Snyderman

Aheam

Magnetic resonance spectroscopy. In: Krishnan

KRR

Doraiswami

, editors. Brian imaging in clinical psychiatry. New York: Marsel Dekker; 1997.

Urenjak

Williams

Gadian

Noble

Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types. J Neurosci 1993;13:981–9.

Schuff

Marmar

Weiss

Neylan

Schoenfeld

Fein

, and others. Reduced hippocampal volume and n-acetyl aspartate in posttraumatic stress disorder. Annal NY Acad Sci 1997;821:516–20.

10.

Freeman

Cardwell

Karson

Komoroski

. In vivo proton magnetic resonance spectroscopy of the medial temporal lobes of subjects with combat-related posttraumatic stress disorder. Magn Reson Med 1998;40:66–71.

11.

Soher

Hurd

Sailasuta

Barker

. Quantitation of automated single-voxel proton MRS using cerebral water as an internal reference. Magn Reson Med 1996;36:335–9.

12.

Brooks

Friedman

Siedly

. Reproducibility of 1H-MRS in vivo. Magn Reson Med 1999 41:193–7.

13.

First

Spitzer

Gibbon

Williams

JAB

. Structured clinical interview for DSM-IV axis I diagnosis-patient edition (SCID-I/P, version 2.0). New York: Biometric research Department, New York State Psychiatric Institute; 1996.

14.

Blake

Weathers

Nagy

Kaloupek

Gusman

Charney

, and others. The development of a clinician-administered PTSD Scale. J Trauma Stress 1995;8(1):75–90.

15.

Brooks

Sabet

Sibbitt

Barker

Zijl v

Duyn

, and others. Neurochemistry of brain lesions determined by spectroscopic imaging in systemic lupus erythematosus. J Rheumatol 1997;24:2323–9.

16.

Petropoulos

Sibbitt

Jr Brooks

. Automated T2 quantitation in neuropsychiatric lupus erythematosus: A marker of active disease. J Magn Reson Imaging 1999;9(1):39–4.3.

17.

Cohen

Statistical power analysis for the behavioral sciences. Hillsdale (NJ): Erlbaum; 1988.

18.

Sheline

. 3D MRI studies of neuroanatomic changes in unipolar major depression: The role of stress and medical comorbidity. Biol Psychiatry 2000;48:791–800.