MRI findings in posttraumatic stress disorder

• Published in: Journal of magnetic resonance imaging Vol. 52; no. 2; pp. 380 - 396
• Main Authors: Kunimatsu, Akira, Yasaka, Koichiro, Akai, Hiroyuki, Kunimatsu, Natsuko, Abe, Osamu
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.08.2020; Wiley Subscription Services, Inc
• Subjects: Abnormalities; Amygdala; Anisotropy; Atrophy; Autonomic nervous system; Brain; Brain - diagnostic imaging; Cortex (cingulate); Cortex (parietal); diffusion tensor imaging; Emotions; Executive function; Fear; Functional magnetic resonance imaging; Functional Neuroimaging; Hippocampus; Humans; Learning; Lentiform nucleus; Magnetic Resonance Imaging; Medical imaging; Mood; Networks; Neural networks; Neuroimaging; Parahippocampal gyrus; Post traumatic stress disorder; posttraumatic stress disorder; Prefrontal cortex; Psychological stress; resting state functional MRI; spontaneous neural activity; Stress Disorders, Post-Traumatic - diagnostic imaging; Structure-function relationships; Substantia alba; Substantia grisea; Trauma; voxel‐based morphometry; diffusion tensor imaging; voxel-based morphometry; resting state functional MRI; spontaneous neural activity; posttraumatic stress disorder
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.26929

Posttraumatic stress disorder (PTSD) is a psychiatric condition that develops after a person experiences one or more traumatic events, characterized by intrusive recollection, avoidance of trauma‐related events, hyperarousal, and negative cognitions and mood. Neurophysiological evidence suggests that the development of PTSD is ascribed to functional abnormalities in fear learning, threat detection, executive function and emotional regulation, and contextual processing. Magnetic resonance imaging (MRI) plays a primary role in both structural and functional neuroimaging for PTSD, demonstrating focal atrophy of the gray matter, altered fractional anisotropy, and altered focal neural activity and functional connectivity. MRI findings have implicated that brain regions associated with PTSD pathophysiology include the medial and dorsolateral prefrontal cortex, orbitofrontal cortex, insula, lentiform nucleus, amygdala, hippocampus and parahippocampus, anterior and posterior cingulate cortex, precuneus, cuneus, fusiform and lingual gyri, and the white matter tracts connecting these brain regions. Of these, alterations in the anterior cingulate, amygdala, hippocampus, and insula are highly reproducible across structural and functional MRI, supporting the hypothesis that abnormalities in fear learning and reactions to threat play an important role in the development of PTSD. In addition, most of these structures have been known to belong to one or more intrinsic brain networks regulating autobiographical memory retrieval and self‐thought, salience detection and autonomic responses, or attention and emotional control. Altered functional brain networks have been shown in PTSD. Therefore, in PTSD MRI is expected to reflect disequilibrium among functional brain networks, malfunction within an individual network, and impaired brain structures closely interacting with the networks. Level of Evidence: 3 Technical Efficacy Stage: 3 J. Magn. Reson. Imaging 2019. J. Magn. Reson. Imaging 2020;52:380–396.