Review Article
MRI findings in posttraumatic stress disorder
Akira Kunimatsu MD, PhD,
Koichiro Yasaka MD, PhD,
Hiroyuki Akai MD, PhD,
Natsuko Kunimatsu MD, PhD,
Osamu Abe MD, PhD,
Corresponding Author
Akira Kunimatsu MD, PhD
Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
Address reprint requests to: A.K., Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan. E-mail: [email protected]Search for more papers by this authorKoichiro Yasaka MD, PhD
Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
Search for more papers by this authorHiroyuki Akai MD, PhD
Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
Search for more papers by this authorNatsuko Kunimatsu MD, PhD
Department of Radiology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
Search for more papers by this authorOsamu Abe MD, PhD
Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Search for more papers by this authorAkira Kunimatsu MD, PhD,
Koichiro Yasaka MD, PhD,
Hiroyuki Akai MD, PhD,
Natsuko Kunimatsu MD, PhD,
Osamu Abe MD, PhD,
Corresponding Author
Akira Kunimatsu MD, PhD
Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
Address reprint requests to: A.K., Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, 4-6-1, Shirokanedai, Minato-ku, Tokyo 108-8639, Japan. E-mail: [email protected]Search for more papers by this authorKoichiro Yasaka MD, PhD
Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
Search for more papers by this authorHiroyuki Akai MD, PhD
Department of Radiology, IMSUT Hospital, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
Department of Radiology, The University of Tokyo Hospital, Tokyo, Japan
Search for more papers by this authorNatsuko Kunimatsu MD, PhD
Department of Radiology, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
Search for more papers by this authorOsamu Abe MD, PhD
Department of Radiology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
Search for more papers by this authorAbstract
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.
Supporting Information
| Filename | Description |
|---|---|
| jmri26929-sup-0001-TableS1.docxWord 2007 document , 35.9 KB | Table S1 Anatomical regions demonstrating gray matter volume alteration in patients with PTSD compared with trauma exposed controls in previous meta-analyses Table S2. Anatomical regions demonstrating gray matter volume alteration in patients with PTSD compared with non-trauma exposed controls in previous meta-analyses Table S3. Anatomical regions demonstrating gray matter volume alteration between trauma exposed and non-trauma exposed controls in previous meta-analyses Table S4. Anatomical regions demonstrating altered spontaneous neural activity in patients with PTSD compared with trauma exposed controls in previous meta-analyses Table S5. Anatomical regions demonstrating altered spontaneous neural activity in patients with PTSD compared with non-trauma exposed controls in previous meta-analyses |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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