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Effects of psychotherapy on hippocampal volume in out-patients with post-traumatic stress disorder: a MRI investigation

Published online by Cambridge University Press:  16 June 2005

RAMÓN J. L. LINDAUER ,
ERIK-JAN VLIEGER ,
MARGJE JALINK ,
MIRANDA OLFF ,
INGRID V. E. CARLIER ,
CHARLES B. L. M. MAJOIE ,
GERARD J. DEN HEETEN  and
BERTHOLD P. R. GERSONS
RAMÓN J. L. LINDAUER
Affiliation:
Centre for Psychological Trauma, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands De Bascule and Department of Child and Adolescent Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Graduate School Neurosciences Amsterdam, Amsterdam, The Netherlands
ERIK-JAN VLIEGER
Affiliation:
Department of Radiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
MARGJE JALINK
Affiliation:
Centre for Psychological Trauma, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
MIRANDA OLFF
Affiliation:
Centre for Psychological Trauma, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
INGRID V. E. CARLIER
Affiliation:
Centre for Work-Related Mental Disorders, Altrecht Institute for Mental Health Care, Utrecht, The Netherlands
CHARLES B. L. M. MAJOIE
Affiliation:
Department of Radiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
GERARD J. DEN HEETEN
Affiliation:
Department of Radiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
BERTHOLD P. R. GERSONS
Affiliation:
Centre for Psychological Trauma, Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
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Abstract

Background. Magnetic resonance imaging (MRI) studies have especially reported smaller hippocampal volume in patients with post-traumatic stress disorder (PTSD), most of them war or sexual abuse victims. The present study compares the hippocampal volumes of out-patients with PTSD who had low co-morbidity rates to those of trauma-exposed control subjects without PTSD, and measures hippocampal volume changes in these patients after brief eclectic psychotherapy. We hypothesized that smaller hippocampal volumes are specific to PTSD and that hippocampal volume changes after effective psychotherapy would be measurable.

Method. Eighteen patients with PTSD and 14 traumatized control subjects were examined with MRI. In a randomized clinical trial, the PTSD patients were assigned to treatment (n=9) or waiting-list group (n=9). After the former received psychotherapy for 4 months, the MRI was repeated on both PTSD groups. Three temporal lobe structures were manually segmented: hippocampus, amygdala, and parahippocampal gyrus. Volumetric analysis was used to measure grey matter, white matter, and cerebrospinal fluid.

Results. PTSD patients had significantly smaller hippocampal volumes at baseline (total 13·8%, right 13·5%, left 14·1%) compared to the control subjects. After effective psychotherapy, however, no volume changes were found in the smaller hippocampi.

Conclusions. We confirmed previous findings of smaller hippocampal volume in PTSD in a new population made up of out-patients who experienced different types of traumas, reducing co-morbidity to a minimum. Smaller hippocampal volumes did not change after effective psychotherapy, even while symptoms resolved.

Type
Original Article
Information
Psychological Medicine , Volume 35 , Issue 10 , October 2005 , pp. 1421 - 1431
Copyright
© 2005 Cambridge University Press

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Footnotes

Presented at the Annual Meeting of the International Society for Traumatic Stress Studies, New Orleans, 16 November 2004, and at the European Congress for Psychotherapy, Amsterdam, 27 November 2004.