Resting Regional Cerebral Perfusion In Acute Posttraumatic Stress Disorder Using Arterial Spin-labeling MR Imaging

ObjectiveThe goal of this study is using resting state arterial spin-labeling (ASL) perfusion MRI to detect regional cerebral blood flow (rCBF) changes in acute PTSD at3months after trauma, as well as the correlation between regional cerebral blood flow(rCBF) and clinical symptoms.MethodUsing non-invasive neuroimaging technique, pulsed arterial spin-labeling (PASL) perfusion MRI and SPM5,to measure rCBF changes of the brain in30cases with acute posttraumatic stress disorder at3months after trauma and36healthy controls.PTSD including17males and13females, all patients were diagnosed with Diagnostici and Statistical Manual of Mental Disorders, Fourth Edition(DSM-IV) of American Psychiatric Association, as well as they has free been the drug treatment.It is used to evaluating the severity of PTSD by clinical administered PTSD scale(CAPS:29.6±18.8); as well as the Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) to evaluate PTSD symptoms of anxiety and depression status:HAMA (10.5±7.7), HAMD(9.2±5.9).In36healthy controls,there are21males and15females. Finally using Xjview extraction of abnormal brain regions as regions of interest(ROI), to analyze the correlation of ROI perfusion in patients with CAPS, HAMA and HAMD in PTSD.ResultIn comparison with the healthy controls(n=36), The rCBF decreased obviously in the right temporal lobe, left middle temporal gyrus, right middle frontal gyrus, right medial orbital gyrus, right insular cortex, right middle occipital gyrus and right precuneus in the cases with PTSD(P<0.05);The rCBF in the right insular cortex negatively correlated with the CAPS(r=-0.396,p=0.030) and HAMA (r=-0.465,p=0.010) scores of all subjects in the region of interest.ConclusionIn the patients with PTSD, the rCBF is decreased in the brain lacally,and the severity of patients symptom is associated with cerebral blood flow of right insular brain.These suggest that rCBF could predict the severity of clinical symptoms of PTSD.