| Objective: Investigating the change of structure in the brain among the persons suffering from trauma, and exploring the pathogenesis of PTSD to provide the foundations for possible pathologic neuroimaging structure in the brain regions.Methods:1. Participants: PTSD group was consisted of 15 PTSD patients who lost their children and control group was consisted of 15 individuals from a local general populations with matching gender and age. All the participants from PTSD group met PTSD diagnostic criteria of International Classification of Diseases, Tenth Revision(ICD-10). All the participants from control group passed the Physical Examination in the top three hospitals. All the participants who were right-handed were in accordance with ethical standards and signed the Medical informed Consent.2. Measures: Post-traumatic Stress Disorder Check-list-Civilian Version(PCL-C), Hamilton Anxiety Scale(HAMA), Hamilton Depression Scale(HAMD), and The self-designed General Condition Questionnaire.3. Research process: Collect the participants’ general information, and evaluate them with some related psychological questionnaires by professional rates. Within the PCL-C scores being over 41, two psychiatrists will assess the participant again.4. MRI Data collection:Magnetom TrioTim3.0T produced by Siemens with gradient of 40 m T/m and standard head coils were used. High resolution T1-weighted image was whole-brain sagittal imaging with scanning parameters as follows: FGREET, flip angle=9°, TR/TE=1900/2.26ms(time repeat,TR; time echo,TE), TI(time inverse)= 900 ms, MATRIX=256×256, thickness of layer= 1mm,gap=0. 5mm,voxel=1.0mm×1.0 mm×1.0 mm, FOV(field of view)=250mm×250mm,bandwidth=200.5.Data analysis::Cooperating with Radiology Department of the Fourth Military University Xijing Hospital, we used Voxel-based Morphometry(VBM) basing on Matlab7.1 scientific calculation software to analysis and process T1 weighted three-dimensional images for quantification of the concentration of the brain structure tissue ingredients. The two-sample t test based on statistic parametric map5(SPM5) was used to analysis volumes of grey matter between groups(PTSD group and control group). Age, gender and total internal-volume(TIV) were treated as covariates in the study. There is a statistical difference when statistic significance existed in each voxel(P<0.001) and region volumes ≥ 30 voxels.6. Statistical method:The two-sample t test and chi-square test based on SPSS17.0 was used to analysis the differences of gender, age, education between groups. Statistical level of significance was set at P<0.05. Dates were expressed as mean ± standard deviation when normally distributed.Results:1. Covariace analysis showed that compared with the control group, volumes of grey matter in the premotor cortex on the right side of the precentral gyrus, right middle frontal gyrus, left precuneus, right dorsomedial nucleus of the thalamus in PTSD group were significantly decreased(P <0.001).2. Compared with the control group, there was no statistical significance in volumes of gray matter in usual brain regions(the hippocampus, the anterior cingulated, the amygdale, the posteror insula).Conclusions:The present study shows that there is an obvious reduction of gray matter volumes in the premotor cortex on the right side of the precentral gyrus, right middle frontal gyrus, left precuneus, right dorsomedial nucleus of the thalamus in PTSD patients. This implies that the brain regions mentioned above either contribute to develop PTSD or served as susceptible regions of PTSD. VBM method based on MRI provide a safe mean to find pathological changes in brain and new standard or target for further define the pathogenesis and treatment of PTSD patients. |
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