Using MR to measure the volume of a patient’s hippocampus — a region in the brain that distinguishes between safety and threat — researchers from Columbia University Medical Center (CUMC) and New York State Psychiatric Institute may have found a way to predict which PTSD patients will have greater success recovering with exposure-based therapy.

The patients, 50 with PTSD and 36 exposed to trauma with no symptoms of PTSD, were evaluated before the study and after 10 weeks using the Clinician-Administered PTSD scale. During this time, the participants with PTSD had prolonged exposure therapy to help them discern between real and imagined trauma.

Although previous research has suggested a smaller hippocampus is associated with an increased risk of PTSD, Yuval Neria, Ph.D., senior author of the paper, professor of medical psychology at CUMC, and his team, discovered that patients with PTSD who responded to treatment had greater hippocampal volume.
“Larger hippocampus can more effectively support highly-needed memory and learning processes than smaller hippocampus, especially with regard to extinction of traumatic memories and normalizing impaired fear processing in the brain,” Neria told HCB News.

“The larger the hippocampus, the better the coping of the person with exposure to trauma,” said Neria. “In particular, hippocampus may have an important role in distinguishing between safe and threat situations, a capacity that is frequently impaired in PTSD.”

Neria believes that these findings could have important implications for screening and treating patients with PTSD, such as with new military recruits. These individuals could be scanned before an assignment to determine if they are capable of dealing with stress and trauma associated with war.

Currently, the researchers are conducting further research using neuroimaging methods to clarify function and structural changes in the brain for those with PTSD, and to what extent symptoms can be reversed with treatment.

“Future research may help to determine if PTSD patients with a smaller hippocampus respond better to other treatments such as medication, either alone or in combination with psychotherapy,” said first author Mikael Rubin, a Ph.D. student at the University of Texas, in a statement.

Alzheimers/Neurology Homepage