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Anterior cingulate cortical thickness is a stable predictor of recovery from post-traumatic stress disorder

Published online by Cambridge University Press:  15 June 2012

E. W. Dickie ,
A. Brunet ,
V. Akerib  and
J. L. Armony
E. W. Dickie
Affiliation:
Douglas Mental Health University Institute, Montreal, Quebec, Canada
A. Brunet
Affiliation:
Douglas Mental Health University Institute, Montreal, Quebec, Canada Department of Psychiatry, McGill University, Montreal, Quebec, Canada
V. Akerib
Affiliation:
Douglas Mental Health University Institute, Montreal, Quebec, Canada
J. L. Armony*
Affiliation:
Douglas Mental Health University Institute, Montreal, Quebec, Canada Department of Psychiatry, McGill University, Montreal, Quebec, Canada
*
*Address for correspondence: J. L. Armony, Ph.D., Douglas Mental Health University Institute, 6875 LaSalle Boulevard, Verdun, QC H4H 1R3, Canada. (Email: [email protected])
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Abstract

Background

Decreased cortical thickness in frontal and temporal regions has been observed in individuals suffering from post-traumatic stress disorder (PTSD), compared to healthy controls and trauma-exposed participants without PTSD. In addition, individual differences, both functional and structural, in the anterior cingulate cortex (ACC) have been shown to predict symptom severity reduction. Although there is some evidence suggesting that activity in this region changes as a function of recovery, it remains unknown whether there are any structural correlates of recovery from PTSD.

Method

Thirty participants suffering from moderate to severe PTSD underwent a magnetic resonance imaging (MRI) scan following an initial clinical assessment. A second assessment took place 6–9 months later. In addition, a subgroup of 25 participants completed a second MRI scan at that time. PTSD symptom severity changes over time were regressed against vertex-based cortical thickness.

Results

We found that cortical thickness in the right subgenual ACC (sgACC) predicted symptom improvement. Moreover, cortical thickness within this region of the ACC, measured 6–9 months later (n = 25), was also correlated with the same measure of symptom improvement. By contrast, no relationship was found between change in cortical thickness in this area and current PTSD symptom levels or degree of recovery.

Conclusions

Our results suggest that sgACC thickness may be a stable marker of recovery potential in PTSD.

Keywords

Cortical thicknessmagnetic resonance imagingmedial prefrontal cortexpost-traumatic stress disorderrecovery
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 3 , March 2013 , pp. 645 - 653
Copyright
Copyright © Cambridge University Press 2012

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References

Ad-Dab'bagh, Y, Lyttelton, O, Muehlboeck, J-S, Lepage, C, Einarson, D, Mok, K, Ivanov, O, Vincent, RD, Lerch, J, Fombonne, E, Evans, AC (2006). The CIVET image-processing environment: a fully automated comprehensive pipeline for anatomical neuroimaging research. In Proceedings of the 12th Annual Meeting of the Organization for Human Brain Mapping, Florence, Italy (ed. Corbetta, M.).Google Scholar
Armony, JL, Corbo, V, Clement, MH, Brunet, A (2005). Amygdala response in patients with acute PTSD to masked and unmasked emotional facial expressions. American Journal of Psychiatry 162, 1961–1963.CrossRefGoogle ScholarPubMed
Beck, AT, Ward, CH, Mendelson, M, Mock, J, Erbaugh, J (1961). An inventory for measuring depression. Archives of General Psychiatry 4, 561–571.CrossRefGoogle ScholarPubMed
Blake, DD, Weathers, FW, Nagy, LM, Kaloupek, DG, Gusman, FD, Charney, DS, Keane, TM (1995). The development of a Clinician-Administered PTSD Scale. Journal of Traumatic Stress 8, 75–90.Google ScholarPubMed
Brunet, A, Weiss, DS, Metzler, TJ, Best, SR, Neylan, TC, Rogers, C, Fagan, J, Marmar, CR (2001). The Peritraumatic Distress Inventory: a proposed measure of PTSD criterion A2. American Journal of Psychiatry 158, 1480–1485.CrossRefGoogle ScholarPubMed
Bryant, RA, Felmingham, K, Kemp, A, Das, P, Hughes, G, Peduto, A, Williams, L (2008 a). Amygdala and ventral anterior cingulate activation predicts treatment response to cognitive behaviour therapy for post-traumatic stress disorder. Psychological Medicine 38, 555–561.CrossRefGoogle ScholarPubMed
Bryant, RA, Felmingham, K, Whitford, TJ, Kemp, A, Hughes, G, Peduto, A, Williams, LM (2008 b). Rostral anterior cingulate volume predicts treatment response to cognitive-behavioural therapy for posttraumatic stress disorder. Journal of Psychiatry and Neuroscience 33, 142–146.Google ScholarPubMed
Bryant, RA, Marosszeky, JE, Crooks, J, Baguley, I, Gurka, J (2000). Coping style and post-traumatic stress disorder following severe traumatic brain injury. Brain Injury 14, 175–180.Google ScholarPubMed
Chen, S, Xia, W, Li, L, Liu, J, He, Z, Zhang, Z, Yan, L, Zhang, J, Hu, D (2006). Gray matter density reduction in the insula in fire survivors with posttraumatic stress disorder: a voxel-based morphometric study. Psychiatry Research 146, 65–72.CrossRefGoogle ScholarPubMed
Clohessy, S, Ehlers, A (1999). PTSD symptoms, response to intrusive memories and coping in ambulance service workers. British Journal of Clinical Psychology 38, 251–265.CrossRefGoogle ScholarPubMed
Collins, DL, Neelin, P, Peters, TM, Evans, AC (1994). Automatic 3D intersubject registration of MR volumetric data in standardized Talairach space. Journal of Computer Assisted Tomography 18, 192–205.CrossRefGoogle ScholarPubMed
Corbo, V, Clement, MH, Armony, JL, Pruessner, JC, Brunet, A (2005). Size versus shape differences: contrasting voxel-based and volumetric analyses of the anterior cingulate cortex in individuals with acute posttraumatic stress disorder. Biological Psychiatry 58, 119–124.CrossRefGoogle ScholarPubMed
Costafreda, SG, Chu, C, Ashburner, J, Fu, CH (2009). Prognostic and diagnostic potential of the structural neuroanatomy of depression. PLoS ONE 4, e6353.CrossRefGoogle ScholarPubMed
Dickie, EW, Brunet, A, Akerib, V, Armony, JL (2008). An fMRI investigation of memory encoding in PTSD: influence of symptom severity. Neuropsychologia 46, 1522–1531.CrossRefGoogle ScholarPubMed
Dickie, EW, Brunet, A, Akerib, V, Armony, JL (2011). Neural correlates of recovery from post-traumatic stress disorder: a longitudinal fMRI investigation of memory encoding. Neuropsychologia 49, 1771–1778.CrossRefGoogle ScholarPubMed
Felmingham, KL, Bryant, RA (2012). Gender differences in the maintenance of response to cognitive behavior therapy for posttraumatic stress disorder. Journal of Consulting and Clinical Psychology 80, 196–200.CrossRefGoogle ScholarPubMed
Felmingham, K, Kemp, A, Williams, L, Das, P, Hughes, G, Peduto, A, Bryant, R (2007). Changes in anterior cingulate and amygdala after cognitive behavior therapy of posttraumatic stress disorder. Psychological Science 18, 127–129.CrossRefGoogle ScholarPubMed
Fischl, B, Dale, AM (2000). Measuring the thickness of the human cerebral cortex from magnetic resonance images. Proceedings of the National Academy of Sciences USA 97, 11050–11055.CrossRefGoogle ScholarPubMed
Francati, V, Vermetten, E, Bremner, JD (2007). Functional neuroimaging studies in posttraumatic stress disorder: review of current methods and findings. Depression and Anxiety 24, 202–218.CrossRefGoogle ScholarPubMed
Grabner, G, Janke, AL, Budge, MM, Smith, D, Pruessner, J, Collins, DL (2006). Symmetric atlasing and model based segmentation: an application to the hippocampus in older adults. Medical Image Computing and Computer-Assisted Intervention 9, 58–66.Google Scholar
Hutton, C, De Vita, E, Ashburner, J, Deichmann, R, Turner, R (2008). Voxel-based cortical thickness measurements in MRI. NeuroImage 40, 1701–1710.CrossRefGoogle ScholarPubMed
Johansen-Berg, H (2011). The future of functionally-related structural change assessment. NeuroImage. Published online: 28 October 2011. doi:10.1016/j.neuroimage.2011.10.073.Google ScholarPubMed
Karl, A, Schaefer, M, Malta, LS, Dorfel, D, Rohleder, N, Werner, A (2006). A meta-analysis of structural brain abnormalities in PTSD. Neuroscience and Biobehavioral Reviews 30, 1004–1031.CrossRefGoogle ScholarPubMed
Kasai, K, Yamasue, H, Gilbertson, MW, Shenton, ME, Rauch, SL, Pitman, RK (2008). Evidence for acquired pregenual anterior cingulate gray matter loss from a twin study of combat-related posttraumatic stress disorder. Biological Psychiatry 63, 550–556.CrossRefGoogle ScholarPubMed
Kim, JS, Singh, V, Lee, JK, Lerch, J, Ad-Dab'bagh, Y, MacDonald, D, Lee, JM, Kim, SI, Evans, AC (2005). Automated 3-D extraction and evaluation of the inner and outer cortical surfaces using a Laplacian map and partial volume effect classification. NeuroImage 27, 210–221.CrossRefGoogle ScholarPubMed
Kroes, MC, Whalley, MG, Rugg, MD, Brewin, CR (2011). Association between flashbacks and structural brain abnormalities in posttraumatic stress disorder. European Psychiatry 26, 525–531.CrossRefGoogle ScholarPubMed
Lerch, JP, Evans, AC (2005). Cortical thickness analysis examined through power analysis and a population simulation. NeuroImage 24, 163–173.CrossRefGoogle Scholar
Lyttelton, O, Boucher, M, Robbins, S, Evans, A (2007). An unbiased iterative group registration template for cortical surface analysis. NeuroImage 34, 1535–1544.CrossRefGoogle ScholarPubMed
Marmar, CR, Weiss, DS, Schlenger, WE, Fairbank, JA, Jordan, BK, Kulka, RA, Hough, RL (1994). Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans. American Journal of Psychiatry 151, 902–907.Google ScholarPubMed
Milad, MR, Orr, SP, Lasko, NB, Chang, Y, Rauch, SL, Pitman, RK (2008). Presence and acquired origin of reduced recall for fear extinction in PTSD: results of a twin study. Journal of Psychiatric Research 42, 515–520.CrossRefGoogle ScholarPubMed
Milad, MR, Pitman, RK, Ellis, CB, Gold, AL, Shin, LM, Lasko, NB, Zeidan, MA, Handwerger, K, Orr, SP, Rauch, SL (2009). Neurobiological basis of failure to recall extinction memory in posttraumatic stress disorder. Biological Psychiatry 66, 1075–1082.CrossRefGoogle ScholarPubMed
Milad, MR, Quinn, BT, Pitman, RK, Orr, SP, Fischl, B, Rauch, SL (2005). Thickness of ventromedial prefrontal cortex in humans is correlated with extinction memory. Proceedings of the National Academy of Sciences USA 102, 10706–10711.CrossRefGoogle ScholarPubMed
Milad, MR, Rauch, SL, Pitman, RK, Quirk, GJ (2006). Fear extinction in rats: implications for human brain imaging and anxiety disorders. Biological Psychology 73, 61–71.CrossRefGoogle ScholarPubMed
Moore, GJ, Cortese, BM, Glitz, DA, Zajac-Benitez, C, Quiroz, JA, Uhde, TW, Drevets, WC, Manji, HK (2009). A longitudinal study of the effects of lithium treatment on prefrontal and subgenual prefrontal gray matter volume in treatment-responsive bipolar disorder patients. Journal of Clinical Psychiatry 70, 699–705.CrossRefGoogle ScholarPubMed
Nardo, D, Hogberg, G, Looi, JC, Larsson, S, Hallstrom, T, Pagani, M (2010). Gray matter density in limbic and paralimbic cortices is associated with trauma load and EMDR outcome in PTSD patients. Journal of Psychiatric Research 44, 477–485.CrossRefGoogle ScholarPubMed
Quirk, GJ, Garcia, R, Gonzalez-Lima, F (2006). Prefrontal mechanisms in extinction of conditioned fear. Biological Psychiatry 60, 337–343.CrossRefGoogle ScholarPubMed
Rauch, SL, Shin, LM, Phelps, EA (2006). Neurocircuitry models of posttraumatic stress disorder and extinction: human neuroimaging research – past, present, and future. Biological Psychiatry 60, 376–382.CrossRefGoogle ScholarPubMed
Rauch, SL, Shin, LM, Segal, E, Pitman, RK, Carson, MA, McMullin, K, Whalen, PJ, Makris, N (2003). Selectively reduced regional cortical volumes in post-traumatic stress disorder. NeuroReport 14, 913–916.Google ScholarPubMed
Robbins, S, Evans, AC, Collins, DL, Whitesides, S (2004). Tuning and comparing spatial normalization methods. Medical Image Analysis 8, 311–323.CrossRefGoogle ScholarPubMed
Schnider, KR, Elhai, JD, Gray, MJ (2007). Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss. Journal of Counseling Psychology 54, 344–350.CrossRefGoogle Scholar
Sheehan, DV, Lecrubier, Y, Sheehan, KH, Amorim, P, Janavs, J, Weiller, E, Hergueta, T, Baker, R, Dunbar, GC (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry 59 (Suppl. 20), 22–33; quiz 34–57.Google ScholarPubMed
Shin, LM, Wright, CI, Cannistraro, PA, Wedig, MM, McMullin, K, Martis, B, Macklin, ML, Lasko, NB, Cavanagh, SR, Krangel, TS, Orr, SP, Pitman, RK, Whalen, PJ, Rauch, SL (2005). A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Archives of General Psychiatry 62, 273–281.CrossRefGoogle ScholarPubMed
Sled, JG, Zijdenbos, AP, Evans, AC (1998). A nonparametric method for automatic correction of intensity nonuniformity in MRI data. IEEE Transactions on Medical Imaging 17, 87–97.CrossRefGoogle ScholarPubMed
Talairach, P, Tournoux, J (1988). Stereotactic Coplanar Atlas of the Human Brain. Thieme: Stuttgart, Germany.Google Scholar
Williams, LM, Kemp, AH, Felmingham, K, Barton, M, Olivieri, G, Peduto, A, Gordon, E, Bryant, RA (2006). Trauma modulates amygdala and medial prefrontal responses to consciously attended fear. NeuroImage 29, 347–357.CrossRefGoogle ScholarPubMed
Woodward, SH, Kaloupek, DG, Streeter, CC, Martinez, C, Schaer, M, Eliez, S (2006). Decreased anterior cingulate volume in combat-related PTSD. Biological Psychiatry 59, 582–587.CrossRefGoogle ScholarPubMed
Woodward, SH, Schaer, M, Kaloupek, DG, Cediel, L, Eliez, S (2009). Smaller global and regional cortical volume in combat-related posttraumatic stress disorder. Archives of General Psychiatry 66, 1373–1382.CrossRefGoogle ScholarPubMed
Worsley, KJ, Andermann, M, Koulis, T, MacDonald, D, Evans, AC (1999). Detecting changes in nonisotropic images. Human Brain Mapping 8, 98–101.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Yamasue, H, Kasai, K, Iwanami, A, Ohtani, T, Yamada, H, Abe, O, Kuroki, N, Fukuda, R, Tochigi, M, Furukawa, S, Sadamatsu, M, Sasaki, T, Aoki, S, Ohtomo, K, Asukai, N, Kato, N (2003). Voxel-based analysis of MRI reveals anterior cingulate gray-matter volume reduction in posttraumatic stress disorder due to terrorism. Proceedings of the National Academy of Sciences USA 100, 9039–9043.CrossRefGoogle ScholarPubMed
Yehuda, R, LeDoux, J (2007). Response variation following trauma: a translational neuroscience approach to understanding PTSD. Neuron 56, 19–32.CrossRefGoogle ScholarPubMed
Zijdenbos, AP, Forghani, R, Evans, AC (2002). Automatic ‘pipeline’ analysis of 3-D MRI data for clinical trials: application to multiple sclerosis. IEEE Transactions on Medical Imaging 21, 1280–1291.CrossRefGoogle ScholarPubMed