Hippocampus Size May Determine PTSD Treatment

By Debbie Gregory.

Thanks to advances in medical technology, researchers have begun to study the effect of PTSD on the brain, with researchers focusing specific attention on the hippocampus. The hippocampus is the region of the brain key to distinguishing between safety and threat, and also the ability to store and retrieve memories.

A recent study from researchers at Columbia University Medical Center (CUMC) and New York State Psychiatric Institute (NYSPI) has found that PTSD patients with a larger hippocampus are more likely to respond to exposure-based therapy for PTSD.

First author Mikael Rubin, MA, a former project coordinator at NYSPI and currently a PhD student at University of Texas at Austin said that future research may help to determine if PTSD patients with a smaller hippocampus would respond better to other treatments, such as medication, either alone or in combination with psychotherapy.

The study was published online in Psychiatry Research: Neuroimaging on May 4, 2016.

Previous research has shown that having a smaller hippocampus is associated with increased risk of PTSD. In this study, the researchers examined the relationship between hippocampus volume, measured with MRI, and response to treatment in 50 participants with PTSD and 36 trauma-exposed healthy controls. The participants were evaluated at baseline and after 10 weeks, during which time the PTSD group had prolonged exposure therapy, a type of cognitive behavioral therapy that has been shown to help patients with PTSD discriminate between real and imagined trauma.

The study found that patients with PTSD who responded to treatment had greater hippocampal volume at the beginning of the study than non-responders to treatment.

The findings add to growing evidence that the hippocampus is key to distinguishing between cues that signal safety and those that signal threat.

“If replicated, these findings have important implications for screening and treating patients who have been exposed to trauma,” noted Yuval Neria, PhD, professor of medical psychology at CUMC, director of the PTSD Program at NYSPI, and senior author of the paper. “For example, new recruits for military service may be scanned before an assignment to determine whether they are capable of dealing with the expected stress and trauma. Having a smaller hippocampus may be a contraindication for prolonged exposure to trauma.”

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