Posttraumatic stress symptom persistence across 24 years: association with brain structures

Area of Science:

• Neuroscience
• Psychiatry
• Aging Research

Background:

• Posttraumatic stress disorder (PTSD) is linked to medical comorbidities and accelerated aging.
• While PTSD diagnosis correlates with reduced brain volumes, long-term associations between posttraumatic stress (PTS) symptoms and brain morphometry are understudied.
• Trauma exposure can lead to persistent psychological distress with potential long-term physiological consequences.

Purpose of the Study:

• To investigate the long-term association between persistent posttraumatic stress (PTS) symptoms and brain morphometry over approximately 24 years.
• To determine if sustained PTS symptoms in late middle age are linked to reduced volumes in specific brain regions, including the hippocampus and amygdala.
• To explore the relationship between changes in PTS symptomatology over time and brain structure.

Main Methods:

• Assessed PTS symptoms in 247 trauma-exposed men at two time points, approximately 24 years apart (average ages 38 and 62).
• Utilized 3T structural magnetic resonance imaging to measure brain volumes at the second time point.
• Correlated PTS symptom severity over time with hippocampal, amygdala, and prefrontal cortex volumes, as well as hippocampal occupancy (HOC).

Main Results:

• Persistent PTS symptoms, both averaged over time and at the initial assessment, were inversely associated with hippocampal, amygdala, rostral middle frontal gyrus (MFG), and medial orbitofrontal cortex (OFC) volumes.
• Higher PTS symptom levels were also linked to a lower hippocampal occupancy (HOC) ratio.
• Increased PTS symptomatology from the first to the second assessment was associated with smaller hippocampal volume.
• Significant results for hippocampal, rostral MFG, and medial OFC persisted even after excluding individuals meeting PTSD diagnostic criteria.

Conclusions:

• Posttraumatic stress symptoms can persist for decades after trauma exposure, even at sub-diagnostic levels.
• Long-term PTS symptoms are associated with structural brain deficits in regions critical for stress regulation and adaptation.
• These findings highlight the enduring impact of trauma on brain morphometry and stress responsivity, underscoring the need for long-term monitoring and intervention.