Brain volume and functional connectivity in firefighters with posttraumatic stress disorder

Firefighters are at an elevated risk of developing posttraumatic stress disorder (PTSD) compared with the general population. The roles of traumatic stress versus individual's predisposition in PTSD development are unclear, and neuroimaging can help identify key brain regions. This study aimed to identify altered brain volumes and connectivity in firefighters with PTSD.

We recruited 11 firefighters with PTSD, 12 firefighters without PTSD, and 25 age- and sex-matched male healthy controls. Participants completed clinical scales assessing depression, anxiety, perceived stress, job stress, somatic symptoms, sleep, suicidality, and alcohol use disorder. Magnetic resonance imaging scans, including brain anatomy and resting-state brain function, were conducted.

Firefighters with PTSD showed higher depression and anxiety scores than those without PTSD. Volumetric analysis revealed a reduced gray matter volume in the right thalamus, which was subsequently used as a seed region for functional connectivity analysis. This analysis demonstrated that increased thalamic-prefrontal connectivity in firefighters was positively correlated with PTSD and depression scores.

Our findings suggest that, in firefighters with PTSD, decreased thalamic volume and increased thalamocortical connectivity are closely associated with symptom severity. Depressive symptoms were the most crucial comorbid condition in terms of clinical symptoms and brain connectivity in firefighters with PTSD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).