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Published Online: 1 January 2013

Hippocampal Volumes in Patients With Chronic Combat-Related Posttraumatic Stress Disorder: A Systematic Review

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Publication: The Journal of Neuropsychiatry and Clinical Neurosciences

Abstract

Recent research has demonstrated that veterans with chronic combat-related posttraumatic stress disorder (PTSD) have a twofold increased risk of developing dementia. This review of current literature details neuroanatomical differences between veterans with PTSD and control subjects, some of whom have also had combat experience. The most common and consistent difference was in size of the hippocampus, which was found to be smaller in PTSD patients. There is a hypothesis that smaller hippocampal area is associated with greater risk for dementia; however, an alternate hypothesis is that a smaller hippocampus predisposes to PTSD.

Abstract

The authors and others have recently demonstrated that veterans with chronic combat-related PTSD (CR-PTSD) have a twofold increased risk of dementia. To understand this increased incidence, they performed a systematic review of the literature on neuroanatomical differences between veterans with chronic CR-PTSD and control subjects (22 included studies). The hippocampus was most commonly and consistently reported to differ between groups, thereby suggesting the hypothesis that PTSD is associated with smaller hippocampi, which increases the risk for dementia. However, an alternate hypothesis is that smaller hippocampal volumes are a preexisting risk factor for PTSD and dementia. Studies are clearly needed to differentiate between these important possibilities.

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Information

Published In

Go to The Journal of Neuropsychiatry and Clinical Neurosciences
Go to The Journal of Neuropsychiatry and Clinical Neurosciences
The Journal of Neuropsychiatry and Clinical Neurosciences
Pages: 12 - 25
PubMed: 23487189

History

Received: 5 January 2012
Revision received: 4 April 2012
Accepted: 16 April 2012
Published online: 1 January 2013
Published in print: Winter 2013

Authors

Details

Jason E. Childress, B.S.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.
Emily J. McDowell, B.A.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.
Venkata Vijaya K. Dalai, M.B.B.S.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.
Saivivek R. Bogale, B.A.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.
Chethan Ramamurthy, B.A.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.
Ali Jawaid, M.B.B.S.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.
Mark E. Kunik, M.D., M.P.H.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.
Salah U. Qureshi, M.D.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.
Paul E. Schulz, M.D.
From the Dept. of Neurology, University of Texas Health Science Center at Houston, Houston, TX; Baylor College of Medicine, Houston, TX; University Hospital Zurich, Institute of Neuropathology, Zurich, Switzerland; Houston HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX; VA South Central Mental Illness Research, Education and Clinical Center; and Mischer Neuroscience Institute and Memorial Hermann Hospital, Houston, TX.

Notes

Send correspondence to Paul E. Schulz, M.D. ([email protected])

Funding Information

This work was partially supported by the VA HSR&D Center of Excellence (Houston Center for Quality of Care & Utilization Studies, HFP-90-020), Houston, TX.The authors report no financial or commercial involvements that may be deemed conflicts of interest in connection with this manuscript.

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