Several studies have noted that an inner brain structure, the hippocampus, is unusually small in individuals who, after surviving extraordinary threats, experience flashbacks, nightmares, and other symptoms of post-traumatic stress disorder (PTSD). A new investigation, in the November Nature Neuroscience, indicates that some of these people possess an undersized hippocampus before they ever develop PTSD.
This finding challenges the theory that hormonal responses to traumatic events shrink the hippocampus, a brain area implicated in memory and in the learning of fear responses (SN: 6/3/95, p. 340).
Psychiatrist Mark W. Gilbertson of Harvard Medical School in Boston and his colleagues studied 40 pairs of identical twins in which one brother had been a Vietnam combat veteran and the other had stayed at home. After the war, PTSD afflicted 17 combat veterans. None of the veterans’ brothers developed PTSD.
Magnetic resonance imaging scans identified a smaller hippocampus, relative to total brain size, in those with PTSD than in other combat veterans. In the PTSD group, the hippocampus reached its lowest relative size in men with the most severe psychiatric symptoms. A comparably small hippocampus appeared in the twin brothers of men with PTSD, but not in brothers of other veterans.
A small hippocampus may predispose a person to form intense, long-lasting emotional responses to sights, smells, and other stimuli associated with traumatic events, the scientists theorize.
Trauma-induced atrophy of the hippocampus may still occur and perhaps contribute to PTSD, comments Stanford University biologist Robert M. Sapolsky. For instance, he notes an earlier study of different Vietnam veterans by Gilbertson and his team. They found a small hippocampus in those who survived severe combat trauma, whether or not PTSD later occurred.
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