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2018 ; 19
(ä): 581-598
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Structural white matter changes in adults and children with posttraumatic stress
disorder: A systematic review and meta-analysis
#MMPMID29984166
Siehl S
; King JA
; Burgess N
; Flor H
; Nees F
Neuroimage Clin
2018[]; 19
(ä): 581-598
PMID29984166
show ga
White matter plasticity occurs throughout life due to learning and can be a
protective factor against as well as a vulnerability factor for the development
of mental disorders. In this systematic review we summarize findings on
structural white matter changes in children and adults with posttraumatic stress
disorder (PTSD) and relate them to theoretical accounts of the pathophysiology of
PTSD with a focus on the disturbed processing of contexts and associated problems
in emotional and cognitive processing and PTSD symptomatology. We particularly
examine studies reporting fractional anisotropy (FA) measured with diffusion
tensor imaging (DTI). We further subdivided the studies in adult-onset PTSD with
traumatic experience in adulthood, adult-onset PTSD with traumatic experience in
childhood and children with PTSD. We included 30 studies comprising almost 1700
participants with 450 adults and 300 children suffering from PTSD. Our systematic
review showed that for children with PTSD and adult-onset PTSD with childhood
trauma, a decrease in FA in the corpus collosum, most prominently in the anterior
and posterior midbody, the isthmus and splenium were reported. For adult-onset
PTSD with traumatic experience in adulthood, changes in FA in the anterior and
posterior part of the cingulum, the superior longitudinal fasciculus and frontal
regions were found. Using GingerAle, we also performed a coordinate-based
meta-analysis of 14 studies of adult-onset PTSD with traumatic experience in
adulthood and did not find any significant clusters. Our results suggest that
changes in white matter microstructure vary depending on traumatic experience and
are associated with changes in brain circuits related to the processing of
contexts. Finally, we present methodological considerations for future studies.