Altered white matter microstructural organization in posttraumatic stress disorder across 3047 adults: results from the PGC-ENIGMA PTSD consortium.

A growing number of studies have examined alterations in white matter organization in people with posttraumatic stress disorder (PTSD) using diffusion MRI (dMRI), but the results have been mixed which may be partially due to relatively small sample sizes among studies. Altered structural connectivity may be both a neurobiological vulnerability for, and a result of, PTSD. In an effort to find reliable effects, we present a multi-cohort analysis of dMRI metrics across 3047 individuals from 28 cohorts currently participating in the PGC-ENIGMA PTSD working group (a joint partnership between the Psychiatric Genomics Consortium and the Enhancing NeuroImaging Genetics through Meta-Analysis consortium). Comparing regional white matter metrics across the full brain in 1426 individuals with PTSD and 1621 controls (2174 males/873 females) between ages 18-83, 92% of whom were trauma-exposed, we report associations between PTSD and disrupted white matter organization measured by lower fractional anisotropy (FA) in the tapetum region of the corpus callosum (Cohen's d = -0.11, p = 0.0055). The tapetum connects the left and right hippocampus, for which structure and function have been consistently implicated in PTSD. Results were consistent even after accounting for the effects of multiple potentially confounding variables: childhood trauma exposure, comorbid depression, history of traumatic brain injury, current alcohol abuse or dependence, and current use of psychotropic medications. Our results show that PTSD may be associated with alterations in the broader hippocampal network.

Amygdala Nuclei Volume and Shape in Military Veterans With Posttraumatic Stress Disorder.

BACKGROUND: The amygdala is a subcortical structure involved in socioemotional and associative fear learning processes relevant for understanding the mechanisms of posttraumatic stress disorder (PTSD). Research in animals indicates that the amygdala is a heterogeneous structure in which the basolateral and centromedial divisions are susceptible to stress. While the amygdala complex is implicated in the pathophysiology of PTSD, little is known about the specific contributions of the individual nuclei that constitute the amygdala complex. METHODS: Military veterans (n = 355), including military veterans with PTSD (n = 149) and trauma-exposed control subjects without PTSD (n = 206), underwent high-resolution T1-weighted anatomical scans. Automated FreeSurfer segmentation of the amygdala yielded 9 structures: basal, lateral, accessory basal, anterior amygdaloid, and central, medial, cortical, and paralaminar nuclei, along with the corticoamygdaloid transition zone. Subregional volumes were compared between groups using ordinary-least-squares regression with relevant demographic and clinical regressors followed by 3-dimensional shape analysis of whole amygdala. RESULTS: PTSD was associated with smaller left and right lateral and paralaminar nuclei, but with larger left and right central, medial, and cortical nuclei (p < .05, false discovery rate corrected). Shape analyses revealed lower radial distance in anterior bilateral amygdala and lower Jacobian determinant in posterior bilateral amygdala in PTSD compared with control subjects. CONCLUSIONS: Alterations in select amygdala subnuclear volumes and regional shape distortions are associated with PTSD in military veterans. Volume differences of the lateral nucleus and the centromedial complex associated with PTSD demonstrate a subregion-specific pattern that is consistent with their functional roles in fear learning and fear expression behaviors.

Genetic predictors of hippocampal subfield volume in PTSD cases and trauma-exposed controls.

Behavioural, structural, and functional neuroimaging have implicated the hippocampus as a critical brain region in posttraumatic stress disorder (PTSD) pathogenesis. Recent work in a normative, primarily European, sample identified 15 unique genetic loci contributing to structural variability in six hippocampal subfield volumes. We explored the relevance of these loci in two samples (Mental Illness Research Education and Clinical Centre [MIRECC] and Grady; n = 290) of trauma-exposed individuals enriched for PTSD and of diverse ancestry. Four of the previous loci demonstrated nominal evidence of replication in the MIRECC dataset, primarily within non-Hispanic whites (NHW). One locus replicated in the Grady cohort, which was composed exclusively of non-Hispanic blacks (NHB). Our data supported genetic interactions with diagnosis of lifetime PTSD and genetic interactions with childhood trauma in the MIRECC sample, but not the Grady sample. Given the racial, diagnostic, and trauma-exposure differences with the original genome-wide association study (GWAS) report, we conducted a full GWAS in the MIRECC and Grady datasets. Interactions between genetic variants and lifetime PTSD or childhood trauma were interrogated for single nucleotide polymorphisms (SNPs) with evidence of main effects. Genetic associations surpassed false discovery rate (FDR)-correction within hippocampal subfields in fimbria, subiculum, cornu ammonis-1 (CA1), and hippocampal amygdala transition area (HATA). One association was replicated in the Grady cohort (rs12880795 in TUNAR with left (L)-HATA volume). The most significant association in the MIRECC dataset was between rs6906714 in LINC02571 and right (R)-fimbria volume (p = 5.99×10-8, q = 0.0056). Interestingly, the effect of rs6906714 on R-fimbria volume increased with exposure to childhood trauma (gene*environment [G*E] interaction p = 0.022). These preliminary results argue for G*E interactions between genetic loci with PTSD and childhood trauma on hippocampal phenotypes. Our results underscore the need for larger neuroimaging-genetic studies in PTSD, trauma, and ancestrally diverse populations.

Las neuroimagenologia, conductual, estructural y funcional ha implicado que el hipocampo se constituye como una región cerebral critica en la patogénesis del trastorno de estrés postraumático (TEPT). Un trabajo reciente, realizado en una muestra normativa, principalmente europea, identifico 15 loci genéticos únicos que contribuyen a la variabilidad estructural de seis volúmenes de subcampos hipocampales. Exploramos la relevancia de estos loci en dos muestras enriquecidas para TEPT (del Centro de Educación y Clínica Investigación sobre Enfermedades Mentales, MIRECC por sus siglas en inglés y Grady; n=290) de individuos expuestos a trauma y de ascendencia diversa. Cuatro de los loci previos demostraron evidencia nominal de replicación en la base de datos MIRECC, principalmente en personas de raza blanca no hispánicos (NHW). Se replicó un locus en la cohorte Grady, que estaba compuesta exclusivamente por personas de raza negra no hispánicos (NHB). Nuestros datos respaldaron las interacciones genéticas con el diagnostico de TEPT a lo largo de la vida e interacciones genéticas con trauma infantil en la muestra MIRECC, pero no en la de Grady. Debido a las diferencias raciales, diagnósticas y de exposición a trauma con el reporte original del estudio de asociación del genoma completo (GWAS por sus siglas en ingles), realizamos un GWAS completo con la base de datos MIRECC y Grady. Se exploraron polimorfismos de nucleótido único (SNPs por sus siglas en ingles) en las interacciones de variantes genéticas del TEPT a lo largo de la vida y del trauma infantil, con evidencia de un efecto genético principal. Las asociaciones genéticas sobrepasaron a la corrección de tasa de falso descubrimiento (FDR) dentro de los subcampos hipocampales de la fimbria, subículo, asta de Amon-1 (CA1), y el área de transición hipocampo-amigdaliana (HATA). Una asociación se replicó en la cohorte de Grady (rs 12880795 en TUNAR con volumen izquierdo del HATA). La asociación más significativa en la base de datos de MIRECC estuvo entre rs6906714 en LINC02571 y el volumen de la fimbria derecha (p=5.99×10-8, q=0.0056). Interesantemente, el efecto rs6906714 sobre el volumen de la fimbria derecha se incrementaba con la exposición al trauma infantil (interacción gen* ambiente [G*A] p=0.022). Estos resultados preliminares orientarían a la presencia de interacciones G*A de loci genéticos con el TEPT y trauma infantil en fenotipos del hipocampo. Nuestro resultados destacan la necesidad de estudios más grandes que vinculen neuroimagenes y genética en poblaciones con TEPT, trauma, y genealogía diversa.