The Link Between Post-traumatic Stress Disorder and Hippocampal Atrophy

The Link Between Post-traumatic Stress Disorder and Hippocampal Atrophy

Neuroscientific findings revealed that combat vets suffering from PTSD showed atrophy of the hippocampus. There is now strong research support that PTSD is an organic disorder rather than neurotic malingering as it has been portrayed throughout much of military history.  

Many tort laws require an injury to be ‘organic’ in order for it to be compensable.  My own state, Michigan, has not yet recognised PTSD to represent a manifestation of brain injury.  Does hippocampal atrophy represent brain injury?  This will be a question legislators will have to wrap their brains around. 

Perhaps our laws and medicine of the future will easily make the mind-body connection.  It is interesting that Freud began his studies into the mind from a neurological perspective, and abandoned it for a purely psychological one.  Is it any wonder we as a society are often out of our minds, as well as out of our bodies?  Disconnection would appear to be the connection.  Thanks to brilliant researchers like Sapolsky, the bridge between mind and body is now being solidly constructed.  Thanks to neuroscience and those working in psychotherapy to integrate the two, the future for humankind is being brightly illuminated in ways unavailable to Freud in the last century.   There is indeed new hope for the cure and prevention of mental illness from this biopsychosocial matrix of knowledge derived from the integration of findings from neuroscience and psychotherapy. 

Does hippocampal atrophy represent brain injury?

Meanwhile, one research discussed that brain areas implicated in the stress response include the amygdala, hippocampus, and prefrontal cortex. Traumatic stress can be associated with lasting changes in these brain areas. Traumatic stress is associated with increased cortisol and norepinephrine responses to subsequent stressors. Antidepressants have effects on the hippocampus that counteract the effects of stress.

Findings from animal studies have been extended to patients with PTSD showing smaller hippocampal and anterior cingulate volumes, increased amygdala function, and decreased medial prefrontal/anterior cingulate function. In addition, patients with PTSD show increased cortisol and norepinephrine responses to stress. Treatments that are efficacious for PTSD show a promotion of neurogenesis in animal studies, as well as promotion of memory and increased hippocampal volume in PTSD.

Furthermore, another study has revealed the size of a person’s hippocampus may indicate their susceptibility to PTSD. Columbia University researchers have found patients with smaller hippocampi have a higher tendency toward the disorder, and are less likely to respond to certain treatments, such as exposure therapy. Meanwhile, one with a larger hippocampus will reflect lower levels of intensity from the disease. This discovery could mean screening processes to assist those at higher risk, prior to their exposure to PTSD-inducing situations. The video below explains this: 

One major voice of integration of brain and mind perspectives is that of Louis Cozolino.  Cozolino’s book the Neuroscience of Psychotherapy offers a brilliant synthesis of where we are to date with applying the findings of neuroscience in how we work as psychotherapists.  One shortcoming I note from Cozolino writings is very little with respect to brain injuries.  We seem to still be at a very early stage of understanding the unique challenges working psychotherapeutically with individuals who have suffered injuries to brain in the traditional sense of biomechanical force damage. 

This is the first text of its kind to link neuroscience and therapy, which has been described as a must-have for all therapists. A revision of the best-selling mental health book, this groundbreaking text explores the recent revolution in psychotherapy that has brought an understanding of the social nature of people’s brains to a therapeutic context. Louis Cozolino is a master at synthesising neuroscientific information and demonstrating how it applies to psychotherapy practice.

With books and research becoming more available, it is hoped that this will shed more lights on the link between PTSD and hippocampal atrophy. 


 

Dr James Zender is a clinical and forensic psychologist with over 30 years trauma experience specialising in auto accident trauma treatment/care. His auto accident patients frequently are dealing with such conditions as post-traumatic stress, traumatic brain injury, and chronic pain conditions. Prior to private practice, he worked as a clinical psychologist at Providence Hospital and Ypsilanti Regional Psychiatric Hospital. He was the founding director of the Center for the Prevention and Treatment of Psychological Trauma at Detroit Receiving Hospital and University Health Center (one of the premier trauma hospitals worldwide) where he also served as Instructor in Psychiatry.


 

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