Meta-Analysis of 89 Structural MRI Studies in Posttraumatic Stress Disorder and Comparison With Major Depressive Disorder

Bromis, Konstantinos; Calem, Maria; Reinders, Antje A.T.S.; Williams, Steven C.R.; Kempton, Matthew J.

doi:10.1176/appi.ajp.2018.17111199

Cited by 177Posttraumatic Stress Disorder ResearchTraumatic Brain Injury ResearchChild Abuse and Trauma

Meta-Analysis of 89 Structural MRI Studies in Posttraumatic Stress Disorder and Comparison With Major Depressive Disorder

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Bromis, Konstantinos, Calem, Maria, Reinders, Antje A.T.S., Williams, Steven C.R., Kempton, Matthew J.·2018·American Journal of Psychiatry

DOI 10.1176/appi.ajp.2018.17111199PMC PMC6169727

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Abstract

OBJECTIVE: The authors conducted a comprehensive meta-analysis of MRI region-of-interest and voxel-based morphometry (VBM) studies in posttraumatic stress disorder (PTSD). Because patients have high rates of comorbid depression, an additional objective was to compare the findings to a meta-analysis of MRI studies in depression. METHOD: The MEDLINE database was searched for studies from 1985 through 2016. A total of 113 studies met inclusion criteria and were included in an online database. Of these, 66 were selected for the region-of-interest meta-analysis and 13 for the VBM meta-analysis. The region-of-interest meta-analysis was conducted and compared with a meta-analysis of major depressive disorder. Within the region-of-interest meta-analysis, three subanalyses were conducted that included control groups with and without trauma. RESULTS: In the region-of-interest meta-analysis, patients with PTSD compared with all control subjects were found to have reduced brain volume, intracranial volume, and volumes of the hippocampus, insula, and anterior cingulate. PTSD patients compared with nontraumatized or traumatized control subjects showed similar changes. Traumatized compared with nontraumatized control subjects showed smaller volumes of the hippocampus bilaterally. For all regions, pooled effect sizes (Hedges' g) varied from -0.84 to 0.43, and number of studies from three to 41. The VBM meta-analysis revealed prominent volumetric reductions in the medial prefrontal cortex, including the anterior cingulate. Compared with region-of-interest data from patients with major depressive disorder, those with PTSD had reduced total brain volume, and both disorders were associated with reduced hippocampal volume. CONCLUSIONS: The meta-analyses revealed structural brain abnormalities associated with PTSD and trauma and suggest that global brain volume reductions distinguish PTSD from major depression.

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A recent meta-analysis confirmed, using voxel-based morphometry, prominent volumetric reductions in the mPFC, including the ACC, when examining over 80 different MRI studies in PTSD compared to depression.
“A recent meta-analysis confirmed, using voxel-based morphometry, that there were prominent volumetric reductions in the mPFC, including the ACC, when examining over 80 different MRI studies in PTSD compared to depression [159].”
From Prefrontal cortex, amygdala, and threat processing: implications for PTSD (2022) · cites this paper as [159]
The Results (VBM meta-analysis; page not available) report prominent medial prefrontal volume reductions, including the anterior cingulate, in PTSD patients compared with control subjects. The Methods (VBM Meta-Analysis; page not available) say this analysis included 13 studies, not over 80. The comparison with depression used region-of-interest data and did not establish that the medial prefrontal reductions were greater in PTSD than in depression. (LLM, conf=0.90)
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[26]Mello AF Juruena MF Pariante CM [Depression and stress: is there an endophenotype?] Rev Bras Psiquiatr 2007 29 suppl 1 S13 S18 (Portuguese) 17546342 PMC4467732

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Authors: Bromis, K., Calem, M., Reinders, A. A. T. S., Williams, S. C. R., & Kempton, M. J.
Affiliations: University of Sussex (GB)
Corresponding author: Kempton, Matthew J.
ORCID: Bromis, Konstantinos
Reinders, Antje A.T.S.
Williams, Steven C.R.
Kempton, Matthew J.
Venue: American Journal of Psychiatry
Publisher: American Psychiatric Association Publishing
Published: 2018-10-01
Volume: 175
Issue: 10
Pages: 989-998
ISSN: 0002-953X (ISSN-L)
1535-7228
DOI: 10.1176/appi.ajp.2018.17111199
PMC: PMC6169727
OpenAlex: W2884899764
Cited by: 177
References: 37
Citations by year: 2026: 20 · 2025: 16 · 2024: 25 · 2023: 18 · 2022: 38 · 2021: 27 · 2020: 17 · 2019: 14 · 2018: 1
FWCI: 2.49
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: American Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Research Portal (King's College London) (submittedVersion, other-oa)
Funders: Wellcome Trust
National Institute for Health and Care Research (NF-SI-0617-10150)
Medical Research Council (MR/J008915/1)
Topics: Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
Keywords: post-traumatic stress disorder, major depressive disorder, structural brain abnormalities, brain atrophy, hippocampal volume, anterior cingulate cortex, medial prefrontal cortex, insula, intracranial volume, trauma exposure, comorbid depression, voxel-based morphometry, region of interest analysis
MeSH terms: Adult, Brain, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Magnetic Resonance Imaging, Male, Stress Disorders, Post-Traumatic, Databases, Factual

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Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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Meta-Analysis of 89 Structural MRI Studies in Posttraumatic Stress Disorder and Comparison With Major Depressive Disorder

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