Gray matter alterations in individuals with PTSD compared to controls : A systematic review

Abstract: This systematic review aims to investigate the alterations in gray matter volume (GMV) observed in the brains of individuals diagnosed with post-traumatic stress disorder (PTSD) through the Clinical Administered PTSD scale (CAPS) using Voxel-Based Morphometry (VBM) as a method. PTSD is diagnosed when an individual meets all the criteria for PTSD as defined by the DSM, which includes having experienced or witnessed a traumatic event, experiencing intrusive symptoms such as flashbacks or nightmares, avoiding triggers related to the trauma, experiencing negative changes in mood and cognition, and experiencing changes in arousal and reactivity. Previous research investigating gray matter alterations in patients with PTSD has yielded heterogeneous findings. The review incorporates a comprehensive search and analysis of pertinent studies conducted between 1995 and the present. Diverse databases were scrutinized to identify articles that fulfilled the inclusion criteria. Ultimately, a total of seven articles meeting our inclusion criteria were included in this systematic review. The sample sizes ranged from 30 to 75 participants. The control groups in the chosen articles varied, some only had healthy controls (HC), while some had trauma-exposed controls (TC) or included both. The results consistently revealed a reduction in GMV predominantly in the hippocampus, with additional areas exhibiting decreased GMV such as the bilateral hypothalamus and left inferior parietal lobule, right middle temporal gyrus, right inferior temporal gyrus, and right fusiform gyrus, as well as the bilateral calcarine cortex, left dorsal anterior cingulate cortex, left anterior cingulate cortex, and bilateral insula.