Skip to main content
Top
Published in: European Child & Adolescent Psychiatry 6/2019

01-06-2019 | Original Contribution

Increased right amygdala metabolite concentrations in the absence of atrophy in children and adolescents with PTSD

Authors: Weina Wang, Huaiqiang Sun, Xiaorui Su, Qiaoyue Tan, Simin Zhang, Chunchao Xia, Lingjiang Li, Graham J. Kemp, Qiang Yue, Qiyong Gong

Published in: European Child & Adolescent Psychiatry | Issue 6/2019

Login to get access

Abstract

Previous studies have shown that posttraumatic stress disorder (PTSD) is associated with dysfunction of the limbic system, in which the amygdala plays an important role. The purpose of this study was to evaluate whether the neurochemical concentrations assessed by proton magnetic resonance spectroscopy (1H-MRS) in the amygdala are abnormal in children and adolescents with PTSD. Twenty-eight pediatric PTSD patients (11 boys, 17 girls) and 24 matched trauma-exposed control subjects (9 boys, 15 girls) underwent magnetic resonance brain imaging and 1H-MRS of the bilateral amygdalae. The concentrations of N-acetylaspartate (NAA), myo-inositol (mI), total creatine (tCr) and total choline (tCho) in the right amygdala were significantly increased in PTSD patients compared with trauma-exposed control subjects. There were significant group-by-age interactions in the left amygdala NAA and right amygdala mI concentrations: older pediatric patients with PTSD had higher left amygdala NAA concentration and younger patients had higher right amygdala mI concentration than trauma-exposed control subjects. There was also a significant correlation between right mI concentration and time since trauma in PTSD patients. Finally, there was significant group-by-age interaction in the left amygdala volume; intragroup analysis revealed that the right amygdala volume was significantly lower than the left in the PTSD group, but not in the control group. These neurochemical abnormalities of the amygdala may indicate that dysfunctions of both neurons and glial cells are involved in the pathology of pediatric PTSD.
Literature
6.
go back to reference Shin LM, Wright CI, Cannistraro PA, Wedig MM, McMullin K, Martis B, Macklin ML, Lasko NB, Cavanagh SR, Krangel TS, Orr SP, Pitman RK, Whalen PJ, Rauch SL (2005) A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Arch Gen Psychiatry 62(3):273–281. https://doi.org/10.1001/archpsyc.62.3.273 CrossRefPubMed Shin LM, Wright CI, Cannistraro PA, Wedig MM, McMullin K, Martis B, Macklin ML, Lasko NB, Cavanagh SR, Krangel TS, Orr SP, Pitman RK, Whalen PJ, Rauch SL (2005) A functional magnetic resonance imaging study of amygdala and medial prefrontal cortex responses to overtly presented fearful faces in posttraumatic stress disorder. Arch Gen Psychiatry 62(3):273–281. https://​doi.​org/​10.​1001/​archpsyc.​62.​3.​273 CrossRefPubMed
7.
go back to reference Hull AM (2002) Neuroimaging findings in post-traumatic stress disorder. Systematic review. Br J Psychiatry 181:102–110PubMed Hull AM (2002) Neuroimaging findings in post-traumatic stress disorder. Systematic review. Br J Psychiatry 181:102–110PubMed
18.
go back to reference Tallan HH, Moore S, Stein WH (1956) N-acetyl-l-aspartic acid in brain. J Biol Chem 219(1):257–264PubMed Tallan HH, Moore S, Stein WH (1956) N-acetyl-l-aspartic acid in brain. J Biol Chem 219(1):257–264PubMed
19.
go back to reference Gill SS, Small RK, Thomas DG, Patel P, Porteous R, Van Bruggen N, Gadian DG, Kauppinen RA, Williams SR (1989) Brain metabolites as 1H NMR markers of neuronal and glial disorders. NMR Biomed 2(5–6):196–200CrossRefPubMed Gill SS, Small RK, Thomas DG, Patel P, Porteous R, Van Bruggen N, Gadian DG, Kauppinen RA, Williams SR (1989) Brain metabolites as 1H NMR markers of neuronal and glial disorders. NMR Biomed 2(5–6):196–200CrossRefPubMed
22.
go back to reference Soher BJ, van Zijl PC, Duyn JH, Barker PB (1996) Quantitative proton MR spectroscopic imaging of the human brain. Magn Reson Med 35(3):356–363CrossRefPubMed Soher BJ, van Zijl PC, Duyn JH, Barker PB (1996) Quantitative proton MR spectroscopic imaging of the human brain. Magn Reson Med 35(3):356–363CrossRefPubMed
23.
go back to reference Hetherington HP, Mason GF, Pan JW, Ponder SL, Vaughan JT, Twieg DB, Pohost GM (1994) Evaluation of cerebral gray and white matter metabolite differences by spectroscopic imaging at 4.1 T. Magn Reson Med 32(5):565–571CrossRefPubMed Hetherington HP, Mason GF, Pan JW, Ponder SL, Vaughan JT, Twieg DB, Pohost GM (1994) Evaluation of cerebral gray and white matter metabolite differences by spectroscopic imaging at 4.1 T. Magn Reson Med 32(5):565–571CrossRefPubMed
26.
go back to reference Massana G, Gasto C, Junque C, Mercader JM, Gomez B, Massana J, Torres X, Salamero M (2002) Reduced levels of creatine in the right medial temporal lobe region of panic disorder patients detected with (1)H magnetic resonance spectroscopy. Neuroimage 16(3 Pt 1):836–842CrossRefPubMed Massana G, Gasto C, Junque C, Mercader JM, Gomez B, Massana J, Torres X, Salamero M (2002) Reduced levels of creatine in the right medial temporal lobe region of panic disorder patients detected with (1)H magnetic resonance spectroscopy. Neuroimage 16(3 Pt 1):836–842CrossRefPubMed
28.
go back to reference Yang ZY, Quan H, Peng ZL, Zhong Y, Tan ZJ, Gong QY (2015) Proton magnetic resonance spectroscopy revealed differences in the glutamate + glutamine/creatine ratio of the anterior cingulate cortex between healthy and pediatric post-traumatic stress disorder patients diagnosed after 2008 Wenchuan earthquake. Psychiatry Clin Neurosci 69(12):782–790. https://doi.org/10.1111/pcn.12332 CrossRefPubMed Yang ZY, Quan H, Peng ZL, Zhong Y, Tan ZJ, Gong QY (2015) Proton magnetic resonance spectroscopy revealed differences in the glutamate + glutamine/creatine ratio of the anterior cingulate cortex between healthy and pediatric post-traumatic stress disorder patients diagnosed after 2008 Wenchuan earthquake. Psychiatry Clin Neurosci 69(12):782–790. https://​doi.​org/​10.​1111/​pcn.​12332 CrossRefPubMed
29.
go back to reference Pavlisa G, Papa J, Pavic L, Pavlisa G (2006) Bilateral MR volumetry of the amygdala in chronic PTSD patients. Coll Antropol 30(3):565–568PubMed Pavlisa G, Papa J, Pavic L, Pavlisa G (2006) Bilateral MR volumetry of the amygdala in chronic PTSD patients. Coll Antropol 30(3):565–568PubMed
38.
go back to reference Weathers FW, Litz BT, Huska JA, Keane TM (1994) PTSD Checklist-Civilian Version, National Center for PTSD. Behavioral Science Division, Boston Weathers FW, Litz BT, Huska JA, Keane TM (1994) PTSD Checklist-Civilian Version, National Center for PTSD. Behavioral Science Division, Boston
39.
go back to reference Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, Keane TM (1995) The development of a Clinician-Administered PTSD Scale. J Trauma Stress 8(1):75–90CrossRefPubMed Blake DD, Weathers FW, Nagy LM, Kaloupek DG, Gusman FD, Charney DS, Keane TM (1995) The development of a Clinician-Administered PTSD Scale. J Trauma Stress 8(1):75–90CrossRefPubMed
40.
go back to reference Denckla MB (1985) Revised neurological examination for subtle signs (1985). Psychopharmacol Bull 21(4):773–800PubMed Denckla MB (1985) Revised neurological examination for subtle signs (1985). Psychopharmacol Bull 21(4):773–800PubMed
42.
go back to reference Provencher SW (1993) Estimation of metabolite concentrations from localized in vivo proton NMR spectra. Magn Reson Med 30(6):672–679CrossRefPubMed Provencher SW (1993) Estimation of metabolite concentrations from localized in vivo proton NMR spectra. Magn Reson Med 30(6):672–679CrossRefPubMed
45.
go back to reference Bryk AS, Raudenbush SW, Congdon RT (2013) HLM 7.01 for Windows. Scientific Software International, Inc, Skokie Bryk AS, Raudenbush SW, Congdon RT (2013) HLM 7.01 for Windows. Scientific Software International, Inc, Skokie
46.
go back to reference Holmbeck GN (2002) Post-hoc probing of significant moderational and mediational effects in studies of pediatric populations. J Pediatr Psychol 27(1):87–96CrossRefPubMed Holmbeck GN (2002) Post-hoc probing of significant moderational and mediational effects in studies of pediatric populations. J Pediatr Psychol 27(1):87–96CrossRefPubMed
47.
go back to reference Hayes AF (2018) Introduction to mediation, moderation, and conditional process analysis—a regression-based approach, 2nd edn. Guilford Press, New York Hayes AF (2018) Introduction to mediation, moderation, and conditional process analysis—a regression-based approach, 2nd edn. Guilford Press, New York
49.
go back to reference Johnson PO, Fay LC (1950) The Johnson–Neyman technique, its theory and application. Psychometrika 15(4):349–367CrossRefPubMed Johnson PO, Fay LC (1950) The Johnson–Neyman technique, its theory and application. Psychometrika 15(4):349–367CrossRefPubMed
50.
go back to reference Murphy DG, Critchley HD, Schmitz N, McAlonan G, Van Amelsvoort T, Robertson D, Daly E, Rowe A, Russell A, Simmons A, Murphy KC, Howlin P (2002) Asperger syndrome: a proton magnetic resonance spectroscopy study of brain. Arch Gen Psychiatry 59(10):885–891CrossRefPubMed Murphy DG, Critchley HD, Schmitz N, McAlonan G, Van Amelsvoort T, Robertson D, Daly E, Rowe A, Russell A, Simmons A, Murphy KC, Howlin P (2002) Asperger syndrome: a proton magnetic resonance spectroscopy study of brain. Arch Gen Psychiatry 59(10):885–891CrossRefPubMed
53.
go back to reference Freeman TW, Cardwell D, Karson CN, Komoroski RA (1998) In vivo proton magnetic resonance spectroscopy of the medial temporal lobes of subjects with combat-related posttraumatic stress disorder. Magn Reson Med 40(1):66–71CrossRefPubMed Freeman TW, Cardwell D, Karson CN, Komoroski RA (1998) In vivo proton magnetic resonance spectroscopy of the medial temporal lobes of subjects with combat-related posttraumatic stress disorder. Magn Reson Med 40(1):66–71CrossRefPubMed
57.
go back to reference Gray JA, McNaughton N (2000) The neuropsychology of anxiety: an enquiry into the functions of the septohippocampal system. Oxford University Press, Oxford Gray JA, McNaughton N (2000) The neuropsychology of anxiety: an enquiry into the functions of the septohippocampal system. Oxford University Press, Oxford
58.
go back to reference Soares JC, Gershon S (2003) Handbook of medical psychiatry. Marcel Dekker Inc, New YorkCrossRef Soares JC, Gershon S (2003) Handbook of medical psychiatry. Marcel Dekker Inc, New YorkCrossRef
59.
go back to reference Shin LM, Whalen PJ, Pitman RK, Bush G, Macklin ML, Lasko NB, Orr SP, McInerney SC, Rauch SL (2001) An fMRI study of anterior cingulate function in posttraumatic stress disorder. Biol Psychiatry 50(12):932–942CrossRefPubMed Shin LM, Whalen PJ, Pitman RK, Bush G, Macklin ML, Lasko NB, Orr SP, McInerney SC, Rauch SL (2001) An fMRI study of anterior cingulate function in posttraumatic stress disorder. Biol Psychiatry 50(12):932–942CrossRefPubMed
61.
go back to reference Shin LM, Orr SP, Carson MA, Rauch SL, Macklin ML, Lasko NB, Peters PM, Metzger LJ, Dougherty DD, Cannistraro PA, Alpert NM, Fischman AJ, Pitman RK (2004) Regional cerebral blood flow in the amygdala and medial prefrontal cortex during traumatic imagery in male and female Vietnam veterans with PTSD. Arch Gen Psychiatry 61(2):168–176. https://doi.org/10.1001/archpsyc.61.2.168 CrossRefPubMed Shin LM, Orr SP, Carson MA, Rauch SL, Macklin ML, Lasko NB, Peters PM, Metzger LJ, Dougherty DD, Cannistraro PA, Alpert NM, Fischman AJ, Pitman RK (2004) Regional cerebral blood flow in the amygdala and medial prefrontal cortex during traumatic imagery in male and female Vietnam veterans with PTSD. Arch Gen Psychiatry 61(2):168–176. https://​doi.​org/​10.​1001/​archpsyc.​61.​2.​168 CrossRefPubMed
62.
go back to reference Hendler T, Rotshtein P, Yeshurun Y, Weizmann T, Kahn I, Ben-Bashat D, Malach R, Bleich A (2003) Sensing the invisible: differential sensitivity of visual cortex and amygdala to traumatic context. Neuroimage 19(3):587–600CrossRefPubMed Hendler T, Rotshtein P, Yeshurun Y, Weizmann T, Kahn I, Ben-Bashat D, Malach R, Bleich A (2003) Sensing the invisible: differential sensitivity of visual cortex and amygdala to traumatic context. Neuroimage 19(3):587–600CrossRefPubMed
63.
go back to reference Rauch SL, Whalen PJ, Shin LM, McInerney SC, Macklin ML, Lasko NB, Orr SP, Pitman RK (2000) Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study. Biol Psychiatry 47(9):769–776CrossRefPubMed Rauch SL, Whalen PJ, Shin LM, McInerney SC, Macklin ML, Lasko NB, Orr SP, Pitman RK (2000) Exaggerated amygdala response to masked facial stimuli in posttraumatic stress disorder: a functional MRI study. Biol Psychiatry 47(9):769–776CrossRefPubMed
64.
go back to reference Pfefferbaum A, Adalsteinsson E, Spielman D, Sullivan EV, Lim KO (1999) In vivo spectroscopic quantification of the N-acetyl moiety, creatine, and choline from large volumes of brain gray and white matter: effects of normal aging. Magn Reson Med 41(2):276–284CrossRefPubMed Pfefferbaum A, Adalsteinsson E, Spielman D, Sullivan EV, Lim KO (1999) In vivo spectroscopic quantification of the N-acetyl moiety, creatine, and choline from large volumes of brain gray and white matter: effects of normal aging. Magn Reson Med 41(2):276–284CrossRefPubMed
65.
66.
go back to reference Barker PB, Bizzi A, Stefano ND, Gullapalli RP, Lin DDM (2009) Clinical MR spectroscopy: techniques and applications. Cambridge University Press, New YorkCrossRef Barker PB, Bizzi A, Stefano ND, Gullapalli RP, Lin DDM (2009) Clinical MR spectroscopy: techniques and applications. Cambridge University Press, New YorkCrossRef
67.
go back to reference Brand A, Richter-Landsberg C, Leibfritz D (1993) Multinuclear NMR studies on the energy metabolism of glial and neuronal cells. Dev Neurosci 15(3–5):289–298CrossRefPubMed Brand A, Richter-Landsberg C, Leibfritz D (1993) Multinuclear NMR studies on the energy metabolism of glial and neuronal cells. Dev Neurosci 15(3–5):289–298CrossRefPubMed
68.
go back to reference Castillo M, Smith JK, Kwock L (2000) Correlation of myo-inositol levels and grading of cerebral astrocytomas. AJNR Am J Neuroradiol 21(9):1645–1649PubMedPubMedCentral Castillo M, Smith JK, Kwock L (2000) Correlation of myo-inositol levels and grading of cerebral astrocytomas. AJNR Am J Neuroradiol 21(9):1645–1649PubMedPubMedCentral
70.
go back to reference Bitsch A, Bruhn H, Vougioukas V, Stringaris A, Lassmann H, Frahm J, Bruck W (1999) Inflammatory CNS demyelination: histopathologic correlation with in vivo quantitative proton MR spectroscopy. AJNR Am J Neuroradiol 20(9):1619–1627PubMedPubMedCentral Bitsch A, Bruhn H, Vougioukas V, Stringaris A, Lassmann H, Frahm J, Bruck W (1999) Inflammatory CNS demyelination: histopathologic correlation with in vivo quantitative proton MR spectroscopy. AJNR Am J Neuroradiol 20(9):1619–1627PubMedPubMedCentral
72.
go back to reference Urenjak J, Williams SR, Gadian DG, Noble M (1993) Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types. J Neurosci 13(3):981–989CrossRefPubMedPubMedCentral Urenjak J, Williams SR, Gadian DG, Noble M (1993) Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types. J Neurosci 13(3):981–989CrossRefPubMedPubMedCentral
73.
go back to reference Schuff N, Neylan TC, Lenoci MA, Du AT, Weiss DS, Marmar CR, Weiner MW (2001) Decreased hippocampal N-acetylaspartate in the absence of atrophy in posttraumatic stress disorder. Biol Psychiatry 50(12):952–959CrossRefPubMedPubMedCentral Schuff N, Neylan TC, Lenoci MA, Du AT, Weiss DS, Marmar CR, Weiner MW (2001) Decreased hippocampal N-acetylaspartate in the absence of atrophy in posttraumatic stress disorder. Biol Psychiatry 50(12):952–959CrossRefPubMedPubMedCentral
Metadata
Title
Increased right amygdala metabolite concentrations in the absence of atrophy in children and adolescents with PTSD
Authors
Weina Wang
Huaiqiang Sun
Xiaorui Su
Qiaoyue Tan
Simin Zhang
Chunchao Xia
Lingjiang Li
Graham J. Kemp
Qiang Yue
Qiyong Gong
Publication date
01-06-2019
Publisher
Springer Berlin Heidelberg
Published in
European Child & Adolescent Psychiatry / Issue 6/2019
Print ISSN: 1018-8827
Electronic ISSN: 1435-165X
DOI
https://doi.org/10.1007/s00787-018-1241-x

Other articles of this Issue 6/2019

European Child & Adolescent Psychiatry 6/2019 Go to the issue