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Published in: Journal of Nuclear Cardiology 2/2021

01-04-2021 | Post-Traumatic Stress Disorder | Original Article

FDG PET imaging of vascular inflammation in post-traumatic stress disorder: A pilot case–control study

Authors: Jakub Toczek, PhD, Ansel T. Hillmer, PhD, Jinah Han, PhD, Chi Liu, PhD, Dana Peters, PhD, Hamed Emami, MD, Jing Wu, PhD, Irina Esterlis, PhD, Kelly P. Cosgrove, PhD, Mehran M. Sadeghi, MD

Published in: Journal of Nuclear Cardiology | Issue 2/2021

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Abstract

The prevalence of cardiovascular diseases (CVD) is increased in subjects with post-traumatic stress disorder (PTSD). Vascular inflammation mediates CVD and may be assessed by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) imaging. In this pilot study, we investigated whether subjects with PTSD have enhanced vascular and systemic inflammation compared to healthy controls, as assessed by FDG PET imaging.

Methods

A prospective group of 16 subjects (9 PTSD and 7 controls, age 34 ± 7) without prior history of CVD underwent FDG PET/CT imaging. The presence of PTSD symptoms at the time of the study was confirmed using PTSD checklist for DSM-5 (PCL5) questionnaire. Blood samples were collected to determine blood glucose, lipid and inflammatory biomarkers (tumor necrosis factor α, interleukin-1β, and interleukin-6) levels. FDG signal in the ascending aorta, amygdala, spleen and bone marrow was quantified.

Results

The two groups matched closely with regards to cardiovascular risk factors. The inflammatory biomarkers were all within the normal range. There was no significant difference in FDG signal in the aorta (target to background ratio: 2.40 ± 0.29 and 2.34 ± 0.29 for control and PTSD subjects, difference: − 0.06, 95% confidence interval of difference: − 0.38 to 0.26), spleen, bone marrow, or amygdala between control and PTSD subjects. There was no significant correlation between aortic and amygdala FDG signal. However, a significant positive correlation existed between amygdala, splenic, and bone marrow FDG signal.

Conclusion

This pilot, small study did not reveal any difference in vascular or systemic inflammation as assessed by FDG PET imaging between PTSD and healthy control subjects. Because of the small number of subjects, a modest increase in vascular inflammation, which requires larger scale studies to establish, cannot be excluded. The correlation between FDG signal in amygdala, spleen and bone marrow may reflect a link between amygdala activity and systemic inflammation.
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Metadata
Title
FDG PET imaging of vascular inflammation in post-traumatic stress disorder: A pilot case–control study
Authors
Jakub Toczek, PhD
Ansel T. Hillmer, PhD
Jinah Han, PhD
Chi Liu, PhD
Dana Peters, PhD
Hamed Emami, MD
Jing Wu, PhD
Irina Esterlis, PhD
Kelly P. Cosgrove, PhD
Mehran M. Sadeghi, MD
Publication date
01-04-2021
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 2/2021
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-019-01724-w

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