Abnormal Brain Density in Victims of Rape with PTSD in Mainland China: A Voxel-Based Analysis of Magnetic Resonance Imaging Study

Posttraumatic stress disorder (PTSD) is a relatively common and predictable psychological syndrome (Miller, 1999). PTSD occurs in a proportion of individuals exposed to severe psychological trauma (Kasai et al., 2006) and in which the individual responds with fear, helplessness, or horror (Danckwerts & Leathem, 2003). Individuals with PTSD suffer from intrusive memories about the traumatic event, persistent avoidance of stimuli associated with the trauma, and persistent symptoms of increased arousal. These symptoms become uncontrollable and disabling (Bremner & Charney, 1994) that serious threaten human health and social function. Due to its debilitating nature, PTSD has emerged as an important public health problem in the general population (Sareen et al., 2007). In recent years, a great deal of research has been directed towards understanding the etiology, phenomenology, neurobiology, clinical characteristics and treatment of PTSD (Nemeroff et al., 2006). However, a number of core psychological processes underlying PTSD have yet to be elucidated (Shin et al., 2006; Liberzon & Sripada, 2008). Over the past decade, findings from neuroimaging studies have allowed for tremendous advances in our understanding of the experience of emotions in healthy individuals and the dysregulation of these processes associated with PTSD. These studies have been useful in both generating hypotheses on the neurobiology of normative human responses to trauma and complementing our understanding of the wide-ranging alterations in trauma survivors who develop PTSD. Structural neuroimaging studies have focused primarily on hippocampal volumetry (Geuze et al., 2005) as well as the prefrontal cortex (Geuze et al., 2008a) and other brain structures. Hippocampal morphology has been correlated with severity of PTSD symptomatology (Gilbertson et al., 2002; Villarreal & King, 2004). However, the results have been inconsistent, with studies reporting significant reductions or increases, as well as unchanged volumes. For example, studies have shown that patients with PTSD are associated with bilateral lower hippocampal volume (Bossini & Castrogiovanni, 2007; Bremner et al., 2003; Emdad et al., 2006; Lindauer et al., 2004a; Vythilingam et al., 2005; Li et al., 2006), which are