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CSA, PTSD, And The Effects On The Hippocampus

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anthony

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The hippo…what?

I wanted to share this bit of scientific information I thought was really interesting.

MRI And PET Study of Deficits in Hippocampal Structure and Function in Women With Childhood Sexual Abuse and Post-Traumatic Stress Disorder

Objective: Animal studies have suggested that early stress is associated with alterations in the hippocampus, a brain area that plays a critical role in learning and memory. The purpose of this study was to measure both hippocampal structure and function in women with and without early childhood sexual abuse and the diagnosis of post-traumatic stress disorder (PTSD).

Method: Thirty-three women participated in this study, including women with early childhood sexual abuse and PTSD (N=10), women with abuse without PTSD (N=12), and women without abuse or PTSD (N=11). Hippocampal volume was measured with magnetic resonance imaging in all subjects, and hippocampal function during the performance of hippocampal-based verbal declarative memory tasks was measured by using positron emission tomography in abused women with and without PTSD.

Results: A failure of hippocampal activation and 16% smaller volume of the hippocampus were seen in women with abuse and PTSD compared to women with abuse without PTSD. Women with abuse and PTSD had a 19% smaller hippocampal volume relative to women without abuse or PTSD.

Conclusions: These results are consistent with deficits in hippocampal function and structure in abuse-related PTSD.C

How Psychological Trauma Affects the Hippocampus and Memory

Childhood abuse and other sources of extreme stress can have lasting effects on the parts of the brain that are involved in memory and emotion. The hippocampus, in particular, seems to be very sensitive to stress. Damage to the hippocampus from stress can not only cause problems in dealing with memories and other effects of past stressful experiences, it can also impair new learning. Exciting recent research has shown that the hippocampus has the capacity to regenerate nerve cells (“neurons”) as part of its normal functioning, and that stress impairs that functioning by stopping or slowing down neuron regeneration.

We recently conducted a study to try to see if PTSD symptoms matched up with a measurable loss of neurons in the hippocampus. We first tested Vietnam combat veterans with declaratory memory problems caused by PTSD. Using brain imaging, these combat veterans were found to have an 8% reduction in right hippocampal volume (i.e., the size of the hippocampus), measured with magnetic resonance imaging (MRI), while no differences were found in other areas of the brain (Figure 1).

Figure 1

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Our study showed that diminished right hippocampal volume in the PTSD patients was associated with short-term memory loss. Similar results were found when we looked at PTSD sufferers who were victims of childhood physical or sexual abuse.

More recent studies have since confirmed hippocampal volume reduction in PTSD. These studies also show that hippocampal volume reduction is specific to PTSD and is not associated with disorders such as anxiety or panic disorders.

Further study on the question of memory and the hippocampus may someday shed light on the controversy surrounding delayed recall, or so-called “recovered memories” of childhood abuse. The hippocampus plays an important role in connecting and organizing different aspects of a memory and is thought to be responsible for locating the memory of an event in its proper time, place and context.

We suspect that damage to the hippocampus following exposure to the stress brought on by childhood abuse leads to distortion and fragmentation of memories. For instance, in the case of the PTSD sufferer who was locked in a closet as a child, she had a memory of the smell of old clothes but other parts of her memory of the experience, such as a visual memory of being in the closet or a memory of the feeling of fear, are difficult to retrieve or completely lost. In cases like this, psychotherapy or an event that triggers similar emotions may help the patient restore associations and bring all aspects of the memory together.

This new understanding of the way childhood trauma affects memory and the brain has important implications for public health policy. One example would be the case of inner-city children who have witnessed violent crimes in their neighborhoods and families. If this kind of stress can cause damage to brain areas involved in learning and memory, it would put these children at a serious academic disadvantage in ways and for reasons that programs such as Head Start may be unable to address. Studies confirm this: in war-torn Beirut, traumatized adolescents with PTSD, as compared to non-traumatized adolescents who were without PTSD, lagged behind in academic achievement.
 
We hear of people who were raised in really unfortunate circumstances who grow to be really productive and at least superficially healthy individuals. I wonder if there's a genetic connection, or if somehow they had processed the information differently than the children around them. Could it be that the people around them were able to shield them from the traumas or give them coping tools at an early age?
 
Something that will baffle you further is that it is more highly thought that those who grow-up within traumatic lifestyles, whilst their brain may mimic someone of PTSD, they function quite normally because the traumatic upbringing is their normal, hence not traumatic to them. What could actually become traumatic is by removing them to a western society location where they suddenly realise their life has been traumatic all the time.
 
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