Neurobiology of sleep disturbances in PTSD patients and traumatized controls: MRI and SPECT findings

Objective: Sleep disturbances such as insomnia and nightmares are core components of
post-traumatic stress disorder (PTSD), yet their neurobiological relationship is still largely
unknown. We investigated brain alterations related to sleep disturbances in PTSD patients
and controls by using both structural and functional neuroimaging techniques.
Method: Thirty-nine subjects either developing (n=21) or not developing (n=18) PTSD
underwent magnetic resonance imaging and a symptom-provocation protocol followed
by the injection of 99mTc-hexamethylpropyleneamineoxime. Subjects were also tested
with diagnostic and self-rating scales on the basis of which a Sleep Disturbances Score
(SDS; i.e., amount of insomnia/nightmares) was computed.
Results: Correlations between SDS and gray matter volume (GMV)/regional cerebral
blood flow (rCBF) were computed in the whole sample and separately in the PTSD and
control groups. In the whole sample, higher sleep disturbances were associated with
significantly reduced GMV in amygdala, hippocampus, anterior cingulate, and insula;
increased rCBF in midbrain, precuneus, and insula; and decreased rCBF in anterior
cingulate. This pattern was substantially confirmed in the PTSD group, but not in controls.
Conclusion: Sleep disturbances are associated with GMV loss in anterior limbic/
paralimbic, PTSD-sensitive structures and with functional alterations in regions implicated
in rapid eye movement-sleep control, supporting the existence of a link between
PTSD and sleep disturbance.

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Nardo D
Högberg G
Jonsson C
Jacobsson H
Hällström T
Pagani M
Frontiers, Losanne, Svizzera
Frontiers in Psychiatry 6 (2015). doi:10.3389/fpsyt.2015.00134
info:cnr-pdr/source/autori:Nardo D, Högberg G, Jonsson C, Jacobsson H, Hällström T, Pagani M/titolo:Neurobiology of sleep disturbances in PTSD patients and traumatized controls: MRI and SPECT findings/doi:10.3389/fpsyt.2015.00134/rivista:Frontiers in Psyc
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