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Reduced Hippocampal Volume in Alcohol and Substance Naïve Vietnam Combat Veterans with Posttraumatic Stress Disorder

Hedges, Dawson W. MD*; Allen, Steven PhD†‡; Tate, David F. BS*; Thatcher, G. William MD§; Miller, Michael J. BA*; Rice, Sara A. BA*; Cleavinger, Howard B. BS*; Sood, Shabnam MD; Bigler, Erin D. PhD*∥

Cognitive and Behavioral Neurology: December 2003 - Volume 16 - Issue 4 - p 219-224
Experimental Studies

Objective This pilot study was undertaken to exclude the effects of alcohol and other substances on brain morphology in posttraumatic stress disorder.

Background Posttraumatic stress disorder and alcohol use are among the conditions associated with decreased hippocampal volume. The possible confounding contribution of alcohol and other substances of abuse to decreased hippocampal volume in posttraumatic stress disorder has not been previously explored directly.

Method In this pilot study, magnetic resonance imaging scans of 4 substance naive subjects with combat-related posttraumatic stress disorder and of 4 controls were quantified.

Results Bilateral hippocampal volumes were significantly smaller in posttraumatic stress disorder subjects. No significant differences were found between posttraumatic stress disorder subjects and the comparison group for total brain, gray and white matter, and ventricular volumes.

Conclusions These findings suggest that posttraumatic stress disorder in the absence of alcohol and other substance abuse may be associated with reduced hippocampal volume. The significance of reduced hippocampal volume in posttraumatic stress disorder is discussed.

*Department of Psychology, Brigham Young University, Provo, Utah; †Department of Psychiatry, Veterans Administration, Salt Lake City Health System, Salt Lake City, Utah; ‡Departments of Educational Psychology and Psychiatry, University of Utah, Salt Lake City, Utah; §Department of Veterans' Affairs (VA), Salt Lake City Health Care System, and Department of Psychiatry, University of Utah, Salt Lake City, Utah; Departments of Psychiatry and Radiology, University of Utah, Salt Lake City, Utah, USA.

Received January 27, 2003;

revised July 1, 2003; accepted July 15, 2003.

Address correspondence and reprint requests to Dr. Dawson W. Hedges, Department of Psychology, 1001 SWKT, Brigham Young University, Provo, UT 84602; E-mail:

An abbreviated form of these data was presented in poster format at the National Academy of Neuropsychology Meetings in San Francisco, California, November 2001. An abstract of the poster was published in Archives of Clinical Neuropsychology, 16:796.

© 2003 Lippincott Williams & Wilkins, Inc.