Investigating amygdala nuclei volumes in military personnel with post-traumatic stress disorder, major depressive disorder, and adjustment disorder: A retrospective cross-sectional study using clinical routine data.

Investigating amygdala nuclei volumes in military personnel with post-traumatic stress disorder, major depressive disorder, and adjustment disorder: A retrospective cross-sectional study using clinical routine data.

Publication date: Jan 17, 2025

Post-traumatic Stress Disorder (PTSD), Major Depressive Disorder (MDD), and Adjustment Disorder (AdjD) are highly prevalent among military personnel, often presenting diagnostic challenges due to overlapping symptoms and reliance on self-reporting. The amygdala, particularly the basolateral complex involved in fear-related memory formation and extinction recall, plays a crucial role in emotional processing. Abnormalities in these amygdala nuclei are implicated in PTSD and may distinguish it from other disorders like MDD and AdjD, where these mechanisms are less central. Investigating structural differences in specific amygdala nuclei could enhance diagnostic precision and inform targeted interventions. This study aimed to explore volumetric differences in amygdala nuclei among patients with PTSD, MDD, comorbid PTSD and MDD (PTSD+MDD), and AdjD using routine clinical MRI data. We hypothesized that patients with PTSD would exhibit distinct amygdala nuclei volumes compared to those with MDD or AdjD. Additionally, we examined the influence of symptom duration, prior medication, and psychotherapeutic experience on amygdala volumes. We conducted a retrospective cross-sectional study with 185 military personnel (162 men, 23 women) diagnosed with PTSD (n = 50), MDD (n = 70), PTSD+MDD (n = 38), and AdjD (n = 27). High-resolution T1-weighted MRI scans were obtained using a 3T Siemens Skyra scanner. Amygdala subfields were automatically segmented and volumetrized using FreeSurfer software. Analysis of covariance (ANCOVA) models compared amygdala nuclei volumes across diagnostic groups, controlling for estimated total intracranial volume (eTIV), age, and gender. Exploratory analyses included symptom duration, medication use, and prior psychotherapy as additional covariates. Sensitivity analyses further examined the impact of depressive episode type (first vs. recurrent), severity (mild, moderate, severe), and AdjD symptom duration. The main analyses revealed no significant differences in the volumes of the basolateral and medial amygdala nuclei among the PTSD, MDD, PTSD+MDD, and AdjD groups. Exploratory analyses did not identify significant associations between amygdala volumes and symptom duration, medication use, or prior psychotherapy. Sensitivity analyses also showed no significant volumetric differences related to depressive episode type, severity, or AdjD symptom duration. Our findings suggest that, within this military population, amygdala nuclei volumes measured using routine clinical MRI data do not significantly differ among patients with PTSD, MDD, PTSD+MDD, and AdjD. This indicates that structural amygdala volumetry alone may not suffice to distinguish between these stress-related disorders in clinical settings. The study highlights the complexity of diagnosing overlapping mental health conditions and underscores the need for comprehensive approaches that integrate neuroimaging with clinical assessments. Future research should include healthy control groups, consider additional brain regions and functional connectivity, and employ longitudinal designs to better understand the temporal dynamics of amygdala changes and their relation to symptomatology.

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Concepts Keywords
Freesurfer Adjustment Disorders
Mri Adult
Psychotherapy Amygdala
Siemens Cross-Sectional Studies
Depressive Disorder, Major
Female
Humans
Magnetic Resonance Imaging
Male
Military Personnel
Retrospective Studies
Stress Disorders, Post-Traumatic
Young Adult

Semantics

Type Source Name
disease MESH post-traumatic stress disorder
disease MESH major depressive disorder
disease MESH adjustment disorder
disease MESH Abnormalities
drug DRUGBANK Tropicamide
pathway REACTOME Reproduction
drug DRUGBANK Cysteamine
disease MESH Mental disorders
disease MESH symptom clusters
disease MESH depression
drug DRUGBANK L-Aspartic Acid
disease MESH central nervous system disorders
disease MESH epilepsy
disease MESH multiple sclerosis
disease MESH tumors
disease MESH psychosis
drug DRUGBANK Ethanol
disease MESH drug dependence
disease MESH contraindication
drug DRUGBANK Serotonin
drug DRUGBANK Flunarizine
disease MESH atrophy
drug DRUGBANK Aminolevulinic acid
drug DRUGBANK Methionine
disease MESH causality
disease MESH privacy
disease MESH childhood trauma
disease MESH personality disorders
disease MESH Borderline Personality Disorder
disease MESH depressive disorders
drug DRUGBANK Testosterone
drug DRUGBANK Trestolone
disease MESH Anxiety

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