Neuroanatomical Risk Factors for Posttraumatic Stress Disorder in Recent Trauma Survivors

Ziv Ben-Zion, Moran Artzi, Dana Niry, Nimrod Jackob Keynan, Yoav Zeevi, Roee Admon, Haggai Sharon, Pinchas Halpern, Israel Liberzon, Arieh Y. Shalev, Talma Hendler*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background: Low hippocampal volume could serve as an early risk factor for posttraumatic stress disorder (PTSD) in interaction with other brain anomalies of developmental origin. One such anomaly may well be the presence of a large cavum septum pellucidum (CSP), which has been loosely associated with PTSD. We performed a longitudinal prospective study of recent trauma survivors. We hypothesized that at 1 month after trauma exposure the relation between hippocampal volume and PTSD symptom severity will be moderated by CSP volume, and that this early interaction will account for persistent PTSD symptoms at subsequent time points. Methods: One hundred seventy-one adults (87 women, average age 34.22 years [range, 18–65 years of age]) who were admitted to a general hospital's emergency department after a traumatic event underwent clinical assessment and structural magnetic resonance imaging within 1 month after trauma. Follow-up clinical evaluations were conducted at 6 (n = 97) and 14 (n = 78) months after trauma. Hippocampal and CSP volumes were measured automatically by FreeSurfer software and verified manually by a neuroradiologist (D.N.). Results: At 1 month after trauma, CSP volume significantly moderated the relation between hippocampal volume and PTSD severity (p = .026), and this interaction further predicted symptom severity at 14 months posttrauma (p = .018). Specifically, individuals with a smaller hippocampus and larger CSP at 1 month posttrauma showed more severe symptoms at 1 and 14 months after trauma exposure. Conclusions: Our study provides evidence for an early neuroanatomical risk factors for PTSD, which could also predict the progression of the disorder in the year after trauma exposure. Such a simple-to-acquire neuroanatomical signature for PTSD could guide early management as well as long-term monitoring.

Original languageEnglish
Pages (from-to)311-319
Number of pages9
JournalBiological Psychiatry: Cognitive Neuroscience and Neuroimaging
Issue number3
StatePublished - Mar 2020


FundersFunder number
Sagol Brain Institute
Sagol School of Neuroscience
National Institute of Mental HealthR01MH103287
Tel Aviv University
Tel Aviv Sourasky Medical CenterNCT03756545


    • Cavum septum pellucidum
    • Hippocampus
    • Posttraumatic stress symptoms
    • Resilience
    • Trauma
    • Vulnerability


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