Post-traumatic Stress Disorder symptom sub-cluster severity predicts gray matter volume changes better than overall symptom severity
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Abstract
Meta-analysis shows that sub-clusters defined by affected domains of psychosocial functioning capture PTSD subtypes better than symptom clusters defined in the DSM-IV. This pilot study investigated the association between symptom sub-clusters and brain volume in twelve persons with PTSD (females, mean age 40.9 years). Structural magnetic resonance imaging (MRI) images were acquired, and voxel-based morphometry (VBM) was used to estimate local gray matter volume throughout the brain. Participants’ gray matter volume was correlated with both overall PTSD severity and sub-cluster severities. In this preliminary study examining sub-clusters and brain morphometry, we found that neuronal changes associated with sub-clusters may provide a more complete understanding of the neuroanatomical changes that occur in PTSD beyond what can be ascertained using overall disorder severity or comparisons with control subjects. The results of our study suggest that the neurobiological changes resulting from severe trauma depend on the specific sub-clusters of symptoms experienced by individuals with PTSD.
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Post-traumatic Stress Disorder symptom sub-cluster severity predicts gray matter volume changes better than overall symptom severity
Peer review report
Title: Post-traumatic Stress Disorder symptom sub-cluster severity predicts gray matter volume changes better than overall symptom severity
version: 1
Referee: Wencai Zhang
Institution: Institute of psychology, Chinese Academy of Sciences
email: Zhangwc@psych.ac.cn
General assessment
The current results provide very limited explanations.
Because there was no comparison of healthy controls, it cannot be concluded that the relationship between symptoms and brain structure is PTSD specific, nor is there a entire-population measure to capture the relationship between symptom severity and gray matter volume.
A total of 12 people, the sample size is too small. The correlation between …
Post-traumatic Stress Disorder symptom sub-cluster severity predicts gray matter volume changes better than overall symptom severity
Peer review report
Title: Post-traumatic Stress Disorder symptom sub-cluster severity predicts gray matter volume changes better than overall symptom severity
version: 1
Referee: Wencai Zhang
Institution: Institute of psychology, Chinese Academy of Sciences
email: Zhangwc@psych.ac.cn
General assessment
The current results provide very limited explanations.
Because there was no comparison of healthy controls, it cannot be concluded that the relationship between symptoms and brain structure is PTSD specific, nor is there a entire-population measure to capture the relationship between symptom severity and gray matter volume.
A total of 12 people, the sample size is too small. The correlation between symptom cluster severity and brain gray matter volume is certainly worth investigating, but a sufficient sample size is needed to obtain reliable results. Because of individual differences, such a small sample is not representative of the population from which the sample came. In this case, it is not reliable for the correlation analysis between the total score and brain gray matter volume. This question is more serious when conducting the correlation analysis between four symptom clusters and brain gray matter volume, the problem of insufficient representation of sample is particularly prominent.
Essential revisions that are required to verify the manuscript
This paper presented a small amount of correlation analysis results between total score and brain gray matter volume and a large number of positive correlation or negative correlation results between symptom clusters and brain gray matter volume. They two are not consistent with each other. The problem here is that, because the results from the total score and symptom clusters can hardly support each other, I think the author needs to discuss, explain or integrate these complex results. If the brain regions associated with the total score and the brain regions associated with the symptom cluster are interpreted separately without integration, it is contradictory to the general view that the PTSD total score means the overall symptom severity.
The authors only discussed and interpreted the results in some brain regions, but not in others. Some explanations are too simple and do not integrate the associations between various brain regions. At present, it is not possible to obtain from these discussions which brain region abnormalities are more valuable for understanding PTSD.
This paper has shortcomings in both sample size, which should be expanded and limitations discussion should be added.
Decision
Requires revisions: The manuscript contains objective errors or fundamental flaws that must be addressed and/or major revisions are suggested.
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