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Fortschr Neurol Psychiatr 2005; 73(7): 377-391
DOI: 10.1055/s-2004-830120
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Bildgebende Befunde bei der posttraumatischen Belastungsstörung (PTBS): Literaturübersicht

Neuroimaging Findings in Posttraumatic Stress Disorder: Review of the LiteratureA.  Jatzko1, 2 , A.  Schmitt2 , A.  Kordon3 , D.  F.  Braus1
  • 1NeuroImage Nord (NIN), Psychiatrie, Universitätsklinikum Hamburg-Eppendorf
  • 2Zentralinstitut für Seelische Gesundheit (ZI) - NMR-Forschung (Prof. Dr. Dr. F. A. Henn)
  • 3Klinik für Psychiatrie und Psychotherapie, Universität Lübeck (Prof. Dr. F. Hohagen)
Die Autoren danken Dr. Isabella Wolf (Mannheim) und PD Dr. Steffen Moritz (Hamburg) für die wertvollen Kommentare und Diskussionsbeiträge bei der Erstellung des Manuskriptes.
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Publication History

Publication Date:
20 January 2005 (online)

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Zusammenfassung

Das Verständnis der Posttraumatischen Belastungsstörung (PTBS) hat sich durch den Einsatz der bildgebenden Verfahren im letzten Jahrzehnt erheblich verändert, so dass Modelle zur Entstehung und Aufrechterhaltung präzisiert werden konnten. Hierdurch hat sich diese Erkrankung von der „traumatischen Neurose” hin zu einer biologisch begründbaren seelischen Störung gewandelt. Die vorliegende Übersichtsarbeit fasst den derzeitigen Stand der strukturellen, funktionellen und metabolischen Bildgebung zur PTBS kritisch zusammen. Vier Hirnarealen kommt dabei besondere Bedeutung zu, den Mandelkernen, die hyperreaktiv auf trauma-assoziierte Stimuli reagieren, der verkleinerten Hippokampusformation, dem zum limbischen System gehörenden Zingulum und orbitofrontalen kortikalen Arealen. Derzeitige Überlegungen zum Verständnis der Pathophysiologie werden ebenso wie methodische Limitierungen der bestehenden Befunde aus den bildgebenden Verfahren diskutiert.

Abstract

The knowledge about the development and maintenance of the posttraumatic stress disorder (PTSD) has increased significantly in the past 10 years with important insights coming from imaging studies. Through these insights PTSD has changed from “traumatic neurosis” to a biologically based psychological disorder. This paper summarises the recent literature on morphological, functional and metabolic neuroimaging on PTSD. Of special interest are four brain areas, the hyperactive amygdala, the hippocampus with volume reduction as well as the cingulate gyrus and orbitofrontal cortical regions, which may not be able to inhibit the hyperactive amygdala to trauma related stimuli. Based on these imaging data the current understanding of the pathophysiology of PTSD as well as present methodological limitations of imaging methods will be discussed.

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Prof. Dr. Dieter F. Braus

NeuroImage Nord (NIN) und Arbeitsbereich Bildgebung, Klinik für Psychiatrie und Psychotherapie

Martinistraße 52

20246 Hamburg

Email: d.braus@uke.uni-hamburg.de

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