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"The relationship between TBI and PTSD has garnered increased attention in recent years as studies have shown a considerable overlap in risk factors and symptoms," said lead author Murray Stein, MD, MPH, FRCPC, a Distinguished Professor of Psychiatry and Family Medicine & Public Health at the University of California, San Diego, La Jolla, CA, USA. "In this study, we were able to use data from TRACK-TBI, a large longitudinal study of patients who present in the Emergency Department with TBIs serious enough to warrant CT (computed tomography) scans."

"MRI studies conducted within two weeks of injury were used to measure volumes of key structures in the brain thought to be involved in PTSD," said Dr. Stein. "We found that the volume of several of these structures were predictive of PTSD 3-months post-injury." Specifically, smaller volume in brain regions called the cingulate cortex, the superior frontal cortex, and the insula predicted PTSD at 3 months. The regions are associated with arousal, attention and emotional regulation. The structural imaging did not predict PTSD at 6 months.

The findings are in line with previous studies showing smaller volume in several of these brain regions in people with PTSD and studies suggesting that the reduced cortical volume may be a risk factor for developing PTSD. Together, the findings suggest that a "brain reserve," or higher cortical volumes, may provide some resilience against PTSD.

Cameron Carter, MD, Editor of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, said of the work, "This very important study uses magnetic resonance imaging to take the field a step closer to understanding why some people develop PTSD after trauma and others do not. It also lays the groundwork for future research aimed at using brain imaging to help predict that a person is at increased risk and may benefit from targeted interventions to reduce the clinical impact of a traumatic event."