Brain structural abnormalities in posttraumatic stress disorder and relations with sleeping problems

Increasing number of neuroimaging studies examine brain structure in posttraumatic stress disorder (PTSD) patients. Limited studies begin to examine the relationship of brain structure and sleep problems in PTSD patients. The current review summarizes the existing findings on structural brain differences between the PTSD patients and control subjects without PTSD, with emphasis on studies related to sleep problems in PTSD patients. The findings of structural differences in hippocampus, prefrontal cortex, anterior cingulate cortex, insular cortex, and corpus callosum of PTSD patients have been reported in multiple studies, but changes in other brain regions are yet to be reliably replicated. Limited studies on pediatric PTSD suggest different picture of structural abnormalities as compared to adult patients. The longitudinal studies suggest that structural properties of prefrontal cortex in trauma-exposed individuals dynamically change over time, and these dynamic brain changes may associate with progression of PTSD symptoms. Finally, limited studies suggest that structural changes in hippocampus and prefrontal brain regions may be associated with the severity of sleep problems in trauma-exposed individuals, but further investigation on this issue is clearly needed.