Chronic Trauma and PTSD Tied to Structural Changes in the Brain

It is known that trauma disrupts the normal processing of the brain. Trauma represents danger, triggering the brain’s amygdala to swing into action. The amygdala is the part of the brain involved in formation and processing of many of our most primitive emotions, including fear, anger and pleasure. The amygdala controls the fight-or-flight instinct, a throwback to our evolutionary origins when the brain was constantly geared to the business of survival.

Once the amygdala senses DANGER, the brain sets off a whole chain of chemical reactions geared to prepare the body for fighting or fleeing. Hormones are released that raise blood sugar (to increase energy), increase blood pressure and heart rate (to elevate cardiac output) and disrupt digestion (no time to eat now!). Brain trauma also causes the brain to go into dissociative mode, a compensatory mechanism that “walls off the event”, separating what otherwise would be normal feelings of horror from the full-scale reality of the life-threatening situation.

Trauma and Structural Changes in the Brain

One of the most fascinating areas of research emerging from brain studies links childhood emotional trauma and post-traumatic stress disorder (PTSD) with structural changes in the hippocampus and prefrontal cortex, areas of the brain that play a critical role in learning and memory functions.

Researchers at Yale University have shown that intense and prolonged stress stemming from childhood emotional abuse triggers a cascade of damaging hormones which bathe the brain with adrenaline, noradrenaline and opiates, resulting in the eventual shrinkage of the hippocampus. Exposure to chronic stress causes the body to release copious amounts of an enzyme known as kinase C, which has been shown to break down the dendritic spines of neurons in the prefrontal cortex of the brain. Dendritic spines receive “excitatory impulses” or signals which are then transferred to the receptive surface of brain neurons. These spines serve to increase the neuron’s surface receptivity; namely, the greater the surface area, the more information that can be processed and integrated. A reduction in dendritic spines obviously has negative implications for learning potential.

PTSD and Brain Structural Changes

These studies have led to further efforts to determine if structural changes in the hippocampus also would be seen in patients diagnosed with post-traumatic stress disorder, such as survivors of childhood sexual abuse and combat. One research study found that patients with PTSD from both combat and early childhood sexual abuse demonstrated marked deficits in verbal memory function. Another study found an 8% reduction in right hippocampal volume, as measured by MRI, in an area correlated with reduction in memory function. Additional research has found smaller left hippocampal volumes in abused women with PTSD and smaller bilateral hippocampal volumes in patients suffering from combat-related PTSD. The outcome of these studies suggests that deficits in the hippocampus may be associated with chronic PTSD.

Unanswered Questions Remain

Studies examining structural changes of the hippocampus pose several unanswered questions. It is not known, for example, whether structural changes are specific to childhood sexual abuse and PTSD or are a nonspecific effect of childhood abuse. Furthermore, it is not clear whether these changes would be seen in other forms of childhood trauma, including traumatic accidents resulting in chronic pain or functional loss.

A Top Trial Lawyer Dedicated to Evolving Research

While questions remain as to the relevance of brain structural changes to other forms of trauma, research exploring the link between mind and body is ongoing and rapidly progressing. As personal injury lawyers, we constantly encounter clients who have suffered unfathomable trauma, yet our judicial system still defines symptoms related to PTSD and chronic stress as largely psychological/emotional in nature. The day will come—and, in my opinion, it is not that far off—when we will be able to challenge such narrow characterizations and recast the effects of trauma as physiologically—not solely emotionally or psychologically—harmful.

If you or a loved one has sustained a trauma due to the negligent or purposeful actions of another and now are suffering from its chronic and debilitating effects, consult with a top trial lawyer: 314-409-7060 or 855-40-CRASH (toll free).

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