This chapter presents the results of studies investigating the restoration of cortical grey matter through treatments used to manage posttraumatic stress disorder (PTSD), suicidality and depression. Targeted pharmacotherapies that can partially reverse PTSD by restoring grey matter in key brain regions include selective serotonin reuptake inhibitors (SSRIs) and ketamine. SSRIs, such as paroxetine and sertraline, yield 3.7–10% hippocampal volumetric gains, and ketamine infusions restore grey matter in the opercular inferior frontal gyrus. With regard to psychotherapies, meta-analytic and individual studies show that eye-movement desensitization and reprocessing therapy increases volume in the bilateral hippocampus, anterior cingulate cortex, dorsolateral and orbitofrontal prefrontal regions and insula, while trauma-focused cognitive behaviour therapies similarly enhance hippocampal and prefrontal cortices. Neurofeedback promotes frontal and temporal cortex thickening. Treatments for suicidality and depression that restore grey matter include lithium, ketamine, deep brain stimulation and dialectical behaviour therapy, which enhance grey matter in the dorsolateral and ventrolateral prefrontal cortex, anterior cingulate cortex, hippocampus and subcortical regions. Overall, these findings underscore the neuroplastic potential of PTSD-targeted interventions to restore grey matter loss.

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Restoring Grey Matter Through Treatment

  • Maxwell Bennett

摘要

This chapter presents the results of studies investigating the restoration of cortical grey matter through treatments used to manage posttraumatic stress disorder (PTSD), suicidality and depression. Targeted pharmacotherapies that can partially reverse PTSD by restoring grey matter in key brain regions include selective serotonin reuptake inhibitors (SSRIs) and ketamine. SSRIs, such as paroxetine and sertraline, yield 3.7–10% hippocampal volumetric gains, and ketamine infusions restore grey matter in the opercular inferior frontal gyrus. With regard to psychotherapies, meta-analytic and individual studies show that eye-movement desensitization and reprocessing therapy increases volume in the bilateral hippocampus, anterior cingulate cortex, dorsolateral and orbitofrontal prefrontal regions and insula, while trauma-focused cognitive behaviour therapies similarly enhance hippocampal and prefrontal cortices. Neurofeedback promotes frontal and temporal cortex thickening. Treatments for suicidality and depression that restore grey matter include lithium, ketamine, deep brain stimulation and dialectical behaviour therapy, which enhance grey matter in the dorsolateral and ventrolateral prefrontal cortex, anterior cingulate cortex, hippocampus and subcortical regions. Overall, these findings underscore the neuroplastic potential of PTSD-targeted interventions to restore grey matter loss.