Disaster survivors show early signs of traumatic stress

An international research team has established the Wenchuan earthquake on May 12, 2008, exacted a toll beyond the nearly 70,000 deaths and 374,000 casualties from the magnitude 8.0 temblor.

Brain scans uncovered stress-related changes in the brains of survivors that suggest the alterations of cerebral function associated with post-traumatic behavioral disorders not only emerge progressively over years, but are also evident within days of the traumatizing event.

Dr. Qiyong Gong of the Huaxi MR Research Center and University of Liverpool led imaging scientists from China, the U.K., and the U.S. to perform whole-brain, resting-state fMRI on 44 adult quake survivors. The studies were performed within 25 days of the disaster.

Compared with control subjects, the survivors showed significant hyperactivity in the prefrontal and striatal systems and the presupplementary motor area (pre-SMA).

The prefrontal-limbic and striatal systems are important for emotional processing and play a critical role in anxiety disorders, including post-traumatic stress disorder, because of their importance for the recollection of traumatic memories and the processing of fear and pain, according to first author Dr. Su Lui. The striatum and pre-SMA are activated when decisions are made under time pressure.

The study was published in the Proceedings of the National Academy of Science (2009;106[36]:15412-15417).

According to Gong and colleagues, the findings suggest that changes seen in patients with chronic stress-related disorders reflect more than slowly progressive alterations or secondary effects of chronic distress and disability. The dysfunction in clinically relevant brain circuitry seems to be already manifested shortly after a massive traumatic event.

“The emergence of altered brain function in trauma survivors associated with emotional symptoms may identify those needing early treatment that might reduce long-term psychological disability in trauma survivors of national disasters, military conflict, and other causes of severe emotional distress,” they wrote.