Thinner medial orbital frontal cortex is associated with early PTSD symptoms, sleep disturbance, and mental health problems that may contribute to PTSD development after acute trauma

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Both thinner medial orbital frontal cortex (mOFC) and an association between sleep disturbance and smaller mOFC volume have both been reported in chronic PTSD patients. However, the relationship between mOFC structure and symptoms of PTSD, sleep disturbance, and other mental health problems has not been studied in the early days to months after trauma. We examined relationships between mOFC thickness 2 weeks after trauma and such symptoms over 2 weeks to 3 months after trauma. We conducted structural MRI scans 2 weeks after trauma. mOFC thickness was measured using FreeSurfer software. PTSD Checklist (PCL-5), Pittsburgh Sleep Quality Index (PSQI), and mental health (SF-12 Health Survey) were acquired at 2 weeks and 3 months. PTSD was diagnosed at 3 months. Symptom severity differences comparing PTSD and non-PTSD groups and relationships between mOFC thickness and symptom severity were assessed.Trauma survivors diagnosed with PTSD (n=46) had more severe sleep and mental health problems at 3 months (P<0.001 and P=0.017, respectively) compared to non-PTSD (n=68) survivors. In PTSD, but not non-PTSD, survivors, left mOFC thickness at 2 weeks was negatively correlated with PCL-5 scores (r=-0.381, p=0.020) at 2 weeks and PSQI scores at nmonths (r=-0.372, p=0.020), and positively correlated with SF-12 mental health scores (r=0.335, p=0.03) at 2 weeks. The findings suggest that within early days after trauma, thinner mOFC appears to be associated with more serious acute PTSD and mental health symptoms and may predict sleep disturbance over subsequent early posttrauma months in PTSD survivors.

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