The authors measured the gray matter density of the brains of combat-exposed Vietnam veterans, some with and some without PTSD, and their combat-unexposed identical twins using a technology called magnetic resonance imaging (MRI). The detailed images provided by the MRI scans then allowed the investigators to compare specific brain regions of the siblings. They found that the gray matter density of the pregenual anterior cingulate cortex, an area of the brain involved in emotional functioning, was reduced in veterans with PTSD, but not in their twins who had not experienced combat. According to Dr. Pitman, "this finding supports the conclusion that the psychological stress resulting from the traumatic stressor may damage this brain region, with deleterious emotional consequences."
John H. Krystal, M.D., Editor of Biological Psychiatry and affiliated with both Yale University School of Medicine and the VA Connecticut Healthcare System, discusses the need for this kind of research because of two separate sets of prior findings: "On the one hand, compelling data from animal research indicates that stress can cause brain atrophy and even neural death in some brain regions. On the other hand, the volume of several brain regions are highly heritable and small brain volumes, presumably related to reduced function, in the hippocampus may increase stress reactivity or impair the capacity for resilience." He adds that findings from this study "suggest that volume reductions in [the anterior cingulate cortex] associated with PTSD arise as a consequence of stress exposure rather than emerging as a heritable trait," leaving one to conclude that "the extent to which particular genes and environmental exposures interact to shape the development of the brain thus appears to be complex and region-specific."