| Study | Method | PTSD | Control | ROI | Main findings |
|---|---|---|---|---|---|
| N-acetylaspartate | |||||
| De Bellis et al. (2000) [75] | NAA/Cr ratio | 11 | 11 (HC) | ACC | ↓ in the ACC |
| Freeman et al. (1998) [76] | NAA/Cr ratio | 21 | 8 (non-PTSD) | TLS | ↓ in the right medial TLS |
| Schuff et al. (2001) [84] | NAA | 18 | 19 (HC) | Hippocampus | ↓ about 23% in the bilateral hippocampus |
| Ham et al. (2007) [86] | NAA | 26 | 25 (HC) | ACC | ↓ in the ACC |
| Negatively related with re-experience symptom scores | |||||
| Hippocampus | ↓ in the bilateral hippocampus | ||||
| Negatively related with re-experience symptom scores | |||||
| Bo et al. (2006) [87] | NAA | 17 | 17 (HC) | Hippocampus | ↓ in the bilateral hippocampus |
| Mohanakrishnan Menon et al. (2003) [88] | NAA/Cr ratio | 14 | 7 (non-PTSD) | Hippocampus | ↓ in the left hippocampus |
| Mahmutyazıcıoğlu et al. (2005) [89] | NAA/Cr ratio | 10 | 6 (HC) | ACC | ↓ in the ACC |
| Hippocampus ↓ in the bilateral hippocampus | |||||
| Li et al. (2006) [90] | NAA/Cr ratio | 12 | 12 (non-PTSD) | Hippocampus | ↓ in the left hippocampus |
| Guo et al. (2012) [91] | NAA/Cr ratio | 50 | 50 (HC) | ACG | ↓ in the ACG |
| Hippocampus ↓ in the bilateral hippocampus | |||||
| Shu et al. (2013) [92] | NAA/Cr ratio | 11 | 11 (HC) | Hippocampus | ↓ in the bilateral hippocampus |
| Negatively related with re-experience, avoidance, and hyper-arousal symptom scores | |||||
| Brown et al. (2003) [93] | NAA/Cr ratio | 9 POWs | 12 POWs (non-PTSD) | MTL | ↓ in the left MTL |
| Strongly correlated with re-experiencing symptom scores in PTSD group | |||||
| Freeman et al. (2006) [94] | NAA/Cr ratio | 10 POWs | 10 POWs (non-PTSD) | Hippocampus | Not significant |
| 6 (HC) | |||||
| Seedat et al. (2005) [95] | NAA/Cr ratio | 16 | 11 (HC) | ACC | Not significant |
| Occipital GM | |||||
| Meyerhoff et al. (2014) [96] | NAA | 17 | 18 (non-PTSD) | ACC | ↓ in the ACC |
| Choline | |||||
|---|---|---|---|---|---|
| Bo et al. (2006) [87] | Cho | 17 | 17 (HC) | Hippocampus | Not significant |
| Mahmutyazıcıoğlu et al. (2005) [89] | Cho | 10 | 6 (HC) | ACG | Not significant |
| Hippocampus ↑ in the bilateral hippocampus | |||||
| Guo et al. (2012) [91] | Cho/Cr ratio | 50 | 50 (HC) | ACG | ↑ in the ACG |
| Hippocampus Not significant | |||||
| Shu et al. (2013) [92] | Cho/Cr ratio | 11 | 11 (HC) | Hippocampus | Positively related with re-experience symptom scores |
| Seedat et al. (2005) [95] | Cho/Cr ratio | 16 | 11 (HC) | ACC | ↑ in the ACC |
| Study | Method | PTSD | Control | ROI | Main findings |
|---|---|---|---|---|---|
| Gamma-aminobutyric acid and Glutamate-glutamine complex | |||||
| Meyerhoff et al. (2014) [96] | GABA | 27 | 18 (non-PTSD) | POC, MTC | ↓ in the POC and MTC |
| Glu | MTC | ↑ in the MTC | |||
| Michels et al. (2014) [101] | GABA | 12 | 17 (non-PTSD) | ACC | ↑ in the ACC |
| DLPFC | ↑ in the DLPFC | ||||
| Rosso et al. (2014) [102] | GABA | 13 | 13 (HC) | Insula | ↓ in the insula |
| Dorsal ACC | Not significant | ||||
| Yang et al. (2015) [101] | Glx/Cr ratio | 10 | 21 (HC) | ACC | PTSD < remitted PTSD < HC |
| 23 (remitted PTSD) | |||||
The ↑symbol indicates an increase, and ↓ a decrease.
Abbreviations: ACC, anterior cingulate cortex; ACG, anterior cingulate gyrus; Cho, choline; Cr, creatine; DLPFC, dorsolateral prefrontal cortex; GABA, gamma aminobutyric acid; Glu, glutamate; Glx, glutamate-glutamine complex; GM, gray matter; HC, healthy controls; 1H-MRS, Proton magnetic resonance spectroscopy; MTC, medial temporal cortex; MTL, medial temporal lobe; NAA, N-acetylaspartate; POC, parieto-occipital cortex; POWs, former prisoners of war; PTSD, posttraumatic disorder; ROI, region of interest; TLS, temporal lobe structure.