In the wake of the devastating Kahramanmaraş earthquakes that struck Turkey and Syria on February 6, 2023, researchers have uncovered intriguing neurological changes in survivors diagnosed with post-traumatic stress disorder (PTSD). As the first anniversary of these catastrophic events approaches, a groundbreaking study sheds light on how traumatic exposure correlates with distinct structural alterations in critical brain regions responsible for memory and emotional processing—the hippocampus and amygdala. These insights not only deepen our understanding of PTSD but also point toward the complex interplay between trauma, brain anatomy, and psychiatric health.
The Kahramanmaraş earthquakes caused immense loss of life and injury, leaving over 60,000 dead and more than 120,000 wounded. Beyond the immediate physical damage, the psychological impact has been profound. PTSD has emerged as one of the most prevalent mental health disorders among survivors, with symptoms severely affecting daily functioning and quality of life. While PTSD’s psychological manifestations are well documented, this study focuses on the neurobiological underpinnings that may explain the disorder’s persistence and severity in earthquake survivors.
To explore these neurobiological changes, the research team retrospectively analyzed brain imaging data from two groups: survivors diagnosed with PTSD who had been undergoing antidepressant treatment for six to twelve months, and trauma-exposed individuals without a PTSD diagnosis. Both groups were carefully matched for age, gender, education level, smoking habits, and, in females, menstrual cycle phases to minimize confounding factors. This rigorous matching ensured that observed differences could more reliably be attributed to the presence or absence of PTSD.
Using magnetic resonance imaging (MRI) scanners operating at 1.5 Tesla strength, detailed volumetric analysis of the hippocampus and amygdala was performed. Automated software segmented these brain structures, allowing precise quantification of their volumes and assessment of hemispheric asymmetry. The hippocampus is a vital structure implicated in memory consolidation and spatial navigation, while the amygdala plays a central role in emotional processing and fear responses. Alterations in these areas have been previously linked to PTSD in various trauma-exposed populations, but this study uniquely ties such changes to survivors of a specific natural disaster.
Findings revealed that individuals with PTSD exhibited a distinct pattern of hemispheric asymmetry compared to non-PTSD survivors. Notably, the hippocampus and amygdala structures in PTSD patients showed a left-sided asymmetry predominance, while non-PTSD individuals primarily demonstrated right-sided amygdala asymmetry. This lateralized difference implies that trauma and subsequent psychiatric morbidity could be associated with specific neuroanatomical changes related to brain hemisphere dominance, adding nuance to the existing models of PTSD neurobiology.
Moreover, total hippocampal volume negatively correlated with symptom severity. Patients with smaller hippocampal volumes tended to score higher on the Post-Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) and the broader psychological burden measured by the Symptom Checklist-90-Revised (SCL-90-R). This suggests that hippocampal atrophy or reduced volume may underlie the persistence of PTSD symptoms, aligning with theories that chronic stress impairs hippocampal neurogenesis and structural integrity.
Importantly, the study controlled for age effects, revealing a robust relationship between hippocampal volume shrinkage and reported symptom intensity. This provides compelling evidence that beyond demographic variables, neuroanatomical changes constitute pivotal biological markers for PTSD. Concurrently, the increased psychiatric symptom severity in the PTSD group, as assessed by comprehensive psychological inventories, reinforces the functional relevance of these structural brain differences.
A noteworthy contextual finding was the higher incidence of PTSD history among first-degree relatives and more frequent loss or injury of close relatives in the PTSD group compared to non-PTSD survivors. This underlines the significant impact of social and familial factors on PTSD risk, potentially interacting with biological vulnerabilities. Together, genetic predisposition, trauma exposure, and neuroanatomical changes create a multifaceted landscape shaping individual outcomes after disaster exposure.
Hierarchical binary logistic regression models integrating demographic factors, hippocampal volume, amygdala asymmetry, and personal loss indices demonstrated promising predictive capacity for PTSD diagnosis. The model achieved a sensitivity of 66.7% and specificity of 81.0% in distinguishing PTSD from non-PTSD status, underscoring the potential clinical utility of combining neuroimaging biomarkers with psychosocial variables for early identification and intervention.
These findings emphasize the enduring impact of traumatic stress on brain architecture, particularly within the context of a large-scale natural disaster. The left-leaning asymmetry in PTSD patients invites further investigation into hemispheric functional specialization and its modulation by trauma. Moreover, hippocampal volume reduction confirms prior hypotheses about stress-induced neurotoxicity, neuroinflammation, or impaired neuroplasticity as mechanisms driving PTSD pathophysiology.
The study’s retrospective design and relatively moderate sample size highlight the need for longitudinal, multi-timepoint research to map the dynamic trajectory of neuroanatomical changes over time post-trauma. Such data could elucidate whether hippocampal and amygdala alterations precede disorder onset or represent consequences of chronic PTSD, informing more targeted therapeutic strategies aimed at neural regeneration or symptom mitigation.
Ultimately, this research contributes substantial evidence supporting the notion of “earthquake brain”—a term that encapsulates the neurological footprints left by seismic disasters on survivors’ mental health. As healthcare systems worldwide contend with spikes in trauma-related disorders following natural catastrophes, understanding underlying brain alterations becomes key to developing precision medicine approaches.
Psychiatric treatment paradigms may one day incorporate neuroimaging biomarkers as part of diagnostic and monitoring processes, allowing clinicians to track disease progression objectively and tailor interventions accordingly. Furthermore, raising awareness of neurobiological impacts helps destigmatize PTSD and legitimizes sufferers’ experiences, fostering improved psychosocial support networks.
This study, published in BMC Psychiatry, marks an important step toward bridging clinical psychiatry with neuroscience in the context of disaster mental health. It reiterates the profound interconnectedness of environmental events, brain biology, and psychological resilience. The continuation of this research trajectory holds promise for revolutionizing how PTSD is understood, diagnosed, and treated, potentially mitigating the long-lasting human burden of trauma exposure.
As the anniversary of the Kahramanmaraş earthquakes approaches, public health authorities, researchers, and clinicians alike are called to consider these neurological dimensions alongside conventional mental health frameworks. By integrating psychosocial and biological insights, society can better address the complex aftermath of natural disasters, ultimately fostering recovery and hope among affected populations.
Subject of Research: Neuroanatomical alterations in hippocampus and amygdala among survivors of Kahramanmaraş earthquakes with PTSD
Article Title: Hippocampus alterations in post-traumatic stress disorder among survivors of the consecutive Kahramanmaraş (Turkey) earthquakes in February 6, 2023: earthquake brain at the end of the first year
Article References:
Bayar-Kapıcı, O., Kapıcı, Y., Örüm, D. et al. Hippocampus alterations in post-traumatic stress disorder among survivors of the consecutive Kahramanmaraş (Turkey) earthquakes in February 6, 2023: earthquake brain at the end of the first year. BMC Psychiatry 25, 653 (2025). https://doi.org/10.1186/s12888-025-06763-x
Image Credits: AI Generated
