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Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
A dreary overstuffed catalogue of bygone orators or a magnificent intellectual achievement? A swan song for public speech or an apology for the art of eloquence? A timid retreat into academic leisure or a brazen challenge to civil war and Caesar? Despite the divergent viewpoints of these questions, it is hard to come away from Cicero’s Brutus without seeing merit in each of them. There is some of almost everything in Cicero’s stunning dialogue, and for that reason its seeming hodgepodge of intellectual curiosity, political statement, and documentary diligence has spurred modern observers to widely differing interpretations.
The Introduction outlines crucial intellectual contexts and frameworks for thinking about how Cicero's Brutus is a crucial intervention in the the civic crisis and the writing of literary history. It also surveys the scholarship to date and examines how Cicero's project reflects general trends in academic inquiry and civic government.
Chapter 7 considers stylistic imitation and appropriation in the debate over Atticism and Asianism, with a special focus on how Cicero distorts the aims and positions of his detractors in the diatribe against the Atticists (285–91). He trades on various meanings of Atticus/Attici in order to make a rhetorical – rather than strictly logical – case. He downplays Atticism as outdated and relegates its stylistic virtues to the plain style (genus tenue). Rejecting Atticism does not entail rejecting the plain style. Instead he acknowledges it as one of many oratorical virtues to be subsumed under the capable orator’s broad stylistic repertoire. Cicero promotes a model of stylistic diversity, examples of which are found in the long histories of Greek and, especially, Roman oratory.
Chapter 2 focuses on the dialogue’s intellectual filiations. It begins by examining the preface’s (1–25) insistence on remaining silent about the civic crisis even as the interlocutors' exchange of written texts incessantly circles back to the accomplishments and struggles of the Roman state. Atticus’ Liber Annalis and Brutus’ de Virtute inspired the Brutus, but to what extent and to what purpose remains initially unclear. In aligning their texts with de Republica and the Brutus, Cicero creates a complex web of learned exchange in the service of the republic. The chapter then considers other potential intellectual predecessors: Varro’s writings on literature, the history of the dialogue genre, and Cicero’s own works. The Brutus draws together several intellectual currents and promises significant innovations in how to document and conceptualize the literary past.
Chapter 4 turns to the pedagogical workings of the Brutus: it instills in the reader a new sense of how to organize and assess the literary past. Syncrisis is central to conceptualizing the past and to portraying individuals and groups across cultures and generations. The dialogue also spends a considerable amount of time reflecting on historical accuracy, for example in the discussions of Coriolanus and Themistocles (41–44), the laudatio funebris (62), the beginning of Latin literature with Livius Andronicus (72–73), and Curio’s dialogue about Caesar’s consulship (218–19). Taken together these reflections on rhetorical presentation of the past help us to understand the freedom with which Cicero handles the data of his literary history. Several claims, exaggerations, and fabrications can be explained by Cicero’s desire to craft meaningful parallels in his history of Latin oratory and literature, including his insistence on Naevius’ death in 204 BCE (60). Such parallels reveal in turn the close interconnection of his intellectual and ideological commitments.
Chapter 8 turns to the famous judgment of Julius Caesar’s commentarii (nudi, recti, venusti, 262). Not only textual aesthetics but also visual analogies and the plastic arts underlie Cicero’s judgments. An analysis of statuary analogies and of the fuller contexts for Cicero’s statements suggests a deft ploy on his part. He portrays himself as Phidias crafting a statue of Minerva (the Parthenon Athena) and Caesar as Praxiteles crafting a statue of Venus (the Aphrodite of Knidos). The fundamentally different symbolic resonances of the goddesses simultaneously challenge Caesar’s military accomplishments and underscore Cicero’s civic achievements. Cicero thereby promotes his vision of the need to restore the Roman republic once the civil war has concluded.
Chapter 6 shows how Cicero establishes a normative framework for the writing of literary history. Across the dialogue and through the various speakers he offers a sustained critique of literary historiography. Several fundamental tensions and conflicts emerge: absolute versus relative criteria in assessing literature and building canons; presentism and antiquarianism; formalism and historicism; and the recognition that all literary histories are subject to their crafters’ emphases and agendas.
Chapter 1 begins with the “Ciceropaideia” (301–29), the account of Cicero’s education and training. It begins with the end of the Brutus in order to provide a sense of what the dialogue has been building up to. Cicero’s concluding discussion of himself reveals and brings together several assumptions, problems, and techniques of presentation that are crucial to the earlier parts of the dialogue. In the Ciceropaideia he carefully shapes biographical and historical details into a tandem narrative, intertwining his ascent with the decline of Hortensius. The account suggestively documents Cicero’s development of a moderate “Rhodian” style and implicitly undermines his Atticist detractors.
Chapter 3 examines the Brutus as an intervention in contemporary politics. It begins by revisiting the preface but focuses on its discussion of the contemporary civic crisis and the immediate history of the civil war (1–25). In both the preface and the digression on Julius Caesar (254–57) Cicero presents an alternative civic vision as a response to the crisis. The chapter concludes by considering the portrayal of the younger generation of orators: Curio (filius), Caelius, Publius Crassus, and Marcellus. The last figure merits special attention because Cicero’s oratorical canon includes only two living figures: Marcellus and Caesar. Marcellus is accorded a prominent role as part of Cicero’s attempt to offer a coherent vision of the republic, one based on the restoration of the senatorial elite and the reinstatement of the traditional institutions of government.