marginally significantP = .06
In addition, random-effects models demonstrated significantly lower left hippocampus N-acetyl aspartate (NAA) in PTSD when referenced to creatine (Cr) (k = 7 studies; pooled standardized mean difference −0.99, 95% CI −1.94 to −0.04, P = .04) with a marginally significant decrease on the right (k = 6 studies; pooled standardized mean difference −0.75, 95% CI −1.54 to 0.04, P = .06), while NAA referenced otherwise demonstrated significant effect for both left (k = 7 studies; pooled standardized mean difference −0.78, 95% CI −1.11 to −0.45, P = .001) and right (k = 6 studies; pooled standardized mean difference −0.73, 95% CI −1.25 to −0.22, P = .01) hippocampus.