Abstract
This study seeks to determine whether white matter integrity in the brain differs between adolescents with post-traumatic stress disorder (PTSD) due to childhood sexual abuse (CSA) and matched healthy adolescents and whether there is a relationship between white matter integrity and symptom severity in the patient group. Using 3T diffusion tensor imaging, we examined fractional anisotropy (FA) in a group of adolescents with CSA-related PTSD (n = 20) and matched healthy controls (n = 20), in a region of interest consisting of the bilateral uncinate fasciculus (UF), the genu, splenium and body of the corpus callosum (CC), and the bilateral cingulum. In addition, we performed an exploratory whole brain analysis. Trauma symptomatology was measured with the Trauma Symptom Checklist for Children (TSCC) to enable correlational analyses between FA differences and trauma symptomatology. The PTSD group had significantly lower FA values in the genu, midbody and splenium of the CC in comparison with controls (p < 0.05, tfce corrected). Post hoc analyses of the eigenvalues of the DTI scan showed increased radial and mean diffusivity in the patient group. In addition, we found a significant negative correlation between scores on the anger subscale of the TSCC and FA values in the left body of the CC in patients (p < 0.05). Adolescents with CSA-related PTSD show decreased FA in the CC, with abnormalities in the integrity of the left body of the CC being related to anger symptoms. These findings suggest that early trauma exposure affects the development of the CC, which may play a role in the pathophysiology of PTSD in adolescents.
Highlights
Childhood psychotrauma is a prevalent and important predictor of both child and adult psychopathology as well as a number of somatic disorders [1, 26, 31, 45]
We examined white matter integrity in a sample of adolescents with childhood sexual abuse (CSA)-related post-traumatic stress disorder (PTSD), using an ROI and an additional exploratory whole brain approach
We found a significant correlation between fractional anisotropy (FA) in the corpus callosum (CC) and Anger scores on the Trauma Symptom Checklist for Children (TSCC) in the adolescents with CSA-related PTSD
Summary
Childhood psychotrauma is a prevalent and important predictor of both child and adult psychopathology as well as a number of somatic disorders [1, 26, 31, 45]. Childhood adversity was found to be associated with changes in brain circuitry involved in stress and emotion regulation, such as the hippocampus and certain prefrontal regions, possibly underlying vulnerability to the impact of stressors later in life [12, 25, 32, 41]. Eur Child Adolesc Psychiatry (2016) 25:869–878 found to be associated with structural and functional damage in key elements of emotion and stress regulating brain circuitry, for example in the hippocampus in adults reporting childhood abuse or in the medial prefrontal cortex in adults reporting childhood emotional maltreatment [5, 56]. Some recent reviews and metaanalyses have addressed structural brain alterations following childhood trauma in both adolescents and (young) adults with and without psychopathology [11, 40, 60]. Next to findings in the cerebellum and sensory cortex, most of the results from reviews and meta-analyses point toward involvement of the corpus callosum (CC) and corticolimbic circuits in the pathophysiological sequelae of psychotrauma in children and young adults
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