Abstract
Childhood trauma increases risk for psychopathology and cognitive impairment. Prior research mainly focused on the hippocampus and amygdala in single diagnostic categories. However, other brain regions may be impacted by trauma as well, and effects may be independent of diagnosis. This cross-sectional study investigated cortical and subcortical gray matter volume in relation to childhood trauma severity. We included 554 participants: 250 bipolar-I patients, 84 schizophrenia-spectrum patients and 220 healthy individuals without a psychiatric history. Participants filled in the Childhood Trauma Questionnaire. Anatomical T1 MRI scans were acquired at 3T, regional brain morphology was assessed using Freesurfer. In the total sample, trauma-related gray matter reductions were found in the frontal lobe (β = -0.049, p = 0.008; q = 0.048), this effect was driven by the right medial orbitofrontal, paracentral, superior frontal regions and the left precentral region. No trauma-related volume reductions were observed in any other (sub)cortical lobes nor the hippocampus or amygdala, trauma-by-group (i.e. both patient groups and healthy subjects) interaction effects were absent. A categorical approach confirmed a pattern of more pronounced frontal gray matter reductions in individuals reporting multiple forms of trauma and across quartiles of cumulative trauma scores. Similar dose-response patterns were revealed within the bipolar and healthy subgroups, but did not reach significance in schizophrenia-spectrum patients. Findings show that childhood trauma is linked to frontal gray matter reductions, independent of psychiatric morbidity. Our results indicate that childhood trauma importantly contributes to the neurobiological changes commonly observed across psychiatric disorders. Frontal volume alterations may underpin affective and cognitive disturbances observed in trauma-exposed individuals.
Highlights
Exposure to childhood trauma, encompassing different forms of maltreatment early in life, is an important risk factor for most psychiatric disorders (Green et al, 2010; Varese et al, 2012)
Cumulative trauma scores, independent from trauma subtype, revealed a similar dose-response pattern: higher quartiles of overall trauma rates were linked to more pronounced gray matter volume reductions in the frontal lobe (J-T = −3.25, p = 0.001, eTable 2, Fig. 2). When repeating these analyses for the individual subgroups, similar significant dose-response patterns were observed in the bipolar-I patients and healthy controls, but did not reach significance for the schizophrenia-spectrum subgroup. Exploring both cortical and subcortical brain regions in the largest transdiagnostic sample to date, we found that childhood trauma was associated with reduced gray matter volume in the frontal lobe, while no trauma-related volume reductions were observed in the hippocampus or amygdala
Sensitivity analyses showed that the right medial orbitofrontal, paracentral, superior frontal regions and the left precentral region contributed to this effect
Summary
Exposure to childhood trauma, encompassing different forms of maltreatment early in life, is an important risk factor for most psychiatric disorders (Green et al, 2010; Varese et al, 2012). Patients with a history of trauma may form a specific group in terms of symptom presentation, response to treatment and clinical needs As this subgroup is fairly large, roughly varying between 40% and 60% across psychiatric disorders, identification of trauma-related features of psychopathology, including their underlying neurobiological correlates, may inform individually tailored mental health care (Álvarez et al, 2011; Devi et al, 2019; Green et al, 2010; Porter, Branitsky, Mansell, & Warwick, 2020; Schäfer & Fisher, 2011; Wiersma et al, 2009). Other brain regions may be impacted by trauma as well, and effects may be independent of diagnosis This cross-sectional study investigated cortical and subcortical gray matter volume in relation to childhood trauma severity. Frontal volume alterations may underpin affective and cognitive disturbances observed in trauma-exposed individuals
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