Abnormalities of white matter integrity in the corpus callosum of adolescents with PTSD after childhood sexual abuse: a DTI study

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.

Preserved cortical thickness, surface area and volume in adolescents with PTSD after childhood sexual abuse

“…The current study reports on cross-sectional baseline data from the adolescents with a history of sexual trauma and healthy non-traumatised controls. See also previous reports from neuroimaging research with the same population [19][20][21][22][23][24][25][26] . Inclusion criteria for the adolescents with a history of sexual trauma were: having experienced sexual abuse during their lifetime more than once by one or more perpetrators inside or outside the family, and being referred for treatment to the Psychotrauma Center of mental health institute GGZ Rivierduinen in Leiden or the child and adolescent psychotrauma center KJTC in Haarlem, both located in the Netherlands.…”

General psychopathology factor and unresolved-disorganized attachment uniquely correlated to white matter integrity using diffusion tensor imaging

“…Consistent with this suggestion, studies on white matter integrity (WMI) in PTSD due to maltreatment show reduced WMI in structures subserving emotional, learning, and memory functions, such as the cingulum, corpus callosum and associated fasciculi. For example, Rinne-Albers and colleagues [10] found abnormalities of WMI in the genu, body and splenium of the corpus callosum in adolescents with PTSD related to childhood sexual abuse (CSA) compared to a control group. Abnormalities of the integrity of the corpus callosum may be the consequence of stress hormones associated with maltreatment earlier in life and may underlie deficits in emotional dysregulation that are often experienced by these individuals [9,11].…”

Childhood adversity associated with white matter alteration in the corpus callosum, corona radiata, and uncinate fasciculus of psychiatrically healthy adults

“…Relative decreases in FA in white matter are suggestive of reduced tract integrity, potentially due to factors such as demyelination or axonal injury (Mori & Zhang, 2006). Maltreated children with PTSD have been found to have lower FA in their CC than healthy controls (Jackowski et al, 2008; Rinne-Albers et al, 2015). These changes appear to persist into adulthood, as healthy adolescents and adults exposed to childhood adversity also have reduced FA in their CC (Huang et al, 2012; Lu et al, 2013; Paul et al, 2008; Teicher et al, 2010; although see Seckfort et al, 2008 for a partial failure to replicate).…”

“…We focus first on findings that have been replicated by at least one other study. Childhood adversity has been reported to be associated with FA reductions in the hippocampal projection of the cingulum bundle in children (Hanson et al, 2013), adolescents (Huang et al, 2012), and young adults (Choi et al, 2009), although Rinne-Albers et al (2015) failed to replicate this finding in adolescent survivors of child sexual abuse with PTSD. The superior longitudinal fasciculus has also been reported to have lower FA in both adolescent (Huang et al, 2012) and young adult (Choi et al, 2009) survivors of childhood adversity.…”