Structural and Functional Brain Abnormalities Associated With Exposure to Different Childhood Trauma Subtypes: A Systematic Review of Neuroimaging Findings

Abstract

Background: Childhood trauma subtypes sexual abuse, physical abuse, emotional maltreatment, and neglect may have differential effects on the brain that persist into adulthood. A systematic review of neuroimaging findings supporting these differential effects is as yet lacking.Objectives: The present systematic review aims to summarize the findings of controlled neuroimaging trials regarding long-term differential effects of trauma subtypes on the human brain.Methods: A systematic literature search was performed using the PubMed and PsycINFO databases from January 2017 up to and including January 2018. Additional papers were identified by a manual search in the reference lists of selected papers and of relevant review articles retrieved by the initial database search. Studies were then assessed for eligibility by the first author. Only original human studies directly comparing neuroimaging findings of exposed and unexposed individuals to well-defined emotional, physical or sexual childhood maltreatment while controlling for the effects of other subtypes were included. A visual summary of extracted data was made for neuroimaging modalities for which comparison between trauma subtypes was feasible, taking the studies' numbers and sample sizes into account.Results: The systematic literature search yielded 25 publications. Sexual abuse was associated with structural deficits in the reward circuit and genitosensory cortex and amygdalar hyperreactivity during sad autobiographic memory recall. Emotional maltreatment correlated with abnormalities in fronto-limbic socioemotional networks. In neglected individuals, white matter integrity and connectivity were disturbed in several brain networks involved in a variety of functions. Other abnormalities, such as reduced frontal cortical volume, were common to all maltreatment types.Conclusions: There is some evidence for long-term differential effects of trauma subtypes on the human brain. The observed alterations may result from both protective adaptation of and damage to the brain following exposure to threatening life events. Though promising, the current evidence is incomplete, with few brain regions and neuroimaging modalities having been investigated in all subtypes. The comparability of the available evidence is further limited by the heterogeneity of study populations regarding gender, age and comorbid psychopathology. Future neuroimaging studies should take this potentially differential role of childhood trauma subtypes into account.

Exploring the impact of trauma type and extent of exposure on posttraumatic alterations in 5-HT1A expression

“…As mentioned previously, qualitatively different types of traumas can produce distinct neurobiological and behavioral consequences (e.g., Ref. 21 ). In addition, while the DSM uses a binary approach to define the boundary between “stress” and “trauma,” it may be important to focus more on qualitative aspects of distinct types of intense stressors and less on a dichotomous variable.…”

“…Some individuals experience rapid and sustained natural recovery, while others develop chronic trauma-related psychopathology 3 . Importantly, the nature and extent of trauma exposure combine to produce different outcomes; research suggests that exposure to qualitatively different events and different degrees of exposure lead to different psychiatric and neurobiological outcomes 4 – 21 . For example, qualitatively different events (e.g., rape, assault, and natural disaster) are associated with different levels of conditional risk for posttraumatic stress disorder (PTSD; 19% rape and 0.3% natural disaster) 20 .…”

Interpersonal early life trauma is associated with increased cerebral perfusion and poorer memory performance in post-9/11 veterans

“…Additional research has shown ELT negatively impacts brain function, with increased functional connectivity and activation in limbic structures during an emotional processing task ( Jedd et al, 2015 ) as well as a sustained attention task ( Fortenbaugh et al, 2017 ) and decreased functional connectivity between amygdalae and prefrontal regions at rest ( Fan et al, 2014 , Pagliaccio et al, 2015 ). Moreover, a recent meta -analysis reported structural and functional abnormalities in association with childhood trauma type ( Cassiers et al, 2018 ), further implicating disruptions to both structure and function in association with ELT.…”

Decomposing complex links between the childhood environment and brain structure in school-aged youth

“…Dimensional approaches have increasingly focused on key aspects of early adversity (Cicchetti & Toth, 1995;Cohodes et al, 2020;Everaerd et al, 2016;McCoy, 2013;McLaughlin et al, 2014;Pynoos et al, 1999), including the type of adversity experienced (Dennison et al, 2019;Machlin et al, 2019;McLaughlin et al, 2014;Miller et al, 2018;Sheridan et al, 2017). Previous work directly comparing distinct types of exposures (e.g., physical abuse, sexual abuse, physical neglect, emotional neglect) has demonstrated differential impacts on brain structure (Cassiers et al, 2018;Edmiston et al, 2011;Heim et al, 2013;Tomoda et al, 2009Tomoda et al, , 2012van Harmelen et al, 2010). Examining findings across studies of specific types of adversity has also suggested unique associations with brain structure.…”