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Brain structures in pediatric maltreatment-related posttraumatic stress disorder: a sociodemographically matched study

  • Michael D. De Bellis
    Correspondence
    Address reprint requests to Michael D. De Bellis, M.D., M.P.H., Healthy Childhood Brain Development/Developmental Traumatology Research Program, Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, Duke South, White Zone, DUMC Box 3615, Durham NC 27710, USA.
    Affiliations
    Department of Psychiatry, Western Psychiatric Institute and Clinic , University of Pittsburgh, Pittsburgh, Pennsylvania USA(MDDB, MSK, SRB, JH, GM)
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  • Matcheri S. Keshavan
    Affiliations
    Department of Psychiatry, Western Psychiatric Institute and Clinic , University of Pittsburgh, Pittsburgh, Pennsylvania USA(MDDB, MSK, SRB, JH, GM)
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  • Heather Shifflett
    Affiliations
    Department of Statistics (HS, SI), University of Pittsburgh, Pittsburgh, Pittsburgh,Pennsylvania, USA
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  • Satish Iyengar
    Affiliations
    Department of Statistics (HS, SI), University of Pittsburgh, Pittsburgh, Pittsburgh,Pennsylvania, USA
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  • Sue R. Beers
    Affiliations
    Department of Psychiatry, Western Psychiatric Institute and Clinic , University of Pittsburgh, Pittsburgh, Pennsylvania USA(MDDB, MSK, SRB, JH, GM)
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  • Julie Hall
    Affiliations
    Department of Psychiatry, Western Psychiatric Institute and Clinic , University of Pittsburgh, Pittsburgh, Pennsylvania USA(MDDB, MSK, SRB, JH, GM)
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  • Grace Moritz
    Affiliations
    Department of Psychiatry, Western Psychiatric Institute and Clinic , University of Pittsburgh, Pittsburgh, Pennsylvania USA(MDDB, MSK, SRB, JH, GM)
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      Abstract

      Background

      Previous investigations suggest that maltreated children evidence alterations of chemical mediators of stress and adverse brain development. Previous anatomical magnetic resonance imaging (MRI) brain studies have not controlled for socioeconomic status.

      Methods

      In this study, 28 psychotropic naïve children and adolescents with maltreatment-related posttraumatic stress disorder (PTSD) and 66 sociodemographically similar healthy control subjects underwent comprehensive clinical assessments and anatomical MRI brain scans.

      Results

      Compared with control subjects, subjects with PTSD had smaller intracranial, cerebral, and prefrontal cortex, prefrontal cortical white matter, and right temporal lobe volumes and areas of the corpus callosum and its subregions (2, 4, 5, 6, and 7), and larger frontal lobe cerebrospinal fluid (CSF) volumes than control subjects. The total midsagittal area of corpus callosum and middle and posterior regions remained smaller in subjects with PTSD, whereas right, left, and total lateral ventricles and frontal lobe CSF were proportionally larger than in control subjects, after adjustment for cerebral volume. Brain volumes positively correlated with age of onset of PTSD trauma and negatively correlated with duration of abuse. Significant gender × group effect demonstrated greater lateral ventricular volume increases in maltreated male subjects with PTSD than maltreated female subjects with PTSD. No hippocampal differences were seen.

      Conclusions

      These data provide further evidence to suggest that maltreatment-related PTSD is associated with adverse brain development. These data also suggest that male children may be more vulnerable to these effects.

      Keywords

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