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Susceptibility or Resilience to Maltreatment Can Be Explained by Specific Differences in Brain Network Architecture

Published:November 01, 2018DOI:https://doi.org/10.1016/j.biopsych.2018.10.016

      Abstract

      Background

      Childhood maltreatment is a major risk factor for psychopathology. However, some maltreated individuals appear remarkably resilient to the psychiatric effects while manifesting the same array of brain abnormalities as maltreated individuals with psychopathology. Hence, a critical aim is to identify compensatory brain alterations that enable resilient individuals to maintain mental well-being despite alterations in stress-susceptible regions.

      Methods

      Network models were constructed from diffusion tensor imaging and tractography in physically healthy unmedicated 18- to 25-year-old participants (N = 342, n = 192 maltreated) to develop network-based explanatory models.

      Results

      First, we determined that susceptible and resilient individuals had the same alterations in global fiber stream network architecture using two different definitions of resilience: 1) no lifetime history of Axis I or II disorders, and 2) no clinically significant symptoms of anxiety, depression, anger-hostility, or somatization. Second, we confirmed an a priori hypothesis that right amygdala nodal efficiency was lower in asymptomatic resilient than in susceptible participants or control subjects. Third, we identified eight other nodes with reduced nodal efficiency in resilient individuals and showed that nodal efficiency moderated the relationship between maltreatment and psychopathology. Fourth, we found that models based on global network architecture and nodal efficiency could delineate group membership (control, susceptible, resilient) with 75%, 82%, and 80% cross-validated accuracy.

      Conclusions

      Together these findings suggest that sparse fiber networks with increased small-worldness following maltreatment render individuals vulnerable to psychopathology if abnormalities occur in specific nodes, but that decreased ability of certain nodes to propagate information throughout the network mitigates the effects and leads to resilience.

      Keywords

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      • Connecting With Resilience
        Biological PsychiatryVol. 85Issue 8
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          When it comes to mental health, we tend to focus more on what can go wrong and how than on what goes right and why. The intriguing question posed by Ohashi et al. (1) in this issue of Biological Psychiatry is what neurobiological systems might confer resilience, allowing some who experience early maltreatment to avoid subsequent mental ill health. Their focus is white matter integrity, and they use graph theory to describe the structural connectivity and, by inference, information flow among brain systems.
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