Abstract
Background: Previous investigations suggest that maltreated children with a diagnosis
of posttraumatic stress disorder (PTSD) evidence alterations of biological stress
systems. Increased levels of catecholaminergic neurotransmitters and steroid hormones
during traumatic experiences in childhood could conceivably adversely affect brain
development.
Methods: In this study, 44 maltreated children and adolescents with PTSD and 61 matched
controls underwent comprehensive psychiatric and neuropsychological assessments and
an anatomical magnetic resonance imaging (MRI) brain scan.
Results: PTSD subjects had smaller intracranial and cerebral volumes than matched
controls. The total midsagittal area of corpus callosum and middle and posterior regions
remained smaller; while right, left, and total lateral ventricles were proportionally
larger than controls, after adjustment for intracranial volume. Brain volume robustly
and positively correlated with age of onset of PTSD trauma and negatively correlated
with duration of abuse. Symptoms of intrusive thoughts, avoidance, hyperarousal or
dissociation correlated positively with ventricular volume, and negatively with brain
volume and total corpus callosum and regional measures. Significant gender by diagnosis
effect revealed greater corpus callosum area reduction in maltreated males with PTSD
and a trend for greater cerebral volume reduction than maltreated females with PTSD.
The predicted decrease in hippocampal volume seen in adult PTSD was not seen in these
subjects.
Conclusions: These data suggest that the overwhelming stress of maltreatment experiences
in childhood is associated with adverse brain development.
Keywords
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Article Info
Publication History
Accepted:
February 19,
1999
Received in revised form:
February 16,
1999
Received:
June 18,
1998
Identification
Copyright
© 1999 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
