Corpus callosum in maltreated children with posttraumatic stress disorder: A diffusion tensor imaging study

Child Study Center, Yale University School of Medicine, New Haven, CT, United States.
Psychiatry Research (Impact Factor: 2.68). 05/2008; 162(3):256-61. DOI: 10.1016/j.pscychresns.2007.08.006
Source: PubMed

ABSTRACT Contrary to expectations derived from preclinical studies of the effects of stress, and imaging studies of adults with posttraumatic stress disorder (PTSD), there is no evidence of hippocampus atrophy in children with PTSD. Multiple pediatric studies have reported reductions in the corpus callosum--the primary white matter tract in the brain. Consequently, in the present study, diffusion tensor imaging was used to assess white matter integrity in the corpus callosum in 17 maltreated children with PTSD and 15 demographically matched normal controls. Children with PTSD had reduced fractional anisotropy in the medial and posterior corpus, a region which contains interhemispheric projections from brain structures involved in circuits that mediate the processing of emotional stimuli and various memory functions--core disturbances associated with a history of trauma. Further exploration of the effects of stress on the corpus callosum and white matter development appears a promising strategy to better understand the pathophysiology of PTSD in children.

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Available from: Joan Kaufman, Jul 05, 2015
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    • "In addition, studies examining white matter in stress-related psychiatric disorders (depressive disorders, anxiety disorders and posttraumatic stress disorder) are of interest because these disorders are often accompanied by an unbalanced hypothalamic–pituitary–adrenal axis, resulting in increased levels of cortisol, as well as psychiatric symptoms similar to those reported by Cushing's disease patients. Stress-related psychiatric disorders have been related to reduced white matter integrity in mainly the corpus callosum, the cingulum and the uncinate fasciculus (Cullen et al., 2010; Eluvathingal et al., 2006; Jackowski et al., 2008; Kieseppa et al., 2010; Schuff et al., 2011; Sexton et al., 2009; Villarreal et al., 2004). "
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    ABSTRACT: Background Hypercortisolism leads to various physical, psychological and cognitive symptoms, which may partly persist after treatment of Cushing's disease. The aim of the present study was to investigate abnormalities in white matter integrity in patients with long-term remission of Cushing's disease, and their relation with psychological symptoms, cognitive impairment and clinical characteristics. Methods In patients with long-term remission of Cushing's disease (n = 22) and matched healthy controls (n = 22) we examined fractional anisotropy (FA) values of white matter in a region-of-interest (ROI; bilateral cingulate cingulum, bilateral hippocampal cingulum, bilateral uncinate fasciculus and corpus callosum) and the whole brain, using 3 T diffusion tensor imaging (DTI) and a tract-based spatial statistics (TBSS) approach. Psychological and cognitive functioning were assessed with validated questionnaires and clinical severity was assessed using the Cushing's syndrome Severity Index. Results The ROI analysis showed FA reductions in all of the hypothesized regions, with the exception of the bilateral hippocampal cingulum, in patients when compared to controls. The exploratory whole brain analysis showed multiple regions with lower FA values throughout the brain. Patients reported more apathy (p = .003) and more depressive symptoms (p < .001), whereas depression symptom severity in the patient group was negatively associated with FA in the left uncinate fasciculus (p < 0.05). Post-hoc analyses showed increased radial and mean diffusivity in the patient group. Conclusion Patients with a history of endogenous hypercortisolism in present remission show widespread changes of white matter integrity in the brain, with abnormalities in the integrity of the uncinate fasciculus being related to severity of depressive symptoms, suggesting persistent structural effects of hypercortisolism.
    02/2014; 4. DOI:10.1016/j.nicl.2014.01.017
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    • "In addition , while past structural MRI studies investigated GM changes after a stress-reduction intervention (Hölzel et al., 2010), effects of chronic stress over 20 years on GMV (Gianaros et al., 2007), or associations of cumulative stress and recent stress life events to GMV (Ansell et al., 2012), direct relations between perceived stress and both GMV and WMV have not been investigated in non-clinical samples of young adults. Previous neuroimaging studies have reported a significant reduction in WMV of the corpus callosum (CC), within samples having had significant early life stress (Jackowski et al., 2011), maltreatment-related PTSD (De Bellis et al., 2002; Jackowski et al., 2008), and PTSD (Villarreal et al., 2004) compared to healthy controls. For example, Teicher et al. (2004) found that total CC area of patients who experienced childhood neglect was significantly reduced compared to psychiatric patients who had not been neglected and non-psychiatric controls. "
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    ABSTRACT: Perceived stress reflects the extent to which situations are appraised as stressful at a given point in one's life. Past brain imaging studies have examined activation patterns underlying the stress response, yet focal differences in brain structures related to perceived stress are not well understood, especially when considering gray matter (GM) and white matter (WM) structures simultaneously. In this study, voxel-based morphometry was used to investigate relations between GM/WM volume and perceived stress levels in a large young adult sample. Participants (138 men, 166 women) completed the Perceived Stress Scale (PSS; Cohen et al., 1983) and underwent an anatomical magnetic resonance imaging scan. Higher PSS scores were associated with larger GM volume in a cluster that included regions in the bilateral parahippocampal gyrus, fusiform cortex, and entorhinal cortex and smaller GM volume in a cluster that included regions of the right insular cortex. Higher PSS scores were also related to smaller WM volume in a cluster that included the body of the corpus callosum. This pattern of results remained significant even after controlling for effects of general intelligence, socioeconomic status, and depression. Together, findings suggest a unique structural basis for individual differences in perceived stress, distributed across different GM and WM regions of the brain.
    NeuroImage 02/2014; 92. DOI:10.1016/j.neuroimage.2014.01.044 · 6.36 Impact Factor
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    • "Karl et al. (2006) conducted a meta-analysis that included three studies (one adult, two adolescent ) and found that the CC was significantly smaller (medium effect size) in a primarily pediatric sample with PTSD compared to healthy controls. Jackowski et al. (2008) also showed, using DTI (Diffusion Tensor Imaging), axonal structural alterations in maltreated children with PTSD, including a reduction in myelination in the CC. This is relevant given that myelination of the CC occurs throughout childhood (Giedd et al., 1996) and early psychological trauma, with concomitant excessive release of stress hormones, may adversely affect myelination of the developing brain. "
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    ABSTRACT: Objectives: Structural magnetic resonance imaging (sMRI) studies of anxiety disorders in children and adolescents are limited. Posttraumatic stress disorder (PTSD) and obsessive compulsive disorder (OCD) have been best studied in this regard. We systematically reviewed structural neuroimaging findings in pediatric PTSD and OCD. Methods: The literature was reviewed for all sMRI studies examining volumetric parameters using PubMed, ScienceDirect, and PsychInfo databases, with no limit on the time frame of publication. Nine studies in pediatric PTSD and six in OCD were suitable for inclusion. Results: Volumetric findings were inconsistent in both disorders. In PTSD, findings suggest increased as well as decreased volumes of the prefrontal cortex (PFC) and corpus callosum; whilst in OCD studies indicate volumetric increase of the putamen, with inconsistent findings for the anterior cingulate cortex (ACC) and frontal regions. Conclusions: Methodological differences may account for some of this inconsistency and additional volume-based studies in pediatric anxiety disorders using more uniform approaches are needed.
    Frontiers in Psychology 12/2012; 3:568. DOI:10.3389/fpsyg.2012.00568 · 2.80 Impact Factor
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