Journal
BIOLOGICAL PSYCHIATRY-COGNITIVE NEUROSCIENCE AND NEUROIMAGING
Volume 4, Issue 2, Pages 171-179Publisher
ELSEVIER
DOI: 10.1016/j.bpsc.2018.07.013
Keywords
Childhood trauma; Functional magnetic resonance imaging; Neurodevelopment; Pediatric; Posttraumatic stress disorder; Structural magnetic resonance imaging
Categories
Funding
- National Institute of Mental Health Career Development Award [K08 MH100267]
- American Academy of Child and Adolescent Psychiatry Junior Investigator Award
- National Alliance for Research on Schizophrenia and Depression Young Investigator Grant
- University of Wisconsin Institute for Clinical and Translational Research Translational Pilot Grant Award (National Institutes of Health National Center for Advancing Translational Sciences) [UL1TR000427]
- University of Wisconsin Institute of Clinical and Translational TL1 Training Award [TL1TR000429]
- University of Wisconsin School of Medicine and Public Health
- National Science Foundation Graduate Research Fellowship Program [DGE-1747503]
- Graduate School at the University of Wisconsin-Madison
- Office of the Vice Chancellor for Research and Graduate Education at the University of Wisconsin-Madison
- Wisconsin Alumni Research Foundation
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BACKGROUND: Prior studies of pediatric posttraumatic stress disorder (PTSD) have reported cross-sectional and age-related structural and functional brain abnormalities in networks associated with cognitive, affective, and self-referential processing. However, no reported studies have comprehensively examined longitudinal gray matter development and its intrinsic functional correlates in pediatric PTSD. METHODS: Twenty-seven youths with PTSD and 21 nontraumatized typically developing (TD) youths were assessed at baseline and 1-year follow-up. At each visit, youths underwent structural magnetic resonance imaging and resting-state functional magnetic resonance imaging. Regions with volumetric abnormalities in whole-brain structural analyses were identified and used as seeds in exploratory intrinsic connectivity analyses. RESULTS: Youths with PTSD exhibited sustained reductions in gray matter volume (GMV) in right ventromedial prefrontal cortex (PFC) and bilateral ventrolateral PFC. Group-by-time analyses revealed aberrant longitudinal development in dorsolateral PFC, where typically developing youths exhibited normative decreases in GMV between baseline and follow-up, and youths with PTSD showed increases in GMV. Using these regions as seeds, patients with PTSD exhibited atypical longitudinal decreases in intrinsic PFC-amygdala and PFC-hippocampus connectivity, in contrast to increases in typically developing youths. Specifically, youths with PTSD showed decreasing ventromedial PFC-amygdala connectivity as well as decreasing ventrolateral PFC-hippocampus connectivity over time. Notably, volumetric abnormalities in ventromedial PFC and ventrolateral PFC were predictive of symptom severity. CONCLUSIONS: These findings represent novel longitudinal volumetric and connectivity changes in pediatric PTSD. Atypical prefrontal GMV and prefrontal-amygdala/hippocampus development may underlie persistence of PTSD in youths and could serve as future therapeutic targets.
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