Sex differences in brain maturation in maltreatment-related pediatric posttraumatic stress disorder

Background. Recent investigations suggested that pediatric posttraumatic stress disorder (PTSD) is associated with adverse brain development. However, sex differences are poorly understood. Methods. In this study, 61 medically healthy children and adolescents (31 males and 30 females) with chronic PTSD secondary to abuse, who had similar trauma and mental health histories, and 122 healthy controls (62 males and 60 females) underwent comprehensive psychiatric assessments and an anatomical MRI brain scan. Results. When gender groups were analyzed separately, findings of larger prefrontal lobe CSF volumes and smaller midsagittal area of the corpus callosum subregion 7 (splenium) were seen in both boys and girls with maltreatment-related PTSD compared to their gender-matched comparison subjects. Subjects with PTSD did not show the normal age related increases in the area of the total corpus callosum and its region 7 (splenium) compared to non-maltreated subjects; however, this finding was more prominent in males with PTSD. Significant sex by group effects demonstrated smaller cerebral volumes and corpus callosum regions I (rostrum) and 6 (isthmus) in PTSD males and greater lateral ventricular volume increases in maltreated males with PTSD than maltreated females with PTSD. Conclusions. These data suggest that there are sex differences in the brain maturation of boys and girls with maltreatment-related PTSD. Longitudinal MRI brain investigations of childhood PTSD and the relationship of gender to psychosocial outcomes are warranted. (C) 2003 Elsevier Science Ltd. All rights reserved.