title: Limbic scars: long-term consequences of childhood maltreatment revealed by functional and structural magnetic resonance imaging.
abstract: BACKGROUND
  Childhood maltreatment represents a strong risk factor for the development of depression and posttraumatic stress disorder (PTSD) in later life. In the present study, we investigated the neurobiological underpinnings of this association. Since both depression and PTSD have been associated with increased amygdala responsiveness to negative stimuli as well as reduced hippocampal gray matter volume, we speculated that childhood maltreatment results in similar functional and structural alterations in previously maltreated but healthy adults.
  
  
  METHODS
  One hundred forty-eight healthy subjects were enrolled via public notices and newspaper announcements and were carefully screened for psychiatric disorders. Amygdala responsiveness was measured by means of functional magnetic resonance imaging and an emotional face-matching paradigm particularly designed to activate the amygdala in response to threat-related faces. Voxel-based morphometry was used to study morphological alterations. Childhood maltreatment was assessed by the 25-item Childhood Trauma Questionnaire (CTQ).
  
  
  RESULTS
  We observed a strong association of CTQ scores with amygdala responsiveness to threat-related facial expressions. The morphometric analysis yielded reduced gray matter volumes in the hippocampus, insula, orbitofrontal cortex, anterior cingulate gyrus, and caudate in subjects with high CTQ scores. Both of these associations were not influenced by trait anxiety, depression level, age, intelligence, education, or more recent stressful life events.
  
  
  CONCLUSIONS
  Childhood maltreatment is associated with remarkable functional and structural changes even decades later in adulthood. These changes strongly resemble findings described in depression and PTSD. Therefore, the present results might suggest that limbic hyperresponsiveness and reduced hippocampal volumes could be mediators between the experiences of adversities during childhood and the development of emotional disorders.
authors: Department of Psychiatry, University of Münster, Albert-Schweitzer-Strasse 11, Münster, Germany. dannlow@uni-muenster.de
authors: Udo
authors: U
authors: Dannlowski
authors: Anja
authors: A
authors: Stuhrmann
authors: Victoria
authors: V
authors: Beutelmann
authors: Peter
authors: P
authors: Zwanzger
authors: Thomas
authors: T
authors: Lenzen
authors: Dominik
authors: D
authors: Grotegerd
authors: Katharina
authors: K
authors: Domschke
authors: Christa
authors: C
authors: Hohoff
authors: Patricia
authors: P
authors: Ohrmann
authors: Jochen
authors: J
authors: Bauer
authors: Christian
authors: C
authors: Lindner
authors: Christian
authors: C
authors: Postert
authors: Carsten
authors: C
authors: Konrad
authors: Volker
authors: V
authors: Arolt
authors: Walter
authors: W
authors: Heindel
authors: Thomas
authors: T
authors: Suslow
authors: Harald
authors: H
authors: Kugel
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology*; D000679:Amygdala / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002649:Child Abuse / Q000175:diagnosis / Q000523:psychology; D003866:Depressive Disorder / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D005149:Facial Expression; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011569:Psychiatric Status Rating Scales; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000523:psychology; D011795:Surveys and Questionnaires; D013995:Time