Regional differences of the prefrontal cortex in pediatric PTSD: an MRI study
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Published on: July 1, 2014
Katherine A Richert1, Victor G Carrion, Asya Karchemskiy
1Stanford Early Life Stress Research Program, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, California 94305-5719, USA.
Insights
Children with posttraumatic stress disorder (PTSD) symptoms exhibit larger gray matter volume in specific prefrontal cortex (PFC) regions. Dorsal PFC gray matter reduction correlated with greater functional impairment in pediatric PTSD.
Area of Science:
- Neuroscience
- Developmental Psychology
- Child Psychiatry
Background:
- Previous research indicates frontal lobe and prefrontal cortex (PFC) structural alterations in children with posttraumatic stress disorder (PTSD) symptoms.
- Detailed structural analysis of the PFC in pediatric PTSD is lacking.
Purpose of the Study:
- To conduct a detailed structural analysis of the PFC in children with and without PTSD symptoms.
- To compare gray and white matter volume in four PFC subregions between groups.
- To investigate associations between PFC volume, PTSD symptom severity, and functional impairment.
Main Methods:
- Magnetic resonance imaging (MRI) was used to extract PFC gray and white matter volumes from 23 children (ages 7-14) with trauma history and PTSD symptoms.
- Data were compared to 24 age-equivalent healthy controls.
- PTSD symptoms and functional impairment were assessed using the Child and Adolescent version of the Clinician-Administered PTSD Scale (CAPS-CA).
Main Results:
- Children with PTSD symptoms displayed significantly larger gray matter volume in the middle-inferior and ventral PFC regions compared to controls.
- Reduced gray matter volume in the dorsal PFC was correlated with higher functional impairment scores.
Conclusions:
- Increased volume in the middle-inferior and ventral PFC may be linked to trauma exposure and PTSD symptoms in children.
- Dorsal PFC neuroanatomy appears to influence functional impairment severity in pediatric PTSD.
Abstract:
Previous studies have revealed altered structural development of the frontal lobes and prefrontal cortex (PFC) in children with symptoms of posttraumatic stress disorder (PTSD). This study is the first to provide a detailed structural analysis of the PFC in children with and without PTSD symptoms. We compared gray and white matter volume in four subregions of the PFC between said groups, then explored whether volume was associated with PTSD symptom severity and functional impairment. PFC measurements were extracted from magnetic resonance imaging (MRI) data from a sample of 23 children (ages 7-14) with a history of trauma and symptoms of PTSD, who had undergone assessment for PTSD symptoms and functional impairment using the Child and Adolescent version of the Clinician-Administered PTSD Scale (CAPS-CA). These measurements were compared to data from an age-equivalent control group of 24 healthy children. Children with PTSD symptoms showed a significantly larger volume of gray matter in the delineated middle-inferior and ventral regions of the PFC than did control children. Decreased volume of gray matter in the dorsal PFC correlated with increased functional impairment scores. Results indicate that increased volume of the middle-inferior and ventral PFC may be associated with trauma and PTSD symptoms in children. Furthermore, the neuroanatomy of the dorsal PFC may influence the degree of functional impairment experienced by children with PTSD symptoms.
