Does pediatric post-traumatic stress disorder alter the brain? Systematic review and meta-analysis of structural and
Ana Carolina C Milani1, Elis V Hoffmann1, Victor Fossaluza2
1Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.
Insights
Pediatric post-traumatic stress disorder (PTSD) is linked to reduced brain volumes, including the corpus callosum, cerebrum, and intracranial space. Functional studies also show altered brain region activation in children with PTSD.
Area of Science:
- Neuroscience
- Developmental Psychology
- Child Psychiatry
Background:
- Pediatric post-traumatic stress disorder (PTSD) is associated with structural brain changes.
- Previous research indicates reduced brain volumes in children and adolescents with PTSD.
Purpose of the Study:
- To investigate the association between early trauma and altered brain regions and functions in pediatric PTSD.
- To systematically review functional magnetic resonance imaging (fMRI) and meta-analyze structural magnetic resonance imaging (sMRI) studies in pediatric PTSD.
Main Methods:
- Systematic literature review of fMRI studies and meta-analysis of sMRI studies (2000-2014).
- Searched databases: PsycINFO, PubMed, Medline, Lilacs, ISI.
- Extracted and analyzed data on amygdala, hippocampus, corpus callosum, brain, and intracranial volumes.
Main Results:
- Meta-analysis revealed significantly reduced total corpus callosum areas, total cerebral volumes, and intracranial volumes in pediatric PTSD patients.
- Reduced total hippocampus, amygdala, and frontal lobe gray matter volumes were observed but not statistically significant.
- Functional studies indicated altered brain region activation patterns in response to stimuli in the PTSD group.
Conclusions:
- Pediatric PTSD is confirmed to involve structural and functional brain abnormalities.
- Some identified brain abnormalities in pediatric PTSD differ from those observed in adult PTSD.
- Findings highlight the impact of early trauma on brain development and function.
Abstract:
Several studies have recently demonstrated that the volumes of specific brain regions are reduced in children and adolescents with post-traumatic stress disorder (PTSD) compared with those of healthy controls. Our study investigated the potential association between early traumatic experiences and altered brain regions and functions. We conducted a systematic review of the scientific literature regarding functional magnetic resonance imaging and a meta-analysis of structural magnetic resonance imaging studies that investigated cerebral region volumes in pediatric patients with PTSD. We searched for articles from 2000 to 2014 in the PsycINFO, PubMed, Medline, Lilacs, and ISI (Web of Knowledge) databases. All data regarding the amygdala, hippocampus, corpus callosum, brain, and intracranial volumes that fit the inclusion criteria were extracted and combined in a meta-analysis that assessed differences between groups. The meta-analysis found reduced total corpus callosum areas and reduced total cerebral and intracranial volumes in the patients with PTSD. The total hippocampus (left and right hippocampus) and gray matter volumes of the amygdala and frontal lobe were also reduced, but these differences were not significant. The functional studies revealed differences in brain region activation in response to stimuli in the post-traumatic stress symptoms/PTSD group. Our results confirmed that the pediatric patients with PTSD exhibited structural and functional brain abnormalities and that some of the abnormalities occurred in different brain regions than those observed in adults.
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