Brain structure in childhood maltreatment-related PTSD across the lifespan: A systematic review

Numerous deleterious outcomes are associated with child maltreatment, and PTSD secondary to maltreatment is one of the most commonly cited diagnoses that may follow individuals throughout their lives. Recent neuroimaging research has observed significant structural abnormalities in individuals with maltreatment-related PTSD (m-PTSD) compared to maltreated individuals without PTSD and healthy controls. Therefore, the aims of this systematic review were to summarize the literature on brain structure in m-PTSD, identify methodological challenges and limitations, and provide directions for future research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to conduct a systematic search across three databases, and 18 studies were identified for inclusion, including 10 pediatric, 1 adolescent, and 7 adult studies. Across the studies, 19 primary brain structures were examined; 15 of the 18 studies identified a significant association between brain structure and m-PTSD. Although studies varied in the structures investigated, the most notable differences appeared in the corpus callosum, total cerebral volume, cerebellum, hippocampus, and amygdala, which appeared significantly smaller in m-PTSD participants. Future research concerning this topic may contribute to the understanding of this association by using longitudinal designs, controlling for psychiatric comorbidities and maltreatment severity, and ensuring that studies are adequately powered.