Characterizing White Matter Changes along Fibers in Treatment-Naive Pediatric Posttraumatic Stress Disorder
Xueling Suo1,2, Du Lei3, Huaiqiang Sun1,2
1Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, China.
Insights
Pediatric posttraumatic stress disorder (PTSD) involves white matter changes in specific brain tracts, correlating with symptom severity and showing diagnostic potential. These findings offer new insights into childhood PTSD neurobiology.
Area of Science:
- Neuroscience
- Child and Adolescent Psychiatry
- Medical Imaging
Background:
- Children and adolescents are more vulnerable to developing posttraumatic stress disorder (PTSD) than adults.
- Pediatric PTSD exhibits functional brain fear circuitry alterations, but microstructural changes remain under-investigated, with prior research focusing mainly on the corpus callosum.
Purpose of the Study:
- To investigate brain-wide microstructural abnormalities in pediatric PTSD.
- To examine the relationship between these abnormalities, age, and sex.
- To assess the diagnostic value of microstructural changes in distinguishing pediatric PTSD.
Main Methods:
- Diffusion tensor imaging (DTI) was used to assess white matter microstructure in 24 treatment-naive, non-comorbid pediatric PTSD patients and 24 matched trauma-exposed non-PTSD controls (TENP).
- Statistical analyses included pointwise comparisons, correlations with symptom severity, and diagnosis-by-age/sex interactions.
- Support vector machine (SVM) analyses were performed for classification.
Main Results:
- Pediatric PTSD patients displayed higher fractional anisotropy and lower radial diffusivity in the right superior longitudinal fasciculus compared to TENP.
- Lower axial diffusivity was observed in the right uncinate fasciculus in pediatric PTSD patients.
- These microstructural abnormalities strongly correlated with PTSD symptom severity, with axial diffusivity measurements showing the best classification performance.
Conclusions:
- Pediatric PTSD is associated with clinically significant white matter microstructural abnormalities in the uncinate and superior longitudinal fasciculi.
- These findings expand the understanding of pediatric PTSD neurobiology beyond the corpus callosum.
- The identified microstructural changes hold potential for diagnosing PTSD in children and adolescents.
Abstract:
Children and adolescents are more susceptible than adults to developing posttraumatic stress disorder (PTSD). Pediatric PTSD is characterized by functional alterations in brain fear circuitry, but little is known about the underlying microstructural changes; previous work has mainly focused on the corpus callosum. This study is aimed at investigating brain-wide microstructural abnormalities in pediatric PTSD, their relationship to age and sex, and their potential diagnostic value. The microstructure of major white matter tracts was assessed from diffusion tensor images acquired from 24 treatment-naive non-comorbid PTSD patients <18 years and 24 trauma-exposed non-PTSD controls (TENP) matched for age, sex, and years of education. Statistical analyses included pointwise comparisons, correlations with symptom severity, and diagnosis-by-age/sex interactions; support vector machine analyses were conducted to determine whether microstructure distinguishes PTSD from TENP. Compared with TENP, pediatric PTSD patients showed higher fractional anisotropy and lower radial diffusivity in right superior longitudinal fasciculus and lower axial diffusivity in right uncinate fasciculus. These white matter microstructural abnormalities were highly correlated with PTSD symptom severity. No significant diagnosis by age or sex interaction was observed. The pointwise axial diffusivity measurements presented the best PTSD vs. TENP classification performance. In summary, pediatric PTSD patients showed clinically relevant microstructural abnormalities in uncinate and superior longitudinal fasciculus, which extend understanding of pediatric PTSD neurobiology beyond the corpus callosum and have diagnostic potential in distinguishing stressed individuals with and without PTSD.
