Sahana Kribakaran1, Andrea Danese2, Konstantinos Bromis3, Matthew J Kempton4, Dylan G Gee5. 1. Department of Psychology, Yale University, New Haven, Connecticut; Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, Connecticut. 2. Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; National and Specialist Child and Adolescent Mental Health Services Clinic for Trauma, Anxiety, and Depression, South London and Maudsley National Health Services Foundation Trust, London, United Kingdom. 3. School of Psychology, University of Sussex, Brighton, United Kingdom; School of Electrical and Computer Engineering, National Technical University of Athens, Greece. 4. Department of Neuroimaging, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom; Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom. 5. Department of Psychology, Yale University, New Haven, Connecticut. Electronic address: dylan.gee@yale.edu.
Abstract
BACKGROUND: Findings on structural brain volume associated with pediatric posttraumatic stress disorder (PTSD) have been variable, and it is unclear whether any structural differences are specific to pediatric PTSD in comparison with adult PTSD or other co-occurring pediatric psychiatric conditions. METHODS: We tested volumetric brain differences between pediatric groups with and without PTSD in a region-of-interest meta-analysis. We conducted meta-regressions to test the effects of age and sex on heterogeneous study findings. To assess specificity, we compared pediatric PTSD with the following: adult PTSD, pediatric trauma exposure without PTSD, pediatric depression, and pediatric anxiety. RESULTS: In 15 studies examined, pediatric PTSD was associated with smaller total gray matter and cerebral, temporal lobe (total, right, and left), total cerebellar vermis, and hippocampal (total, right, and left) volumes, compared to peers without PTSD. In the pediatric PTSD group, but not the comparison group, we found a trend toward smaller total, right, and left amygdalar volumes. In an external comparison, smaller hippocampal volume was not significantly different between adult and pediatric PTSD groups. Qualitative comparisons with a pediatric trauma exposure without PTSD group, a pediatric depression group, and a pediatric anxiety group revealed differences that may be unique to pediatric PTSD, and others that may be convergent with these related clinical conditions in youth. CONCLUSIONS: Pediatric PTSD is associated with structural differences that parallel those associated with adult PTSD. Furthermore, pediatric PTSD appears to be distinct from other related pediatric conditions at the structural level. Future studies employing longitudinal, dimensional, and multimodal neuroimaging approaches will further elucidate the nature of neurobiological differences in pediatric PTSD.
BACKGROUND: Findings on structural brain volume associated with pediatric posttraumatic stress disorder (PTSD) have been variable, and it is unclear whether any structural differences are specific to pediatric PTSD in comparison with adult PTSD or other co-occurring pediatric psychiatric conditions. METHODS: We tested volumetric brain differences between pediatric groups with and without PTSD in a region-of-interest meta-analysis. We conducted meta-regressions to test the effects of age and sex on heterogeneous study findings. To assess specificity, we compared pediatric PTSD with the following: adult PTSD, pediatric trauma exposure without PTSD, pediatric depression, and pediatric anxiety. RESULTS: In 15 studies examined, pediatric PTSD was associated with smaller total gray matter and cerebral, temporal lobe (total, right, and left), total cerebellar vermis, and hippocampal (total, right, and left) volumes, compared to peers without PTSD. In the pediatric PTSD group, but not the comparison group, we found a trend toward smaller total, right, and left amygdalar volumes. In an external comparison, smaller hippocampal volume was not significantly different between adult and pediatric PTSD groups. Qualitative comparisons with a pediatric trauma exposure without PTSD group, a pediatric depression group, and a pediatric anxiety group revealed differences that may be unique to pediatric PTSD, and others that may be convergent with these related clinical conditions in youth. CONCLUSIONS: Pediatric PTSD is associated with structural differences that parallel those associated with adult PTSD. Furthermore, pediatric PTSD appears to be distinct from other related pediatric conditions at the structural level. Future studies employing longitudinal, dimensional, and multimodal neuroimaging approaches will further elucidate the nature of neurobiological differences in pediatric PTSD.
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