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Publications

Journal Article Ahead of print

PubMed: 42859210 DOI: 10.1038/s41380-026-03624-1

The role of white matter microstructure in the association between childhood maltreatment and adult post-traumatic symptoms.

Mol Psychiatry

Authors: Luisa Berger, Philine Rojczyk, Johanna Seitz-Holland, Fan Zhang, Lara Pankatz, Nico Sollmann, Elisabeth Kaufmann, Holly Carrington, Twishi Puri, Michael J Coleman, Ofer Pasternak, Sylvain Bouix, Yogesh Rathi, Suheyla Cetin-Karayumak, Lauren J O'Donnell, Peter Falkai, Mark S George, Thomas W McAllister, Ross Zafonte, Murray B Stein, Martha E Shenton, Inga K Koerte

Affiliations

  • Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, USA.
  • cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany.
  • Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
  • University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
  • Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.
  • Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
  • TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.
  • Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany.
  • Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, USA.
  • Department of Software Engineering and IT, École de Technologie Supérieure, Montreal, Quebec, Canada.
  • Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany.
  • Max Planck Institute of Psychiatry, Munich, Germany.
  • Psychiatry Department, Medical University of South Carolina, Charleston, USA.
  • Ralph H. Johnson VA Medical Center, Charleston, USA.
  • Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA.
  • Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, USA.
  • Department of Physical Medicine and Rehabilitation, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
  • Department of Psychiatry, University of California San Diego, La Jolla, USA.
  • School of Public Health, University of California San Diego, La Jolla, USA.
  • Psychiatry Service, VA San Diego Healthcare System, San Diego, USA.
  • Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Somerville, MA, USA.
  • cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany.
  • Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
  • German Center for Child and Adolescent Health (DZKJ), partner site Munich, Munich, Germany.

Abstract

Childhood maltreatment (CM) is a risk factor for adult post-traumatic symptoms and white matter (WM) alterations. It remains unknown how WM microstructure is affected alongside two common military conditions, post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Data from 299 participants (53% male, 35.69 ± 12.23 years of age) of the Injury and Traumatic Stress (INTRuST) clinical consortium was analyzed. The study included 56 individuals with PTSD (41 with comorbid mTBI), 107 with mTBI, and 136 controls (no PTSD and/or mTBI). Diffusion parameters (mean, axial, and radial diffusivity, MD, AD, RD; fractional anisotropy, FA) in major WM tracts were extracted from diffusion MRI. CM was assessed using the Childhood Trauma Questionnaire (CTQ). Multiple regression models examined associations between CM severity and WM diffusion. Moderation analyses assessed the effect of PTSD and/or mTBI on these associations. Mediation analyses examined how WM diffusion affects the associations between CM and both PTSD and post-concussive symptom severity. Greater CM severity was associated with lower MD and AD, independent of PTSD and/or mTBI. WM diffusion, particularly in the corpus callosum and the superior longitudinal fasciculus, mediated the associations between CM severity and both PTSD (MD b ab = 0.022, AD b ab = 0.019-0.034) and post-concussive symptoms (MD b ab = 0.028-0.040, AD b ab = 0.032-0.047). Findings suggest that WM alterations are more strongly associated with CM itself than with either PTSD and/or mTBI. Mediating effects in regions critical for sensory integration highlight the role of WM microstructure as a neurobiological pathway through which CM might predispose to post-traumatic symptoms.

MeSH

White Matter, Stress Disorders, Post-Traumatic, Mental Disorders, Signs And Symptoms, Neurosciences, Stress Disorders, Traumatic, Wounds And Injuries, Post-Concussion Syndrome