Journal Article

The effects of childhood maltreatment on brain structure, function and connectivity

Samson, Jacqueline A., Ohashi, Kyoko, Teicher, Martin H., Anderson, Carl M.

2016

Overview

Key Points Childhood maltreatment (specifically, physical, sexual and emotional abuse, and physical and emotional neglect) exerts a prepotent influence on trajectories of child brain development and constitutes a major risk factor for adult psychopathology. Brain alterations resulting from maltreatment are highly specific, depend on the type and timing of exposure, and probably were once phenotypic adaptations that enhanced species survival and reproductive success but are now associated with substantial medical and psychiatric disadvantages. Maltreatment reduces the volume of the hippocampus (particularly in adults), as well as the volume of anterior cingulate and ventromedial and dorsomedial cortices; affects the development of key fibre tracts (including the corpus callosum, superior longitudinal fasciculus, uncinate fasciculus and cingulum bundle); and appears to alter the development of sensory systems that process and convey stressful experiences. This Review reveals consistent reports of augmented amygdala response to threatening stimuli, diminished ventral striatal response to anticipation or receipt of reward, diminished connectivity between prefrontal regions and the amygdala, and increased volume and network centrality of the precuneus in maltreated individuals. Maltreated and non-maltreated individuals with the same primary psychiatric diagnoses differ clinically, neurobiologically and genetically, such that maltreated individuals seem to represent distinct ecophenotypes of established psychiatric disorders. Thus, maltreatment may be an unrecognized confound in psychiatric neuroimaging studies. Maltreatment-associated brain changes are frequently reported in resilient individuals who show no past or current symptoms of psychopathology. Other neurobiological or molecular alterations are probably present that enable these individuals to effectively compensate for stress-related neurobiological alterations. Adverse childhood experiences have a wide range of effects on the structure, function and connectivity of the developing brain. Teicher et al . suggest that such changes might reflect adaptive modifications that, in some susceptible individuals, could contribute to psychopathology. Maltreatment-related childhood adversity is the leading preventable risk factor for mental illness and substance abuse. Although the association between maltreatment and psychopathology is compelling, there is a pressing need to understand how maltreatment increases the risk of psychiatric disorders. Emerging evidence suggests that maltreatment alters trajectories of brain development to affect sensory systems, network architecture and circuits involved in threat detection, emotional regulation and reward anticipation. This Review explores whether these alterations reflect toxic effects of early-life stress or potentially adaptive modifications, the relationship between psychopathology and brain changes, and the distinction between resilience, susceptibility and compensation.

• Publisher: Nature Publishing Group UK,Nature Publishing Group
• Subject: 631/378/1831 / 631/378/2571 / 692/699/476 / 692/700/1421/65 / Adaptation, Physiological / Adaptation, Psychological / Adverse childhood experiences / Analysis / Animal Genetics and Genomics / Animals / Behavioral Sciences / Biological Techniques / Biomedicine / Brain - growth & development / Brain - pathology / Brain - physiopathology / Brain research / Causality / Child / Child abuse / Child abuse & neglect / Child Abuse - psychology / Humans / Hypotheses / Localization (Brain function) / Medical imaging / Mental disorders / Mental Disorders - pathology / Mental Disorders - physiopathology / Mental Disorders - psychology / Models, Neurological / Neural circuitry / Neurobiology / Neuroimaging / Neurosciences / Observations / Physiological aspects / Psychopathology / Resilience (Personality trait) / Resilience, Psychological / review-article / Risk factors