Neurocognitive, emotional and neuroendocrine correlates of exposure to sexual assault in women

Neurocognitive, emotional and neuroendocrine correlates of exposure to sexual assault in women


J Psychiatry Neurosci 2018;43(5):318-326

Yann Quidé, PhD;* Helen Cléry, PhD;* Frédéric Andersson, PhD; Céline Descriaud, MD; Pauline Saint-Martin, MD, PhD; Laurent Barantin, PhD; Valérie Gissot, MD; Marie-Paule Carrey Le Bas; Sylvie Osterreicher, MD; Diane Dufour-Rainfray, MD; Bruno Brizard, MSc; Maja Ogielska, MD; Wissam El-Hage, MD, PhD*


Background: Survivors of sexual assault are vulnerable to long-term negative psychological and physical health outcomes, but few studies have investigated changes in cognition, emotional processing and brain function in the early stages after sexual assault. We used a multimodal approach to identify the cognitive and emotional correlates associated with sexual assault in women.

Methods: Twenty-seven female survivors of sexual assault were included within 4 weeks of the traumatic event, and they were compared with 20 age-matched controls. Participants underwent functional MRI while performing cognitive/emotional tasks (n-back, emotional go/no-go, mental imagery). We also measured diurnal salivary cortisol and conducted neuropsychological assessments of attention and memory abilities.

Results: Relative to the control group, the survivor group had lower levels of morning cortisol and showed attentional deficits. We observed no between-group differences in brain activation during the n-back or mental imagery tasks. During the emotional go/no-go task, however, the survivor group showed a lack of deactivation in the dorsal anterior cingulate cortex when processing emotional material, relative to neutral material. Exploratory analyses in the survivor group indicated that symptom severity was negatively associated with cerebellar activation when positive emotional (happy) content interfered with response inhibition, and positively associated with cerebellar activation when thinking of positive (happy) memories.

Limitations: The small sample size was the main limitation of this study.

Conclusion: Dysfunctions in the dorsal anterior cingulate cortex and the cerebellum may represent early functional brain modifications that alter higher cognitive processes when emotional material is involved.

*These authors contributed equally to this work.

Submitted June 19, 2017; Revised Oct. 15, 2017; Revised Nov. 20, 2017; Revised Nov. 22, 2017; Accepted Nov. 22, 2017; Published online first Apr. 5, 2018

Acknowledgments: The authors are grateful for the invaluable contributions of the participants. This project was funded by a Hospital Clinical Research Program (Hôpital Promoteur, CHRU de Tours). The authors acknowledge the Fondation Pierre Deniker and the SFR FED4226 Neuroimagerie Fonctionnelle for their financial support. Y. Quidé was supported by a postgraduate scholarship from the French Ministry of Higher Education, Research and Innovation. The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. An abstract of the preliminary data from this study was presented as a poster at the 72nd Annual Scientific Convention and Meeting, Society of Biological Psychiatry Annual Meeting, May 19, 2017. The authors also thank the reviewers for their insightful comments on an earlier version of this manuscript.

Affiliations: From the School of Psychiatry, University of New South Wales, Randwick, NSW, Australia (Quidé); Neuroscience Research Australia, Randwick, NSW, Australia (Quidé); Inserm U1253 ‘‘Imaging and Brain: iBrain,’’ Université de Tours, Tours, France (Cléry, Andersson, Barantin, Dufour-Rainfray, Brizard, El-Hage); Centre d’Accueil des Victimes d’Agressions Sexuelles, Centre Hos- pitalier Régional d’Orléans, Orléans, France (Descriaud); Service de Médecine Légale, CHRU de Tours, Tours, France (Saint-Martin); Inserm CIC 1415, Centre d’Investigation Clinique, CHRU de Tours, Tours, France (Gissot, El-Hage); Association Départementale d’Aide aux Victimes d’Infractions Pénales d’Indre-et-Loire, ADAVIP 37, France Victimes 37, Tours, France (Carrey Le Bas); Centre d’Accueil des Victimes d’Agressions Sexuelles, Centre Hospitalier de Blois, Blois, France (Osterreicher); and CHRU de Tours, Tours, France (Dufour-Rainfray, Ogielska, El-Hage).

Competing interests: None declared.

Contributors: Y. Quidé, F. Andersson and W. El-Hage designed the study. F. Andersson, C. Descriaud, P. Saint-Martin, L. Barantin, V. Gissot, M.-P. Carrey Le Bas, S. Osterreicher, B. Brizard, M. Ogielska and W. El-Hage acquired the data, which Y. Quidé, H. Cléry, F. Andersson, V. Gissot, D. Dufour-Rainfray and W. El-Hage analyzed. Y. Quidé, H. Cléry and W. El-Hage wrote the article, which all authors reviewed. All authors approved the final version to be published and can certify that no other individuals not listed as authors have made substantial contributions to the paper.

DOI: 10.1503/jpn.170116

Correspondence to: W. El-Hage, Inserm U1253 ‘‘Imaging and Brain: iBrain,” Université de Tours, CHRU de Tours, Boulevard Tonnellé, 37044 Tours Cedex 9, France;