Effect of childhood maltreatment on brain structure in adult patients with major depressive disorder and healthy participants

Effect of childhood maltreatment on brain structure in adult patients with major depressive disorder and healthy participants

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J Psychiatry Neurosci 2013; 39(1): 50-59

Aisling Chaney, MRes; Angela Carballedo, MD; Francesco Amico, PhD; Andrew Fagan, PhD; Norbert Skokauskas, PhD; James Meaney, MD; Thomas Frodl, MD, MA

Chaney, Carballedo, Amico, Skokauskas, Frodl — Department of Psychiatry, Institute of Neuroscience, Adelaide and Meath Hospital incorporating the National Children’s Hospital (AMNCH), Dublin 24, University Dublin, Trinity College, Dublin; Fagan, Meaney, Frodl— Department of Radiology, Centre of Advanced Medical Imaging, St. James Hospital and Trinity College Dublin, Dublin, Ireland


Background: Childhood maltreatment has been found to play a crucial role in the development of psychiatric disorders. However, whether childhood maltreatment is associated with structural brain changes described for major depressive disorder (MDD) is still a matter of debate. The aim of this study was to investigate whether patients with MDD and a history of childhood maltreatment display more structural changes than patients without childhood maltreatment or healthy controls.

Methods: Patients with MDD and healthy controls with and without childhood maltreatment experience were investigated using high-resolution magnetic resonance imaging (MRI), and data were analyzed using voxel-based morphometry.

Results: We studied 37 patients with MDD and 46 controls. Grey matter volume was significantly decreased in the hippocampus and significantly increased in the dorsomedial prefrontal cortex (DMPFC) and the orbitofrontal cortex (OFC) in participants who had experienced childhood maltreatment compared with those who had not. Patients displayed smaller left OFC and left DMPFC volumes than controls. No significant difference in hippocampal volume was evident between patients with MDD and healthy controls. In regression analyses, despite effects from depression, age and sex on the DMPFC, OFC and hippocampus, childhood maltreatment was found to independently affect these regions.

Limitations: The retrospective assessment of childhood maltreatment; the natural problem that patients experienced more childhood maltreatment than controls; and the restrictions, owing to sample size, to investigating higher order interactions among factors are discussed as limitations.

Conclusion: These results suggest that early childhood maltreatment is associated with brain structural changes irrespective of sex, age and a history of depression. Thus, the study highlights the importance of childhood maltreatment when investigating brain structures.

Submitted Oct. 24, 2012; Revised Mar. 15, 2013; Accepted Apr. 12, 2013.

Acknowledgements: We thank Science Foundation Ireland for a fund to conduct the present research granted to Thomas Frodl (SFI/ 07/ SK/ B1214C Science Foundation Strokes Professorship Grant) and Health Research Board Ireland for funding the research Centre of Advanced Medical Imaging.

Competing interests: As above for T. Frodl. None declared by any other authors.

Contributors: A. Carballedo, N. Skokauskas and T. Frodl designed the study. A. Chaney, A. Carballedo, A. Fagan, J. Meaney and T. Frodl acquired the data, which all authors except J. Meaney analyzed. A. Chaney, N. Skokauskas and T. Frodl wrote the article, which all authors reviewed and approved for publication.

DOI: 10.1503/jpn.120208

Correspondence to: T. Frodl, Department of Psychiatry & Institute of Neuroscience, University Dublin, Trinity College, Ireland; thomas.frodl@tcd.ie