Differential Effects of Early Adversity and Posttraumatic Stress Disorder on Amygdala Reactivity: The Role of Developmental Timing

Maurizio Sicorello; Janine Thome; Julia Herzog; Christian Schmahl

doi:10.1016/j.bpsc.2020.10.009

Differential Effects of Early Adversity and Posttraumatic Stress Disorder on Amygdala Reactivity: The Role of Developmental Timing

Biol Psychiatry Cogn Neurosci Neuroimaging. 2021 Nov;6(11):1044-1051. doi: 10.1016/j.bpsc.2020.10.009. Epub 2020 Oct 30.

Authors

Maurizio Sicorello¹, Janine Thome², Julia Herzog³, Christian Schmahl³

Affiliations

¹ Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany. Electronic address: Maurizio.sicorello@zi-mannheim.de.
² Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.
³ Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany.

PMID: 33359153
DOI: 10.1016/j.bpsc.2020.10.009

Abstract

Background: Posttraumatic stress disorder (PTSD) is associated with altered processing of threat-related stimuli. Neurobiological models implicate right amygdala hyperreactivity in these alterations, but this potential biomarker also has been observed in individuals exposed to adverse childhood experiences (ACEs) (i.e., abuse and neglect) without psychopathology. Separation of the differential contributions of PTSD and ACEs to amygdala reactivity might benefit from incorporating the developmental timing of the events.

Methods: We conducted comprehensive retrospective interviews assessing ACEs for each life year between the ages of 1 and 17 years in a sample of 60 women exposed to trauma (including 34 participants with PTSD and 26 healthy participants). Functional magnetic resonance imaging was used to extract amygdala reactivity to threatening versus neutral scenes. Amygdala reactivity was predicted from PTSD diagnosis, total ACE severity, and ACE severity by life year using random forest regression.

Results: PTSD and ACEs significantly predicted reactivity in the right amygdala (R² = 7%) but did not explain variance in the left amygdala. ACEs during both a prepubertal (ages 3 and 4) and a postpubertal (ages 16 and 17) period emerged as particularly predictive, while total ACE severity did not contribute to prediction. Follow-up analyses revealed a positive relationship between amygdala activity and PTSD and a negative relationship between amygdala activity and ACEs during predictive life years.

Conclusions: The opposing effects of PTSD and ACEs caution against simplistic etiological and diagnostic interpretations of amygdala function. The identification of potentially sensitive periods for the effects of ACEs on amygdala reactivity to threat may help to uncover interactions between traumatization and development of PTSD.

Keywords: Adverse childhood experiences; Amygdala; Functional magnetic resonance imaging; Maltreatment; Posttraumatic stress disorder.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adverse Childhood Experiences*
Amygdala
Child
Child, Preschool
Female
Humans
Infant
Magnetic Resonance Imaging
Retrospective Studies
Stress Disorders, Post-Traumatic*