PTSD following sexual violence linked to profound fronto-limbic brain changes

PTSD following sexual violence linked to profound fronto-limbic brain changes

Research on PTSD in women after sexual assault

About 70% of women who suffer a sexual crime develop post-traumatic stress disorder (PTSD). Scientists have now found that many of these women have a significant reduction in normal communication between two key brain regions involved in processing and controlling emotions: the amygdala and the prefrontal cortex. For some women, the synchronization between these areas can be almost zero. These results were presented at the ECNP conference in Amsterdam.

Background to the study

Globally, between 17% and 25% of women experience sexual assault, with approximately 70% of them subsequently developing PTSD. Previous studies of PTSD following natural disasters, accidents or wars have shown changes in how the brain communicates. A group of Spanish scientists have now shown that sexual assault can cause similar changes in the brain.

Details about the investigation

Researchers studied 40 women with PTSD due to recent sexual trauma (within the past year) who were recruited at the Barcelona Hospital. There was also a suitable control group. All women underwent brain scans (via resting-state functional MRI) to analyze brain connectivity and its association with depressive and PTSD symptoms. Resting-state fMRI measures how different areas of the brain communicate with each other.

Statements from the main researcher

The lead researcher Dr. Lydia Fortea (from Barcelona Hospital) said:

"PTSD after sexual assault is often particularly severe and is often associated with higher rates of depression, anxiety, and suicidal ideation. Although sexual violence is one of the most common forms of trauma in women, most research on PTSD has focused on other types of trauma, such as war. This is one of the first and certainly the largest study to link PTSD to sexual assault Teenagers and adult women examined.”

"We examined how key brain regions involved in fear and emotion regulation are synchronized with the rest of the brain in women with PTSD after sexual assault. Our focus was on the fronto-limbic system, which plays a critical role in emotion regulation and threat response."

Results of the study

"We found that in 22 of the 40 women with PTSD after a recent sexual assault, communication between the amygdala and the prefrontal cortex was almost lost, dropping to zero or near zero. The amygdala helps process emotions such as fear, while the prefrontal cortex helps control and regulate these emotions. When this connection weakens, the brain can have difficulty controlling fear responses or regulating emotions, which explains why people with PTSD often experience intense anxiety and mood swings.”

"However, we did not find that these brain changes were directly linked to the severity of PTSD and depression symptoms. This suggests that while this difference in the brain could be a feature of the disorder itself, it is not necessarily a sign of how bad the symptoms are. It likely depends on other factors."

"This supports the idea that PTSD after sexual assault is associated with problems in brain circuits that regulate emotions and fear. One of the next steps will be to examine whether these disruptions in connectivity after sexual assault could help predict response to PTSD treatments. If so, we could identify early on which patients are at higher risk for poorer outcomes and intensify clinical efforts to to help them recover. So far it is a study of 40 women, but the research is ongoing. We need further studies to confirm the results.”

Comment from another expert

Dr. Marin Jukić (from the Karolinska Institute in Stockholm and the University of Belgrade, Serbia) commented on this study:

"This study demonstrates profound fronto-limbic dyscommunication in women with post-sexual assault PTSD, a population historically underrepresented in brain connectivity research. The finding that communication between the amygdala and prefrontal cortex can decline to near zero highlights the severity of circuit-level disruptions in the brain Regulatory networks for emotions after trauma. Notably, the absence of a direct correlation with symptom severity suggests that these connectivity deficits may serve more as a biological sign of the disorder than as a condition-dependent marker. This raises the possibility that such disorders could become predictive biomarkers of response to treatments, which would guide personalized interventions. Bigger however, longitudinal studies are needed to determine how these neural patterns develop and whether targeted therapies can improve connectivity.”

This is an independent comment; Dr. Jukić was not involved in this research.

Sources: