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Childhood maltreatment is associated with specific subcortical and cortical volume changes in MDD and PTSDChildhood Maltreatment Linked to Specific Changes in Brain Structure

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Key Takeaway
Note the association between childhood maltreatment and specific subcortical and cortical volume changes in MDD and PTSD.

This meta-analysis evaluates the impact of childhood maltreatment, including abuse and neglect, on brain morphometry in a large cohort of 3711 participants from the ENIGMA MDD and PTSD Working Groups. The study specifically examines 14 subcortical volume measures, 68 cortical thickness (CT) measures, and 68 surface area (SA) measures.

Key findings indicate that larger thalamus and pallidum volumes in young adults (ages 18-35) are associated with abuse. Conversely, thinner isthmus cingulate and middle frontal regions cortical thickness and a thicker medial orbitofrontal cortex are associated with abuse in the same age group. In young female adults, greater abuse and neglect are associated with smaller hippocampus and putamen volumes (|β| = 0.07-0.22, q <.05), thinner entorhinal cortex (q <.05), and smaller surface area in fusiform and inferior parietal regions (q <.05). Additionally, larger surface area in orbitofrontal and occipital cortices was associated with higher maltreatment in young females. Males showed widespread effects in cortical thickness and surface area associated with abuse (|β| = 0.1-0.18, q <.05).

The authors note that these findings represent associations between childhood maltreatment and brain morphology, not direct causation. Clinical application of these findings is currently limited by the lack of reported practice relevance or specific clinical guidelines.

How this fits prior evidence

This meta-analysis addresses a gap in the neurobiological understanding of Major Depressive Disorder (MDD) and Posttraumatic Stress Disorder (PTSD) by linking childhood maltreatment to specific brain morphometry. While prior coverage has focused on pharmacological and lifestyle interventions for MDD, such as lumateperone for sexual dysfunction or lifestyle therapy as an alternative to CBT, this study provides neuroimaging data regarding the long-term impact of early life stress on brain structure.

Researchers analyzed data from over 3,700 participants to see how childhood maltreatment, such as abuse and neglect, relates to brain structure. The study focused on individuals with Major Depressive Disorder and Posttraumatic Stress Disorder, as well as healthy participants. The findings were based on measurements of brain volume, thickness, and surface area.

In young adults aged 18 to 35, the study found that history of abuse was linked to larger volumes in the thalamus and pallidum, but thinner tissue in the isthmus cingulate and middle frontal regions. For young women specifically, greater abuse and neglect were associated with smaller volumes in the hippocampus and putamen, as well as thinner tissue in the entorhinal cortex.

It is important to note that these findings show a link between past experiences and brain structure, not a direct cause. Because this is a large-scale data analysis, the results highlight patterns in a large group rather than predicting what will happen to any one individual. These findings help researchers better understand the physical impact of early trauma.

What this means for you:
Childhood maltreatment is linked to specific changes in brain structure in young adults with MDD and PTSD.

Common questions

What specific parts of the brain were affected by childhood abuse?

The study found that abuse was linked to larger volumes in the thalamus and pallidum in young adults. In young women, greater abuse and neglect were linked to smaller volumes in the hippocampus and putamen, and thinner tissue in the entorhinal cortex.

Who was included in this study?

The study included 3,711 participants from 25 different sites. This group included individuals with Major Depressive Disorder and Posttraumatic Stress Disorder, as well as healthy control participants.

Does this mean childhood abuse caused these brain changes?

The study shows a link between childhood maltreatment and brain structure, but it does not prove that one caused the other. These results are associations found in a large group of people, not a direct cause for every individual.

Study Details

Study typeMeta analysis
Sample sizen = 3,711
EvidenceLevel 1
Follow-up156.0 mo
PublishedSep 2026
View Original Abstract ↓
BACKGROUND: Childhood maltreatment (CM), encompassing abuse and neglect, is highly prevalent and associated with elevated risk for major depressive disorder (MDD), posttraumatic stress disorder (PTSD), and other related conditions. However, the extent to which neuroanatomical alterations in MDD and PTSD are attributable to CM is uncertain. METHODS: Here, we analyzed CM and whole-brain magnetic resonance imaging (MRI) data from 3711 participants in the ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) MDD and PTSD Working Groups (25 sites; mean age = 33.3 ± 13.0 years; 59.9% female). Normative modeling estimated deviation z scores for 14 subcortical volume, 68 cortical thickness (CT), and 68 surface area (SA) measures. To identify transdiagnostic effects, associations between CM and brain deviation scores were evaluated across all participants (patients and healthy control participants) stratified by sex and 3 age bins (pediatric, young adult, older adult). RESULTS: In young adults (ages 18-35), abuse was associated with larger volumes in the thalamus and pallidum, thinner isthmus cingulate and middle frontal regions, and thicker medial orbitofrontal cortex; there were no significant effects in pediatric (≤18 years) participants. The strongest effects were observed in young female adults (|β| = 0.07-0.22, q < .05): Greater abuse and neglect were correlated with smaller hippocampus and putamen volumes, thinner entorhinal cortex, and smaller SA in fusiform/inferior parietal regions and with larger SA in the orbitofrontal and occipital cortices. In males, abuse had widespread effects on CT and SA (|β| = 0.1-0.18, q < .05); effects for neglect were minimal. CONCLUSIONS: Our findings of age- and sex-specific instantiations of CM on brain morphometry highlight the importance of developmental context in understanding how adverse experiences shape neurobiological vulnerability to MDD and PTSD.
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