Altered white matter connectivity in young people exposed to childhood abuse: a tract-based spatial statistics (TBSS) and tractography study

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• Diffusion tensor imaging (DTI) measures the restricted diffusion of water molecules and provides a more detailed assessment of fibre tracts than conventional MRI and has emerged as a powerful technique for examining structural connectivity.17 Fractional anisotropy (FA), a DTI-derived metric, describes the directionality of water diffusion and may reflect aspects of membrane integrity and myelin thickness, where decreased FA is usually associated with white-matter disruption.18

• altered structure of neural pathways connecting the frontal, temporal and occipital cortices that are known to mediate affect and cognitive control

• everal DTI studies reported that childhood maltreatment was associated with reduced FA in various large white-matter tracts, particularly the inferior fronto–occipital fasciculus (IFoF), which is a direct pathway connecting the occipital, posterior temporal and the OFC areas;23–25

• hildhood Trauma Questionnaire (CTQ

• correlated with greater abuse severity in the abuse group. This suggests differences exist not only at the microstructural level as measured by FA, but also at the volumetric level of the entire tract.

• The IFoF, which overlaps spatially and functionally with the ILF, connects the ventral occipital, posterior temporobasal areas to the frontal lobe (inferior frontal, dorsolateral prefrontal and emotion-related OFC regions) and runs parallel to the ILF in its occipital course.

• It has also been argued that childhood sexual abuse is associated with experiences unique to sexual victimization relative to other abuse experiences; for example, traumatic sexualization, betrayal, stigmatization as well as feelings of guilt and shame may affect victims of sexual abuse differently than victims of other abuse experiences.35