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Peer-reviewedCC BY 4.0Molecular Psychiatry

The role of white matter microstructure in the association between childhood maltreatment and adult post-traumatic symptoms

  • Luisa Berger1,2
  • Philine Rojczyk1,2
  • Johanna Seitz-Holland1,3
  • Fan Zhang1,4,5
  • Lara Pankatz1,2
  • Nico Sollmann1,2,6,7,8
  • Elisabeth Kaufmann1,2,9
  • Holly Carrington1,10
  • Twishi Puri1
  • Michael J. Coleman1
  • Ofer Pasternak1,3,4
  • Sylvain Bouix1,11
10 more authors
  • Yogesh Rathi1,3,4
  • Suheyla Cetin-Karayumak1
  • Lauren J. O’Donnell4
  • Peter Falkai12,13
  • Mark S. George14,15
  • Thomas W. McAllister16
  • Ross Zafonte17,18
  • Murray B. Stein19,20,21
  • Martha E. Shenton1,3,4
  • Inga K. Koerte1,2,3,22
22 affiliations
  1. 1Psychiatry Neuroimaging Laboratory, Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Somerville, MA USA
  2. 2cBRAIN, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
  3. 3Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA USA
  4. 4Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA
  5. 5University of Electronic Science and Technology of China, Chengdu, Sichuan China
  6. 6Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
  7. 7Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
  8. 8TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
  9. 9Department of Neurology, LMU University Hospital, LMU Munich, Munich, Germany
  10. 10Brain Injury Research Center of Mount Sinai, Icahn School of Medicine at Mount Sinai, New York, USA
  11. 11Department of Software Engineering and IT, École de Technologie Supérieure, Montreal, Quebec, Canada
  12. 12Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
  13. 13Max Planck Institute of Psychiatry, Munich, Germany
  14. 14Psychiatry Department, Medical University of South Carolina, Charleston, USA
  15. 15Ralph H. Johnson VA Medical Center, Charleston, USA
  16. 16Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA
  17. 17Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, USA
  18. 18Department of Physical Medicine and Rehabilitation, Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
  19. 19Department of Psychiatry, University of California San Diego, La Jolla, USA
  20. 20School of Public Health, University of California San Diego, La Jolla, USA
  21. 21Psychiatry Service, VA San Diego Healthcare System, San Diego, USA
  22. 22German Center for Child and Adolescent Health (DZKJ), partner site Munich, Munich, Germany
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Abstract

Childhood maltreatment (CM) is a risk factor for adult post-traumatic symptoms and white matter (WM) alterations. It remains unknown how WM microstructure is affected alongside two common military conditions, post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Data from 299 participants (53% male, 35.69 ± 12.23 years of age) of the Injury and Traumatic Stress (INTRuST) clinical consortium was analyzed. The study included 56 individuals with PTSD (41 with comorbid mTBI), 107 with mTBI, and 136 controls (no PTSD and/or mTBI). Diffusion parameters (mean, axial, and radial diffusivity, MD, AD, RD; fractional anisotropy, FA) in major WM tracts were extracted from diffusion MRI. CM was assessed using the Childhood Trauma Questionnaire (CTQ). Multiple regression models examined associations between CM severity and WM diffusion. Moderation analyses assessed the effect of PTSD and/or mTBI on these associations. Mediation analyses examined how WM diffusion affects the associations between CM and both PTSD and post-concussive symptom severity. Greater CM severity was associated with lower MD and AD, independent of PTSD and/or mTBI. WM diffusion, particularly in the corpus callosum and the superior longitudinal fasciculus, mediated the associations between CM severity and both PTSD (MD bab = 0.022, AD bab = 0.019-0.034) and post-concussive symptoms (MD bab = 0.028-0.040, AD bab = 0.032-0.047). Findings suggest that WM alterations are more strongly associated with CM itself than with either PTSD and/or mTBI. Mediating effects in regions critical for sensory integration highlight the role of WM microstructure as a neurobiological pathway through which CM might predispose to post-traumatic symptoms.

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Cite

BibTeXRIS
BibTeX
@article{berger2026role,
  title = {{The role of white matter microstructure in the association between childhood maltreatment and adult post-traumatic symptoms}},
  author = {Luisa Berger and Philine Rojczyk and Johanna Seitz-Holland and Fan Zhang and Lara Pankatz and Nico Sollmann and Elisabeth Kaufmann and Holly Carrington and Twishi Puri and Michael J. Coleman and Ofer Pasternak and Sylvain Bouix and Yogesh Rathi and Suheyla Cetin-Karayumak and Lauren J. O’Donnell and Peter Falkai and Mark S. George and Thomas W. McAllister and Ross Zafonte and Murray B. Stein and Martha E. Shenton and Inga K. Koerte},
  journal = {Molecular Psychiatry},
  year = {2026},
  month = oct,
  doi = {10.1038/s41380-026-03624-1},
  url = {https://doi.org/10.1038/s41380-026-03624-1},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - The role of white matter microstructure in the association between childhood maltreatment and adult post-traumatic symptoms
AU  - Luisa Berger
AU  - Philine Rojczyk
AU  - Johanna Seitz-Holland
AU  - Fan Zhang
AU  - Lara Pankatz
AU  - Nico Sollmann
AU  - Elisabeth Kaufmann
AU  - Holly Carrington
AU  - Twishi Puri
AU  - Michael J. Coleman
AU  - Ofer Pasternak
AU  - Sylvain Bouix
AU  - Yogesh Rathi
AU  - Suheyla Cetin-Karayumak
AU  - Lauren J. O’Donnell
AU  - Peter Falkai
AU  - Mark S. George
AU  - Thomas W. McAllister
AU  - Ross Zafonte
AU  - Murray B. Stein
AU  - Martha E. Shenton
AU  - Inga K. Koerte
PY  - 2026
DA  - 2026/10/10
JO  - Molecular Psychiatry
DO  - 10.1038/s41380-026-03624-1
UR  - https://doi.org/10.1038/s41380-026-03624-1
AB  - Childhood maltreatment (CM) is a risk factor for adult post-traumatic symptoms and white matter (WM) alterations. It remains unknown how WM microstructure is affected alongside two common military conditions, post-traumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI). Data from 299 participants (53% male, 35.69 ± 12.23 years of age) of the Injury and Traumatic Stress (INTRuST) clinical consortium was analyzed. The study included 56 individuals with PTSD (41 with comorbid mTBI), 107 with mTBI, and 136 controls (no PTSD and/or mTBI). Diffusion parameters (mean, axial, and radial diffusivity, MD, AD, RD; fractional anisotropy, FA) in major WM tracts were extracted from diffusion MRI. CM was assessed using the Childhood Trauma Questionnaire (CTQ). Multiple regression models examined associations between CM severity and WM diffusion. Moderation analyses assessed the effect of PTSD and/or mTBI on these associations. Mediation analyses examined how WM diffusion affects the associations between CM and both PTSD and post-concussive symptom severity. Greater CM severity was associated with lower MD and AD, independent of PTSD and/or mTBI. WM diffusion, particularly in the corpus callosum and the superior longitudinal fasciculus, mediated the associations between CM severity and both PTSD (MD bab = 0.022, AD bab = 0.019-0.034) and post-concussive symptoms (MD bab = 0.028-0.040, AD bab = 0.032-0.047). Findings suggest that WM alterations are more strongly associated with CM itself than with either PTSD and/or mTBI. Mediating effects in regions critical for sensory integration highlight the role of WM microstructure as a neurobiological pathway through which CM might predispose to post-traumatic symptoms.
SN  - 1359-4184
SN  - 1476-5578
ER  -