Type and timing of childhood maltreatment and reduced visual cortex volume in children and adolescents with reactive attachment disorder

• Published in: NeuroImage clinical Vol. 20; pp. 216 - 221
• Main Authors: Fujisawa, Takashi X., Shimada, Koji, Takiguchi, Shinichiro, Mizushima, Sakae, Kosaka, Hirotaka, Teicher, Martin H., Tomoda, Akemi
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Inc 01.01.2018; Elsevier
• Subjects: Adolescent; Age Factors; Child; Child Abuse - classification; Child Abuse - psychology; Child, Preschool; Childhood maltreatment; Female; Gray matter (GM) volume; Humans; Magnetic Resonance Imaging - methods; Male; Organ Size; Radiology; Reactive attachment disorder (RAD); Reactive Attachment Disorder - classification; Reactive Attachment Disorder - diagnostic imaging; Reactive Attachment Disorder - psychology; Regular; Sensitive period; Visual cortex; Visual Cortex - diagnostic imaging; Voxel-based morphometry; Gray matter (GM) volume; Childhood maltreatment; Visual cortex; Sensitive period; Reactive attachment disorder (RAD); Voxel-based morphometry
• ISSN: 2213-1582; 2213-1582
• DOI: 10.1016/j.nicl.2018.07.018

Reactive attachment disorder (RAD) is a severe social functioning disorder associated with early childhood maltreatment where the child displays emotionally withdrawn/inhibited behaviors toward caregivers. Brain regions develop at different rates and regions undergoing rapid change may be particularly vulnerable during these times to stressors or adverse experiences. The aim of this study was to investigate the effect of type and timing of childhood adversities on structural alterations in regional gray matter (GM) volume in maltreated children with RAD. High-resolution magnetic resonance imaging datasets were obtained for children and adolescents with RAD (n = 21; mean age = 12.76 years) and typically developing (TD) control subjects (n = 22; mean age = 12.95 years). Structural images were analyzed using a whole-brain voxel-based morphometry approach and the type and timing of maltreatment, which may be more strongly associated with structural alterations, was assessed using random forest regression with conditional inference trees. Our findings revealed that there is a potential sensitive period between 5 and 7 years of age for GM volume reduction of the left primary visual cortex (BA17) due to maltreatment. We also found that the number of types of maltreatment had the most significant effect on GM volume reduction and that the second most significant variable was exposure to neglect. The present study provides the first evidence showing that type and timing of maltreatment have an important role in inducing structural abnormalities in children and adolescents with RAD. •We studied the effect of maltreatment type and timing on brain structure in RAD.•There was a sensitive period for GM volume reduction in the visual cortex.•The clinical symptoms of RAD showed the same sensitive period.•The number of types of maltreatment had significant effects on GM volume reduction.•Neglect was common and could be acting as a basis for the effects of maltreatment.