Neural correlates of memories of childhood sexual abuse in women with and without posttraumatic stress disorder

Objective: Childhood sexual abuse is very common in our society, but little is known about the long-term effects of abuse on brain function. The purpo se of this study was to measure neural correlates of memories of childhood abuse in sexually abused women with and without the diagnosis of posttrauma tic stress disorder (PTSD), Method: Twenty-two women with a history of chil dhood sexual abuse underwent injection Of [O-15]H2O, followed by positron e mission tomography imaging of the brain while they listened to neutral and traumatic (personalized childhood sexual abuse events) scripts. Brain blood flow during exposure to traumatic and neutral scripts was compared for sex ually abused women with and without PTSD, Results: Memories of childhood se xual abuse were associated with greater increases in blood flow in portions of anterior prefrontal cortex (superior and middle frontal gyri-areas 6 an d 9), posterior cingulate (area 31), and motor cortex in sexually abused wo men with PTSD than in sexually abused women without PTSD. Abuse memories we re associated with alterations in blood flow in medial prefrontal cortex, w ith decreased blood flow in subcallosal gyrus (area 25), and a failure of a ctivation in anterior cingulate (area 32), There was also decreased blood f low in right hippocampus, fusiform/inferior temporal gyrus, supramarginal g yrus, and visual association cortex in women with PTSD relative to women wi thout PTSD. Conclusions: These findings implicate dysfunction of medial pre frontal cortex (subcallosal gyrus and anterior cingulate), hippocampus, and visual association cortex in pathological memories of childhood abuse in w omen with PTSD. Increased activation in posterior cingulate and motor corte x was seen in women with PTSD. Dysfunction in these brain areas may underli e PTSD symptoms provoked by traumatic reminders in subjects with PTSD.