Associations between childhood trauma and amygdala- and insula-centered resting-state functional connectivity in alcohol use disorder.

OBJECTIVES

Childhood trauma (CT) increases risk for alcohol use disorder (AUD) and is linked to alterations in several brain regions. However, it remains unclear whether CT is associated with network-level resting-state functional connectivity (rs-FC) alterations in adults with AUD, and whether trauma subtypes show dissociable neural signatures. We examined associations between cumulative and subtype-specific CT exposure and amygdala- and insula-seeded rs-FC in adults with AUD versus healthy controls (HC).

METHODS

The sample included 214 adults (120 with AUD; 94 HC) who underwent resting-state fMRI and comprehensive clinical assessment. CT exposure was retrospectively assessed using the Childhood Trauma Questionnaire (CTQ). Whole-brain seed-to-voxel rs-FC analyses were conducted using bilateral amygdala and insula seeds to probe connectivity with large-scale brain networks. Linear mixed-effects models tested interactions between diagnostic group (AUD vs. HC) and CT exposure (total CTQ score and exploratory subtype scores).

RESULTS

Greater cumulative CT exposure was associated with weaker amygdala- and insula-centered rs-FC in AUD relative to HC. The most consistent effects involved reduced connectivity between these seeds-core nodes of the fronto-limbic and salience networks-and regions within the default mode network (DMN) and ventral visual stream. Exploratory CT subtype analyses (emotional abuse, emotional neglect, physical neglect) revealed largely overlapping rs-FC patterns.

CONCLUSIONS

CT is associated with a distinct pattern of network-level hypoconnectivity in adults with AUD, affecting circuits relevant to emotion regulation, memory, and socio-affective visual processing. The convergence of subtype-specific findings likely reflects high polytraumatization and widespread AUD-related network disruption and should be further investigated in future studies.