Influences of early sexual trauma on brain structural connectome in panic disorder and their relationship with short- and long-term treatment responses.

BACKGROUND: Early traumatic experiences, particularly early sexual trauma (EST), are associated with panic disorder (PD). Using connectome-based analyses of diffusion tensor imaging, we examined the effects of EST on the brain structural networks and the associations with symptom severity and short- and long-term treatment responses in patients with PD compared to healthy controls (HCs).

METHODS: 188 participants (82 PD patients and 106 HCs) were enrolled. Brain structural networks were constructed using white matter tractography. Network-based statistics with permutation tests examined EST-related connectivity differences between groups. Early Trauma Inventory Self-Report and the Panic Disorder Severity Scale were administered. PD patients were followed up for 1 year to measure the pharmacological treatment response.

RESULTS: Significant PD-EST interactions revealed hyperconnectivity in the parahippocampal gyrus, middle temporal gyrus, and inferior parietal lobule in PD compared to HC groups. After false discovery rate correction, analyses revealed positive correlations between global and local properties of interaction networks and anxiety levels in PD. The eigenvector centrality values of the cingulate gyrus and inferior frontal gyrus were negatively correlated with short- and long-term treatment responses in PD.

LIMITATIONS: Considering recall bias and lack of follow-up imaging, longitudinal studies are needed for long-term changes.

CONCLUSIONS: Our study suggested that PD patients with a history of EST showed distinct brain connectivity alterations related to traumatic emotional memory processing, particularly in regions associated with the default mode network. These structural connectome changes are associated with key PD symptoms and treatment responses across short- and long-term pharmacological interventions.