Gray matter alterations across different dimensions of trauma exposure in post-traumatic stress disorder: A voxel-wise meta-analysis.

BACKGROUND

Post-traumatic stress disorder (PTSD) is associated with gray matter (GM) reductions in regions linked to impaired fear extinction, yet reported patterns remain inconsistent. Furthermore, the impact of specific trauma characteristics on GM deficits is not well understood. We conducted a voxel-wise meta-analysis comparing structural brain differences in relational (interpersonal versus non-interpersonal) and temporal (acute versus chronic) aspects of trauma exposure.

METHODS

This meta-analysis included 32 voxel-based morphometry (VBM) neuroimaging studies of adults with PTSD, trauma-exposed controls (TEC), and healthy controls (HC).

RESULTS

PTSD patients showed consistent GM deficits in the pregenual anterior cingulate cortex (pgACC) compared to TEC and HC. Conversely, TEC exhibited increased GM in the insula. Unique GM alterations in frontal, temporal, and parietal regions differentiated interpersonal, acute, and chronic trauma subtypes, while non interpersonal trauma showed no significant peaks compared to TEC.

CONCLUSION

Reduced pgACC GM is a consistent correlate of PTSD vulnerability, while increased insular GM may correlate with stress resilience. These cross-trauma and trauma-specific findings underscore the importance of personalized, culturally humble.