White matter integrity and its relationship to PTSD and childhood trauma—a systematic review and meta-analysis
Open accessAbstract
Recent reviews and meta-analyses reported structural gray matter changes in patients suffering from adult-onset posttraumatic stress disorder (PTSD) and in subjects with and without PTSD who experienced childhood trauma. However, it remains unclear if such structural changes are also affecting the white matter. The aim of this systematic review is to provide a comprehensive overview of all empirical investigations measuring white matter integrity in populations affected by PTSD and/or childhood trauma. To this end, results from different methodological approaches were included. Twenty-five articles are reviewed of which 10 pertained to pediatric PTSD and the effects of childhood trauma measured during childhood, seven to the effects of childhood trauma measured during adulthood, and eight to adult-onset PTSD. Overall, reductions in white matter volume were reported more often than increases in these populations. However, the heterogeneity of the exact locations indicates only a weak overlap across published studies. In addition, a meta-analysis was carried out on seven whole-brain diffusion tensor imaging (DTI) studies in adults. Significant clusters of both increases and decreases were identified in various structures, most notably the cingulum and the superior longitudinal fasciculus. Future research directions are discussed.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Dorsal cingulum changes occur in PTSD, as measured both by dMRI indices and tract volume.
“Dorsal cingulum changes occur in PTSD, as measured both by dMRI indices (Table 2) and tract volume (Daniels et al., 2013).”
From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Daniels et al., 2013
The Summary reports cingulum white-matter volume changes in studies of adult-onset PTSD, supporting the tract-volume part of the citation. It locates those changes in anterior or posterior cingulum sections, but does not identify a dorsal cingulum volume change. The paper's mention of a dorsal subregion concerns FA-based white-matter integrity, not tract volume; the citing sentence attributes its dMRI evidence to Table 2 rather than to Daniels et al. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn adult onset PTSD meta-analysis, the largest cluster related to decreased FA in the right cingulum.
“While the largest cluster related to decreased FA in the right cingulum”
From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Daniels et al., 2013
In adult onset PTSD, different sections of the cingulum were associated with both increases and decreases of FA.
“different sections of the cingulum were associated with both increases and decreases of FA (Daniels et al., 2013; Table 2).”
From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Daniels et al., 2013
In a meta-analysis of adult onset PTSD from seven studies, clusters of dMRI changes were most evident in the cingulum and the superior longitudinal fasciculus.
“Meanwhile clusters of dMRI changes were most evident in the cingulum and the superior longitudinal fasciculus in a meta-analysis of adult onset PTSD from seven studies (Daniels et al., 2013).”
From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Daniels et al., 2013
Different parts of the cingulum may show opposite changes in diffusivity in both PTSD and OCD.
“the finding that different parts of the cingulum may show opposite changes in diffusivity in both PTSD (Daniels et al., 2013) and OCD (Cannistraro et al., 2007)”
From The cingulum bundle: Anatomy, function, and dysfunction (2018) · cites this paper as Daniels et al., 2013
A preliminary quantitative meta-analysis of seven adult-onset PTSD studies revealed white matter abnormalities in the cingulum bundle and the superior longitudinal fasciculus.
“A preliminary quantitative meta-analysis of seven adult onset PTSD studies (89) revealed white matter abnormalities in the cingulum bundle, a white matter tract that links the anterior medial prefrontal cortex to the medial temporal lobes, and the superior longitudinal fasciculus, which connects the frontal and parietal lobes”
From Exercise Intervention in PTSD: A Narrative Review and Rationale for Implementation (2019) · cites this paper as [89]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Tract-based spatial statistics: Voxelwise analysis of multi-subject diffusion data
Smith, S. M., Jenkinson, M., Johansen-Berg, H., Rueckert, D., Nichols, T. E., Mackay, C., Watkins, K., Ciccarelli, O., Cader, M., Matthews, P., et al. (2006) · NeuroImage · doi:10.1016/j.neuroimage.2006.02.024 · Cited by 6,035 · see citing works
Mapping cortical change across the human life span
Sowell, E. R., Peterson, B. S., Thompson, P. M., Welcome, S. E., Henkenius, A. L., & Toga, A. W. (2003) · Nature Neuroscience · doi:10.1038/nn1008 · Cited by 2,328 · see citing works
Nanni, V., Uher, R., & Danese, A. (2012) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2011.11020335 · Cited by 1,480 · see citing works
The neurobiological consequences of early stress and childhood maltreatment
Teicher, M. H., Andersen, S. L., Polcari, A., Anderson, C. M., Navalta, C. P., & Kim, D. M. (2003) · Neuroscience & Biobehavioral Reviews · doi:10.1016/s0149-7634(03)00007-1 · Cited by 1,465 · see citing works
WITELSON, S. F. (1989) · Brain · doi:10.1093/brain/112.3.799 · Cited by 1,424 · see citing works
Heim, C., & Binder, E. B. (2012) · Experimental Neurology · doi:10.1016/j.expneurol.2011.10.032 · Cited by 986 · see citing works
Developmental traumatology part II: brain development∗∗See accompanying Editorial, in this issue.
De Bellis, M. D., Keshavan, M. S., Clark, D. B., Casey, B. J., Giedd, J. N., Boring, A. M., Frustaci, K., & Ryan, N. D. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00045-1 · Cited by 974 · see citing works
A meta-analysis of structural brain abnormalities in PTSD
KARL, A., SCHAEFER, M., MALTA, L., DORFEL, D., ROHLEDER, N., & WERNER, A. (2006) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2006.03.004 · Cited by 881 · see citing works
Andersen, S. L., Tomada, A., Vincow, E. S., Valente, E., Polcari, A., & Teicher, M. H. (2008) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/jnp.2008.20.3.292 · Cited by 788 · see citing works
(2000) · PubMed · Cited by 676 · see citing works
Neuroimaging of child abuse: a critical review
Hart, H., & Rubia, K. (2012) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2012.00052 · Cited by 660 · see citing works
De Bellis, M. D., Keshavan, M. S., Shifflett, H., Iyengar, S., Beers, S. R., Hall, J., & Moritz, G. (2002) · Biological Psychiatry · doi:10.1016/s0006-3223(02)01459-2 · Cited by 632 · see citing works
Mehta, M. A., Golembo, N. I., Nosarti, C., Colvert, E., Mota, A., Williams, S. C. R., Rutter, M., & Sonuga‐Barke, E. J. S. (2009) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2009.02084.x · Cited by 488 · see citing works
A sensorimotor paradigm for Bayesian model selection
Genewein, T., & Braun, D. A. (2012) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2012.00291 · Cited by 487 · see citing works
Childhood neglect is associated with reduced corpus callosum area
Teicher, M. H., Dumont, N. L., Ito, Y., Vaituzis, C., Giedd, J. N., & Andersen, S. L. (2004) · Biological Psychiatry · doi:10.1016/j.biopsych.2004.03.016 · Cited by 484 · see citing works
Psychopathology in a large cohort of sexually abused children followed up to 43 years
Cutajar, M. C., Mullen, P. E., Ogloff, J. R. P., Thomas, S. D., Wells, D. L., & Spataro, J. (2010) · Child Abuse & Neglect · doi:10.1016/j.chiabu.2010.04.004 · Cited by 472 · see citing works
Hanson, J. L., Chung, M. K., Avants, B. B., Shirtcliff, E. A., Gee, J. C., Davidson, R. J., & Pollak, S. D. (2010) · The Journal of Neuroscience · doi:10.1523/jneurosci.0859-10.2010 · Cited by 455 · see citing works
Eluvathingal, T. J., Chugani, H. T., Behen, M. E., Juhász, C., Muzik, O., Maqbool, M., Chugani, D. C., & Makki, M. (2006) · Pediatrics · doi:10.1542/peds.2005-1727 · Cited by 451 · see citing works
Choi, J., Jeong, B., Rohan, M. L., Polcari, A. M., & Teicher, M. H. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2008.06.022 · Cited by 376 · see citing works
Frodl, T., Reinhold, E., Koutsouleris, N., Reiser, M., & Meisenzahl, E. M. (2010) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2010.01.006 · Cited by 323 · see citing works
Excess Significance Bias in the Literature on Brain Volume Abnormalities
Ioannidis, J. P. A. (2011) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2011.28 · Cited by 299 · see citing works
(2009) · PubMed · Cited by 285 · see citing works
Choi, J., Jeong, B., Polcari, A., Rohan, M. L., & Teicher, M. H. (2012) · NeuroImage · doi:10.1016/j.neuroimage.2011.09.033 · Cited by 215 · see citing works
Posttraumatic Resilience in Former Ugandan Child Soldiers
Klasen, F., Oettingen, G., Daniels, J. K., Post, M., Hoyer, C., & Adam, H. (2010) · Child Development · doi:10.1111/j.1467-8624.2010.01456.x · Cited by 213 · see citing works
Self-citationTeicher, M. H., Samson, J. A., Sheu, Y.-S., Polcari, A., & McGreenery, C. E. (2010) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2010.10010030 · Cited by 211 · see citing works
Jackowski, A. P., Douglas-Palumberi, H., Jackowski, M., Win, L., Schultz, R. T., Staib, L. W., Krystal, J. H., & Kaufman, J. (2008) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2007.08.006 · Cited by 206 · see citing works
Sex differences in brain maturation in maltreatment-related pediatric posttraumatic stress disorder
Bellis, M. D. D., & Keshavan, M. S. (2003) · Neuroscience & Biobehavioral Reviews · doi:10.1016/s0149-7634(03)00013-7 · Cited by 193 · see citing works
The neurobiology of post-traumatic stress disorder
Bisson, J. I. (2009) · Psychiatry · doi:10.1016/j.mppsy.2009.04.018 · Cited by 179 · see citing works
Schuff, N. W., Zhang, Y., Wang, Z., Lenoci, M., Ching, C. R. K., Boreta, L. C., Mueller, S. G., Wang, Z., Marmar, C. R., Weiner, M. W., et al. (2010) · NeuroImage · doi:10.1016/j.neuroimage.2010.05.024 · Cited by 155 · see citing works
Abe, O., Yamasue, H., Kasai, K., Yamada, H., Aoki, S., Iwanami, A., Ohtani, T., Masutani, Y., Kato, N., & Ohtomo, K. (2006) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2006.01.004 · Cited by 129 · see citing works
Regional differences of the prefrontal cortex in pediatric PTSD: an MRI study
Richert, K. A., Carrion, V. G., Karchemskiy, A., & Reiss, A. L. (2006) · Depression and Anxiety · doi:10.1002/da.20131 · Cited by 118 · see citing works
Asymmetrically altered integrity of cingulum bundle in posttraumatic stress disorder
Kim, S. J., Jeong, D.-U., Sim, M. E., Bae, S. C., Chung, A., Kim, M. J., Chang, K. H., Ryu, J., Renshaw, P. F., & Lyoo, I. K. (2006) · Neuropsychobiology · doi:10.1159/000098262 · Cited by 102 · see citing works
Reduced area of the corpus callosum in posttraumatic stress disorder
Villarreal, G., Hamilton, D. A., Graham, D. P., Driscoll, I. F., Qualls, C., Petropoulos, H., & Brooks, W. M. (2004) · Psychiatry Research Neuroimaging · doi:10.1016/j.pscychresns.2004.05.002 · Cited by 96 · see citing works
Diffusion Tensor Imaging in Anxiety Disorders
Ayling, E., Aghajani, M., Fouché, J., & van der Wee, N. J. A. (2012) · Current Psychiatry Reports · doi:10.1007/s11920-012-0273-z · Cited by 87 · see citing works
Zhang, L., Zhang, Y., Li, L., Li, Z., Li, W., Ma, N., Hou, C., Zhang, Z., Zhang, Z., Wang, L., et al. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2011.03.040 · Cited by 81 · see citing works
Morphologic Alterations in the Corpus Callosum in Abuse-Related Posttraumatic Stress Disorder
Kitayama, N., Brummer, M. E., Hertz, L., Quinn, S., Kim, Y., & Bremner, J. D. (2007) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e31815c044f · Cited by 80 · see citing works
Disrupted white matter tract integrity of anterior cingulate in trauma survivors
Kim, M. J., Lyoo, I. K., Kim, S. J., Sim, M., Kim, N., Choi, N., Jeong, D. U., Covell, J., & Renshaw, P. F. (2005) · Neuroreport · doi:10.1097/00001756-200507130-00004 · Cited by 68 · see citing works
Wang, H., Zhang, Z., Tan, Q., Yin, H. J., Chen, Y., Wang, H., Zhang, R., Wang, Z., Guo, L., Tang, L., et al. (2009) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2009.10.001 · Cited by 51 · see citing works
Early Life Stress on Brain Structure and Function Across the Lifespan: A Preliminary Study
Seckfort, D. L., Paul, R., Grieve, S. M., Vandenberg, B., Bryant, R., Williams, L. M., Clark, C., Cohen, R. A., Bruce, S., & Gordon, E. (2008) · Brain Imaging and Behavior · doi:10.1007/s11682-007-9015-y · Cited by 48 · see citing works
Zhang, L., Li, W., Shu, N., Zheng, H., Zhang, Z., Zhang, Y., He, Z., Hou, C., Li, Z., Liu, J., et al. (2011) · Acta Neuropsychiatrica · doi:10.1111/j.1601-5215.2011.00580.x · Cited by 35 · see citing works
Hedges, D. W., Thatcher, G. W., Bennett, P. J., Sood, S., Paulson, D. A., Creem-Regehr, S. H., Brown, B. L., Allen, S. J., Johnson, J., Froelich, B., et al. (2008) · Neurocase · doi:10.1080/13554790701851551 · Cited by 29 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- De Bellis MD, Keshavan MS, Clark DB, et al. A.E. Bennett Research Award. Developmental traumatology. Part II: brain development. Biol Psychiatry 1999;45(10):1271- 1284.
Cited by
Sorted by citations
The cingulum bundle: Anatomy, function, and dysfunction
Bubb, E. J., Metzler-Baddeley, C., & Aggleton, J. P. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.05.008 · Cited by 740 · see citing works
“These findings reinforce the value of separating different types of trauma associated with PTSD, while also showing that FA can increase as well as decrease in this condition.”
InfluentialAgorastos, A., Pervanidou, P., Chrousos, G. P., & Baker, D. G. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00118 · Cited by 385 · see citing works
Sleep and REM sleep disturbance in the pathophysiology of PTSD: the role of extinction memory
Pace-Schott, E. F., Germain, A., & Milad, M. R. (2015) · Biology of Mood & Anxiety Disorders · doi:10.1186/s13587-015-0018-9 · Cited by 255 · see citing works
“While a complete review of this diverse literature is beyond the scope of this article, excellent reviews can be found in [116, 119–126].”
BackgroundExercise Intervention in PTSD: A Narrative Review and Rationale for Implementation
Hegberg, N. J., Hayes, J. P., & Hayes, S. M. (2019) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2019.00133 · Cited by 154 · see citing works
Fani, N., King, T. Z., Shin, J., Srivastava, A., Brewster, R. C., Jovanovic, T., Bradley, B., & Ressler, K. J. (2016) · Depression and Anxiety · doi:10.1002/da.22483 · Cited by 80 · see citing works
Jensen, S. K. G., Pangelinan, M., Björnholm, L., Klasnja, A., Leemans, A., Drakesmith, M., Evans, C. J., Barker, E. D., & Paus, T. (2018) · NeuroImage · doi:10.1016/j.neuroimage.2017.10.033 · Cited by 44 · see citing works
Daniels, J. K., Frewen, P., Theberge, J., & Lanius, R. A. (2016) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12464 · Cited by 40 · see citing works
Self-citationRiem, M. M. E., van Hoof, M. J., Garrett, A. S., Rombouts, S. A. R. B., van der Wee, N. J. A., van IJzendoorn, M. H., & Vermeiren, R. R. J. M. (2019) · Behavioural Brain Research · doi:10.1016/j.bbr.2018.10.014 · Cited by 36 · see citing works
Park, S., Lee, J.-M., Kim, J.-W., Kwon, H., Cho, S.-C., Han, D. H., Cheong, J. H., & Kim, B.-N. (2016) · Psychiatry Research: Neuroimaging · doi:10.1016/j.pscychresns.2015.09.012 · Cited by 17 · see citing works
Maron, E., Lan, C.-C., & Nutt, D. (2018) · Current Topics in Behavioral Neurosciences · doi:10.1007/7854_2018_49 · Cited by 9 · see citing works
Kim, H.-J., Bang, M., Park, C. I., & Lee, S.-H. (2023) · Neuropsychobiology · doi:10.1159/000530313 · Cited by 2 · see citing works
- Authors
- Daniels, J. K., Lamke, J.-P., Gaebler, M., Walter, H., & Scheel, M.
- Affiliations
- Charité – Universitätsmedizin Berlin (DE)
- Corresponding author
- Daniels, Judith K.
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2013-01-14
- Volume
- 30
- Issue
- 3
- Pages
- 207-216
- ISSN
- 1091-4269 (ISSN-L)
- OpenAlex
- W1503126161
- Cited by
- 190
- References
- 41
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 5 · 2023: 15 · 2022: 15 · 2021: 23 · 2020: 13 · 2019: 14 · 2018: 18 · 2017: 15 · 2016: 19 · 2015: 19 · 2014: 8 · 2013: 5 · 2012: 1
- FWCI
- 2.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Funders
- Volkswagen Foundation (II/84051)
- Stiftung Charité
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Keywords
- white matter integrity, post-traumatic stress disorder, childhood trauma, pediatric PTSD, diffusion tensor imaging, white matter volume, cingulum, superior longitudinal fasciculus, brain structural changes
- MeSH terms
- Adult, Brain, Child, Child Abuse, Humans, Stress Disorders, Post-Traumatic, Anisotropy, Diffusion Tensor Imaging, Leukoencephalopathies
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
