Neural impact of neighborhood socioeconomic disadvantage in traumatically injured adults

Abstract

Nearly 14 percent of Americans live in a socioeconomically disadvantaged neighborhood. Lower individual socioeconomic position (iSEP) has been linked to increased exposure to trauma and stress, as well as to alterations in brain structure and function; however, the neural effects of neighborhood SEP (nSEP) factors, such as neighborhood disadvantage, are unclear. Using a multi-modal approach with participants who recently experienced a traumatic injury ( N = 185), we investigated the impact of neighborhood disadvantage, acute post-traumatic stress symptoms, and iSEP on brain structure and functional connectivity at rest. After controlling for iSEP, demographic variables, and acute PTSD symptoms, nSEP was associated with decreased volume and alterations of resting-state functional connectivity in structures implicated in affective processing, including the insula, ventromedial prefrontal cortex, amygdala, and hippocampus. Even in individuals who have recently experienced a traumatic injury, and after accounting for iSEP, the impact of living in a disadvantaged neighborhood is apparent, particularly in brain regions critical for experiencing and regulating emotion. These results should inform future research investigating how various levels of socioeconomic circumstances may impact recovery after a traumatic injury as well as policies and community-developed interventions aimed at reducing the impact of socioeconomic stressors.

Neighborhood Socioeconomic Disadvantage and the Neurobiology of Uncertainty in Traumatically Injured Adults

“…This study evaluated a traumatically injured adult sample to investigate the intersection of neighborhood disadvantage, uncertainty neurobiology, and recent trauma exposure. This study builds off our previous work with this sample showing that neurocognitive ( 27 ) and resting-state aberrations ( 8 ) are related to neighborhood disadvantage. Specifically, greater neighborhood disadvantage was associated with greater connectivity between the amygdala and inferior parietal lobule and between the anterior insula and ventrolateral prefrontal cortex, suggesting an impact of neighborhood disadvantage on emotion regulation circuits ( 8 ).…”

“…This study builds off our previous work with this sample showing that neurocognitive ( 27 ) and resting-state aberrations ( 8 ) are related to neighborhood disadvantage. Specifically, greater neighborhood disadvantage was associated with greater connectivity between the amygdala and inferior parietal lobule and between the anterior insula and ventrolateral prefrontal cortex, suggesting an impact of neighborhood disadvantage on emotion regulation circuits ( 8 ). Even at rest, regions underlying uncertainty processing showed altered connectivity related to greater neighborhood disadvantage, although it is unclear if these alterations are relevant during tasks.…”

“…A total of 215 participants who recently experienced a traumatic injury were recruited from an Emergency Department at an urban level 1 trauma center as part of a longitudinal observational study investigating neurobiological and socio-environmental predictors of PTSD [iSTAR study ( 8 , 27 – 29 )]. Individuals were considered eligible if they were between the ages of 18 and 65 years old, were English speaking, had no contraindications for magnetic resonance imaging scanning, and had not sustained a head injury more severe than a mild traumatic brain injury.…”

“…The relationship between socioeconomic factors, including neighborhood disadvantage, and neurobiology has received considerable attention ( 1 – 3 ). Studies suggest that neighborhood disadvantage is associated with decreased volume of brain regions, widespread alteration of resting-state connectivity patterns, and changes to activation patterns during tasks (e.g., response inhibition, fear learning) ( 4 – 8 ). Although individuals living in more disadvantaged neighborhoods are faced with high levels of uncertainty ( 2 , 9 ) and greater exposure to trauma-related or injury-causing events ( 10 ), it remains unclear how neighborhood disadvantage may be impacting the neurobiological correlates of uncertainty, particularly in the aftermath of traumatic injury.…”

Acute White Matter Integrity Post-trauma and Prospective Posttraumatic Stress Disorder Symptoms

“…Nine-hundred sixty-nine individuals treated for traumatic injuries in the Emergency Department (ED) of a Level 1 Trauma Center in Southeastern Wisconsin were recruited directly from the ED or by phone following ED discharge for the Imaging Study on Trauma and Resilience (iSTAR study: Bird et al, 2021 ; Webb et al, 2021a , b ; Weis et al, 2021a , b ). After expressed interest in study participation the participant received a complete verbal overview of the study and were screened to ensure eligibility.…”