Sexual assault and white matter hyperintensities among midlife women

Abstract

BackgroundTraumatic experiences have been linked to poor mental and physical health. However, there has been little examination of their relationship to neuroimaging markers of cerebrovascular risk. White matter hyperintensities (WMHs) are markers of brain small vessel disease. WMHs can be detected decades before the onset of dementia and other disorders and can serve as early markers for these brain disorders. We tested whether traumatic experiences were associated with brain WMH volume among midlife women. MethodsIn the MsBrain study, 145 women (mean age = 59 years) without cardiovascular disease, stroke, or dementia were recruited. Women completed questionnaires [trauma checklist, depression, post-traumatic stress measures]; physical measures [body mass index (BMI), blood pressure (BP)]; phlebotomy; actigraphy sleep measurement, and 3 Tesla magnetic resonance brain imaging for WMHs. Crosssectional associations between traumatic experiences and WMH volume were assessed in linear regression models. Covariates were age, race/ethnicity, education, BMI, BP, lipids, preeclampsia, sleep, and additionally depressive and post-traumatic stress disorder symptoms. Results68% of women endorsed at least one of the traumas assessed. The most common trauma was sexual assault (23% of women). Women with trauma exposure had greater WMH volume than women without trauma [B(SE) = .24 (.09), p = .01, multivariable]. The single trauma most associated with WMH was sexual assault [B(SE) = .25 (.11), p = .02, multivariable]. Results persisted adjusting for depressive or posttraumatic stress symptoms. ConclusionsA trauma history, particularly sexual assault, was associated with greater WMH volume controlling for covariates, including depressive and post-traumatic symptoms. Sexual assault may place women at risk for poor brain health.

Do correlates of white matter features differ between older men and women living with human immunodeficiency virus?

“…35,36 We also failed to assess for a history of trauma and sexual assault, which may be especially high in this population and has recently been shown to be associated with higher WMH volumes in uninfected midlife women. 37 Furthermore, because this study used a cross-sectional design, we were unable to draw conclusions that consider the causality of white matter disease in this population. Future studies should include longitudinal MRI data to examine if risk factors of interest are associated with the extent of white matter disease progression over time.…”

“…We also did not obtain depression scores from study participants, and depressive symptoms and apathy have been associated with higher WMH volumes 35,36 . We also failed to assess for a history of trauma and sexual assault, which may be especially high in this population and has recently been shown to be associated with higher WMH volumes in uninfected midlife women 37 . Furthermore, because this study used a cross-sectional design, we were unable to draw conclusions that consider the causality of white matter disease in this population.…”

Child sexual abuse versus adult sexual assault: A review of psychological and neurobiological sequelae

“…On the other hand, there is evidence that ASA is related to WMHs and alterations in dACC function (Quidé et al, 2018b;Thurston et al, 2022).…”

The peripheral epigenome predicts white matter volume contingent on developmental stage: An ECHO study

“…Importantly, white matter development in the rst ve years of life is highly correlated with cognitive maturation and abilities imperative for life-long function 17 . Additionally, its degradation, as measured by MRI hyperintensities, is associated with stressful life events, early life socioeconomic status, sexual assault, psychiatric and neurodegenerative diseases, and cognitive decline in aging [18][19][20][21][22][23] .…”