Sexual assault leaves an imprint on the brains of women who have developed a post-traumatic stress disorder (PTSD). These are the conclusions of a study led by a team from the Hospital Clínic of Barcelona that has examined the brain activity of 40 assaulted women and has discovered alterations in connectivity in the frontolimbic system, which plays a crucial role in the regulation of emotions and the response to threats.
The team of Lydia Fortea, of the Hospital Clínic, examined through fMRI the brains of 40 women with PTSD as a result of recent sexual assault trauma (within the last year) and compared them with the brain images of 45 volunteers in a control group. The researchers, who present their results in the Conference of the European College of Neuropsychopharmacology (ECNP) in Amsterdam, they saw that in 22 of the 40 attacked women, communication between the amygdala, which helps process emotions such as fear, and the prefrontal cortex, which helps regulate these emotions, had almost completely disappeared.
“This is one of the first, and undoubtedly the largest, connectivity study that analyzes PTSD in sexual assault in adolescents and adult women,” says Fortea. “This supports the idea that PTSD after sexual assault is linked to problems in the brain circuits that regulate emotions and fear.”
This supports the idea that PTSD after sexual assault is linked to problems in the brain circuits that regulate emotions and fear.
Lydia Fortea
— Researcher at Hospital Clínic and main author of the study
Globally, between 17% and 25% of women experience sexual assault, and around 70% subsequently develop PTSD. The amygdala helps process emotions like fear, and the prefrontal cortex helps control and regulate them. When this connection weakens, the brain may have difficulty managing fear responses or regulating emotions, which could explain why people with PTSD often experience intense fear and mood swings.
Personalize treatment
“PTSD after a sexual assault tends to be especially severe and is usually accompanied by higher rates of depression, anxiety and suicidal thoughts,” Fortea emphasizes. However, the authors emphasize that this brain difference could be a characteristic of the disorder itself, but is not necessarily an indicator of the severity of the symptoms, which probably depend on other factors.
“One of the things we will do now is see if these disruptions in connectivity after a sexual assault could help predict response to PTSD treatment,” says the lead researcher. “If so, we could identify early which patients are at risk for worse outcomes and intensify clinical efforts to help them recover.”
“These connectivity deficits could serve more as a biological signature of the disorder than as a state-dependent marker,” he adds. Marin Jukicresearcher at the Karolinska Institute in Stockholm and co-author of the article. “This raises the possibility that these alterations become predictive biomarkers of the response to treatment, guiding personalized interventions.”
The authors emphasize that larger longitudinal studies are needed. So far, this is a study with 40 women, but the work requires more studies to confirm the findings. Although sexual violence is one of the most widespread forms of trauma affecting women, until now most research on PTSD has focused on other types of trauma, such as war.
“Extraordinarily remarkable”
César San Juan Guillénprofessor of Psychology at the University of the Basque Country (UPV/EHU), considers that the methodology is solid and assures that frontolimbic disconnection coincides with previous findings in PTSD. “The novelty is having carried out the analysis after a sexual assault,” he indicates in statements to the SMC. “That in more than half of the patients the amygdala-cortex connection, responsible for managing emotions, almost disappears is an extraordinarily remarkable result.”
That in more than half of the patients the amygdala-cortex connection, responsible for managing emotions, almost disappears is an extraordinarily remarkable result.
César San Juan Guillén
— Professor of Psychology at the University of the Basque Country (UPV/EHU)
For the expert, this work reinforces the neurobiological basis of PTSD after sexual assault and underlines the need for early psychological follow-up of victims. “If it is confirmed that amygdala-prefrontal disconnection predicts therapeutic response, neuroimaging could help identify higher-risk cases and personalize treatment,” he concludes.
“These types of studies provide valuable evidence on the functional changes that accompany psychological trauma and show a disruption of the fronto-limbic circuit involved in the regulation of fear responses,” he says. Manuela Costaresearcher at the Autonomous University of Madrid (UAM), elDiario.es.
Costa studies the creation of negative memories in patients who have electrodes in the amygdala and hippocampus, which allows us to observe the dynamics of communication between brain regions with enormous temporal precision. “Reviews like this complement ours, offering a deeper understanding of how alterations in communication between the amygdala, hippocampus and prefrontal cortex may be at the basis of disorders derived from traumatic experiences and memories.”
