Association between Childhood Trauma and Limbic System Activation under Stress: A Study of Neurological Mechanisms for Adverse Cardiovascular Events Open Access

Abstract

Background: Mental stress is a risk factor for cardiovascular health and adverse cardiovascular events, and trauma exposure in childhood may influence the risk of development of cardiovascular disease later in life. However, the neurological mechanisms underpinning the possible links between early trauma exposure, mental stress, and cardiovascular disease are largely unknown, although there is evidence to suggest activation of the limbic system may play a role in physiologic response to stress and increased risk of cardiovascular disease. This study aims to provide further evidence of a link between early trauma and increased activation of the limbic system later in life as a possible mechanism of cardiovascular disease risk.

Methods: Participants with coronary artery disease were recruited from three hospitals in Atlanta, Georgia for the Mental Stress Ischemia Prognosis Study. Selected participants underwent psychometric evaluation using the Early Trauma Inventory: Self-Report scale to measure childhood trauma exposure. Perfusion in selected brain regions was measured at rest and under stressful conditions to measure activation of those regions. Correlations between early trauma and perfusion were calculated, and a dose-response relationship across quintiles of early trauma score were also calculated for the amygdala and hippocampus.

Results: Mild correlations between early trauma exposure and perfusion were found in the left (r = 0.16) and right amygdala (r = 0.20), the left hippocampus (r = 0.30), and the right medial orbitofrontal cortex (r = 0.17). Subgroup analysis showed differences in correlations in the hippocampus across age, gender, and race. Both the amygdala and the hippocampus exhibited a dose-response relationship between early trauma and perfusion.

Conclusion: There is a possible association between early trauma exposure and activation of key areas of the limbic system. These associations could have implications for neurological interventions to prevent cardiovascular disease. More research is needed to assess the neurologic underpinnings of physiologic response and how much these possible mechanisms affect the development of cardiovascular disease outcomes.

Table of Contents

I. Introduction 1

II. Methods 3

a. Population 3

b. Psychometric Assessment 3

c. Mental Stress Testing 4

d. Brain Imaging 4

e. Statistical Analysis 5

III. Results 6

IV. Discussion 8

V. References 11

VI. Tables 14

VII. Figures 15

About this Master's Thesis

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• Permission granted by the author to include this thesis or dissertation in this repository. All rights reserved by the author. Please contact the author for information regarding the reproduction and use of this thesis or dissertation.

School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health Health Sciences, Mental Health Health Sciences, Epidemiology
Keyword	mental stress adverse childhood experiences trauma limbic system cardiovascular disease neurology
Committee Chair / Thesis Advisor	Shah, Amit, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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