New Research: Women with a History of Sexual Trauma Are at Risk for Poor Brain Health Later in Life

A team of investigators including Pitt Psychiatry scientists Rebecca Thurston, PhD (Pittsburgh Foundation Chair in Women's Health and Dementia and Professor of Psychiatry, Clinical and Translational Science, Epidemiology, and Psychology); Karen Jakubowski, PhD (Assistant Professor of Psychiatry); Minjie Wu, PhD (Assistant Professor of Psychiatry); and Howard Aizenstein, MD, PhD (Charles F. Reynolds III and Ellen G. Detlefsen Endowed Chair in Geriatric Psychiatry and Professor of Bioengineering and Clinical and Translational Science), tested whether women with a history of trauma are at risk for a greater volume of white matter hyperintensities in the brain. They published the results in Brain Imaging and Behavior

“We have long understood that traumatic experiences, such as sexual assault, place individuals at risk for poor mental health outcomes, and, in some of our recent work, cardiovascular disease outcomes. In this study, we take the next step, showing that sexual violence is associated with greater white matter hyperintensities in the brain, markers of small vessel disease in linked to dementia, stroke, and even mortality later in life,” said Dr. Thurston, the study’s corresponding author. 

Participants included 145 women with an average age of 59, who were assessed for trauma exposure, underwent three days of sleep actigraphy measurement, as well as magnetic resonance imaging (MRI) that segmented white matter hyperintensities. In analyzing the data, the scientists tested the relation of any trauma exposure to white matter hyperintensities. They additionally considered the number of trauma exposures in relation to white matter hyperintensities, as well as post-traumatic stress disorder symptoms, depressive symptoms, childhood abuse, and substance use. 

Findings from the study showed that women in midlife who had experienced trauma had a higher volume of white matter hyperintensities than women without a history of trauma. In particular, they specifically identified sexual assault as significantly related to white matter hyperintensities. The association between sexual assault and white matter hyperintensities were not explain by depressive or post-traumatic stress disorder symptoms, cardiovascular disease risk factors, a history of childhood abuse, substance abuse, or sleep. 

“It is particularly relevant to ask this question among women, as sexual violence is highly prevalent in women; approximately a third of women will experience sexual assault in their lifetime,” said Dr. Thurston. “Further, the preponderance of those with dementia are women. Identifying those women who are at risk for poor brain outcomes earlier in life, such as at midlife, is critical to prevention of dementia later in life.”

Sexual assault and white matter hyperintensities among midlife women
Thurston RC, Jakubowski KP, Wu M, Aizenstein HJ, Chang Y, Derby CA, Koenen KC, Barina-Mitchell E, Maki PM

Brain Imaging and Behavior (2021).