LAUSR

Introduction - Cortical thickness (CT) and surface area (SA) are established biomarkers of brain pathology in posttraumatic stress disorder (PTSD). Structural covariance networks (SCN) are represented as graphs with brain regions as nodes and correlations between nodes as edges. Methods - We built SCNs for PTSD and control groups using 148 CT and SA measures that were harmonized for site in n=3439 subjects from ENIGMA-PGC PTSD. We compared centrality between PTSD and controls as well as interactions of diagnostic group with age, sex, and comorbid major depressive disorder (MDD) status. We investigated associations between network modularity and diagnostic grouping. Results - Nodes with higher CT-based centrality in PTSD compared to controls included the left inferior frontal sulcus, left fusiform gyrus, left superior temporal gyrus, and right inferior temporal gyrus. Children (<10 years) and adolescents (10-21) with PTSD showed greater centrality in frontotemporal areas compared to young (22-39) and middle-aged adults (40-59) with PTSD, who showed higher centrality in occipital areas. PTSD diagnostic group interactions with sex and comorbid MDD showed altered centrality in occipital regions, along with greater visual network modularity in PTSD subjects compared to controls. Conclusion - Structural covariance in PTSD is associated with centrality differences in occipital areas and visual network modularity differences in a large well powered sample. In context of extensive structural covariance remodeling taking place prior to and during adolescence, the present findings suggest a process of cortical remodeling that commences with trauma and/or the onset of PTSD but may also predate these events.