Trauma, sexual assault exposure may be ‘toxic’ for women’s brain health

Key takeaways:

• Greater vs. no exposure to trauma was tied to older white matter age but not gray matter age in women.
• Trauma was tied to higher neurofilament light and glial fibrillary acidic protein measures for Black women.

CHICAGO — Exposure to trauma was tied to increased measures of inflammation and neuronal death for Black women and accelerated brain age indicators regardless of race and ethnicity, researchers reported.

The findings were presented at the Annual Meeting of The Menopause Society.

“These findings indicate that trauma experiences, particularly sexual assault, may be toxic not only for women’s mental health, but also their brain health,” Rebecca Thurston, PhD, FABMR, FSBSM, Pittsburgh Foundation Chair in Women’s Health and Dementia, director of the Women’s Behavioral Health Program and professor of psychiatry at the University of Pittsburgh, told Healio. “This adverse effect of interpersonal trauma on the brain may be most pronounced for minoritized women, indicating populations that may warrant particular attention.”

For the MsBrain study, researchers analyzed data from 252 perimenopausal or postmenopausal women aged 45 to 67 years (mean age, 58.98 years; 16.3% Black). All women had at least one ovary and a uterus and no documented neurological disorders. They did not report taking selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors or hormone therapy. Researchers collected data via physical measures, questionnaires, interviews, 3T brain MRI and fasting blood draws for apolipoprotein E genotyping and amyloid beta blocker ratios, phosphorylated tau, glial fibrillary acidic protein and neurofilament light.

Using pre-trained deep learning-based AI models to assess brain age, researchers estimated white and gray matter ages and evaluated associations between trauma exposure, white and gray matter age and Alzheimer’s disease biomarkers.

Compared with no trauma exposure, exposure to one to two traumas (P = .005) or three or more traumas (P = .019) was associated with older white matter age. Among Black women, greater exposure to three or more traumas was significantly associated higher neurofilament light (P = .018) and glial fibrillary acidic protein (P = .19) measures compared with no trauma exposure. Trauma exposure was not associated with any Alzheimer’s disease biomarkers.

When evaluating individual traumas, researchers noted that sexual trauma was the most powerful exposure associated with white matter brain age for all women and neurofilament light and glial fibrillary acidic protein measures for Black women.

Researchers observed no associations between trauma exposure and gray matter brain age.

According to Thurston, these findings also highlight the importance of considering whether trauma-focused interventions after an experience, such as a sexual assault, can protect women’s brain health.

“We need to better understand the biological mechanisms underlying links between sexual trauma and brain health,” Thurston told Healio. “We also need to know whether treatments such as with trauma-focused therapies can protect women’s brains following a traumatic experience.”

For more information:

Rebecca Thurston, PhD, can be reached at thurstonrc@upmc.edu.