Pituitary volumes in pediatric maltreatment-related posttraumatic stress disorder

Background Previous findings suggest that corticotrophin-releasing hormone (CRH) is elevated in adults with posttraumatic stress disorder (PTSD), maltreated children, and children with maltreatment-related PTSD. Methods Magnetic resonance imaging was used to measure pituitary volumes in 61 medication-naïve maltreated subjects with PTSD (31 male and 30 female subjects) and 121 nontraumatized healthy comparison subjects (62 male and 59 female subjects). Results Overall, no differences were seen between PTSD and control subjects in pituitary volumes. There was a significant age-by-group effect for PTSD subjects to have greater differences in pituitary volume with age than control subjects. Post hoc analyses revealed that pituitary volumes were significantly larger in pubertal and postpubertal maltreated subjects with PTSD than control subjects but were similar in prepubertal maltreated subjects with PTSD and control subjects. Pituitary volumes were larger in the PTSD subjects with history of suicidal ideation. Conclusions These findings may suggest developmental alterations in pituitary volume in maltreatment-related pediatric PTSD. This finding may be associated with stress-related differences in CRH and may be more pronounced in pediatric patients with PTSD comorbid with suicidal ideation.