Accelerated Brain Aging in Young Women with Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) has been associated with structural brain alterations, suggesting accelerated brain aging. Evidence from peripheral biological markers supports this hypothesis, although direct neuroimaging findings remain limited. Moreover, this phenomenon remains insufficiently examined in younger populations. To address this gap, this study investigated accelerated brain aging in young women with PTSD and its association with symptom severity. The study included 85 women younger than 40 years: 34 with PTSD and 51 age-matched, trauma-unexposed healthy controls (HCs). T1-weighted magnetic resonance imaging scans were analyzed using a population-specific deep learning model to estimate brain age. The brain age gap (BAG) was calculated as the difference between predicted brain age and chronological age. PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), providing total and domain-specific scores. Women with PTSD demonstrated significantly accelerated brain aging, with a mean BAG increase of approximately 2.1 years relative to HCs (p=0.022). The positive association between total CAPS-5 scores and BAG reached marginal significance (β=0.304, p=0.066). Notably, greater severity of negative alterations in cognition and mood (Criterion D) was significantly associated with a larger BAG (β=0.338, p=0.036). These findings suggest that PTSD may accelerate brain aging even when onset occurs in young adulthood. This effect appears particularly related to cognitive and mood symptom severity. The results underscore the impact of trauma on neural health and highlight the potential of the BAG as a biomarker for specific symptom dimensions in PTSD, with possible implications for targeted intervention strategies.