Childhood Emotional Abuse and Neuroimaging Findings: A Scoping Review

Background Childhood emotional abuse (CEA) is the most prevalent subtype of childhood maltreatment globally, yet it remains the least detected due to its lack of physical markers. While neuroimaging research on childhood maltreatment broadly has implicated the prefrontal cortex, amygdala, hippocampus, and fronto-limbic networks, evidence specific to CEA has not been systematically mapped. Objectives This scoping review aimed to map the existing neuroimaging evidence on childhood emotional abuse, covering study characteristics, approaches to measuring CEA, neuroimaging modalities used, and key neurobiological findings. Methods Following JBI guidance, the PCC framework, and PRISMA-ScR reporting standards, a systematic search was conducted across Scopus and PubMed/MEDLINE with no restriction on publication year. Eligible studies used human samples with history of CEA, employed at least one neuroimaging modality (MRI, fMRI, EEG, PET, DTI, or MEG), and reported original quantitative findings. Results Nineteen articles published between 2010 and 2025 were included, predominantly from the Netherlands and the United States (14 of 19 studies), with no studies from Southeast Asia, Africa, Latin America, or Middle East. The Childhood Trauma Questionnaire was the most widely used measurement instrument (63%). Structural findings most consistently showed reduced dorsomedial prefrontal cortex volume, while functional findings revealed a paradoxical amygdala pattern: hyperactivation to emotional stimuli in task-based studies, alongside reduced connectivity in resting-state and seed-based analyses. No studies used EEG, PET, or MEG. Key gaps identified included measurement heterogeneity, geographic bias, absence of longitudinal designs, cohort clustering (notably NESDA and DASH), and limited testing of mediation mechanism. Conclusion Current neuroimaging evidence on CEA points to consistent prefrontal and amygdala alterations but is constrained by cross-sectional designs, cohort overlap, and limited geographic diversity. Future research should prioritize standardized measurement, longitudinal designs, cross-cultural representation, and underrepresented modalities such as EEG, PET, and MEG.