De Bellis Michael D, Keshavan Matcheri S
Healthy Childhood Brain Development and Developmental Traumatology Research Program, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3613, Durham, NC 27710, USA.
Neurosci Biobehav Rev. 2003 Jan-Mar;27(1-2):103-17. doi: 10.1016/s0149-7634(03)00013-7.
Recent investigations suggested that pediatric posttraumatic stress disorder (PTSD) is associated with adverse brain development. However, sex differences are poorly understood.
In this study, 61 medically healthy children and adolescents (31 males and 30 females) with chronic PTSD secondary to abuse, who had similar trauma and mental health histories, and 122 healthy controls (62 males and 60 females) underwent comprehensive psychiatric assessments and an anatomical MRI brain scan.
When gender groups were analyzed separately, findings of larger prefrontal lobe CSF volumes and smaller midsagittal area of the corpus callosum subregion 7 (splenium) were seen in both boys and girls with maltreatment-related PTSD compared to their gender-matched comparison subjects. Subjects with PTSD did not show the normal age related increases in the area of the total corpus callosum and its region 7 (splenium) compared to non-maltreated subjects; however, this finding was more prominent in males with PTSD. Significant sex by group effects demonstrated smaller cerebral volumes and corpus callosum regions 1 (rostrum) and 6 (isthmus) in PTSD males and greater lateral ventricular volume increases in maltreated males with PTSD than maltreated females with PTSD.
These data suggest that there are sex differences in the brain maturation of boys and girls with maltreatment-related PTSD. Longitudinal MRI brain investigations of childhood PTSD and the relationship of gender to psychosocial outcomes are warranted.
近期研究表明，儿童创伤后应激障碍（PTSD）与不良脑发育有关。然而，性别差异尚不清楚。
在本研究中，61名因虐待导致慢性PTSD的医学健康儿童和青少年（31名男性和30名女性），他们有相似的创伤和心理健康史，以及122名健康对照者（62名男性和60名女性）接受了全面的精神评估和脑部解剖MRI扫描。
当分别分析性别组时，与性别匹配的对照对象相比，患有与虐待相关PTSD的男孩和女孩均出现额叶脑脊液体积增大以及胼胝体7区（压部）矢状中面积减小。与未受虐待的受试者相比，患有PTSD的受试者胼胝体及其7区（压部）面积未显示出与年龄相关的正常增加；然而，这一发现在患有PTSD的男性中更为突出。显著的性别×组效应表明，患有PTSD的男性脑容量较小，胼胝体1区（嘴部）和6区（峡部）较小，且与患有PTSD的受虐待女性相比，患有PTSD的受虐待男性侧脑室体积增加更大。
这些数据表明，患有与虐待相关PTSD的男孩和女孩在脑成熟方面存在性别差异。有必要对儿童PTSD进行纵向MRI脑部研究以及研究性别与心理社会结果的关系。
