Thomas Lisa A, De Bellis Michael D
Child and Adolescent Psychiatry, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Biol Psychiatry. 2004 Apr 1;55(7):752-8. doi: 10.1016/j.biopsych.2003.11.021.
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.
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).
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.
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.
先前的研究结果表明，促肾上腺皮质激素释放激素（CRH）在患有创伤后应激障碍（PTSD）的成年人、受虐待儿童以及患有与虐待相关的PTSD的儿童中水平升高。
采用磁共振成像测量61名未接受药物治疗的患有PTSD的受虐待受试者（31名男性和30名女性受试者）以及121名未受过创伤的健康对照受试者（62名男性和59名女性受试者）的垂体体积。
总体而言，PTSD受试者和对照受试者在垂体体积上没有差异。存在显著的年龄-组别效应，即PTSD受试者的垂体体积随年龄的差异比对照受试者更大。事后分析显示，患有PTSD的青春期和青春期后受虐待受试者的垂体体积显著大于对照受试者，但患有PTSD的青春期前受虐待受试者和对照受试者的垂体体积相似。有自杀意念史的PTSD受试者的垂体体积更大。
这些发现可能表明与虐待相关的儿童PTSD患者垂体体积存在发育改变。这一发现可能与CRH的应激相关差异有关，并且在合并自杀意念的PTSD儿童患者中可能更为明显。
