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创伤后应激障碍儿童和青少年的海马体分段体积

Segmented hippocampal volume in children and adolescents with posttraumatic stress disorder.

作者信息

Tupler Larry A, De Bellis Michael D

机构信息

Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina 27710, USA.

出版信息

Biol Psychiatry. 2006 Mar 15;59(6):523-9. doi: 10.1016/j.biopsych.2005.08.007. Epub 2005 Sep 30.

Abstract

BACKGROUND

Although many studies of adults with posttraumatic stress disorder (PTSD) have reported smaller hippocampal volume compared with control subjects, comparable studies of children and adolescents have failed to replicate these findings or have noted opposite trends suggesting a larger hippocampus. We therefore performed a secondary analysis combining data from prior studies to examine the hypothesis that hippocampus would be larger in pediatric subjects with PTSD compared with non-maltreated control subjects. We also hypothesized that differences in PTSD subjects would be observed between boys and girls.

METHODS

Sixty-one subjects (31 boys, 30 girls) with maltreatment-related PTSD and 122 control subjects matched on age and gender underwent magnetic resonance imaging.

RESULTS

As hypothesized, we observed a significantly larger hippocampus controlling for cerebral volume in PTSD subjects compared with control subjects. Segmented hippocampal white-matter volume was greater in PTSD subjects but not gray-matter volume. Hippocampal volume was positively related to age of trauma onset and level of psychopathology, particularly externalizing behavior. No interactions with group were observed for age or gender.

CONCLUSIONS

Future longitudinal studies with trauma control subjects and neuropsychological measures are indicated to further elucidate the relationship between hippocampus and behavioral abnormalities in young PTSD subjects.

摘要

背景

尽管许多针对成年创伤后应激障碍(PTSD)患者的研究报告称,与对照组相比,其海马体体积较小,但针对儿童和青少年的类似研究未能重复这些发现,或者发现了相反的趋势,即海马体较大。因此,我们进行了一项二次分析,整合了先前研究的数据,以检验以下假设:与未受虐待的对照组相比,患有PTSD的儿科患者的海马体会更大。我们还假设,PTSD患者在男孩和女孩之间会观察到差异。

方法

61名与虐待相关的PTSD患者(31名男孩,30名女孩)和122名年龄和性别匹配的对照者接受了磁共振成像检查。

结果

正如假设的那样,与对照组相比,我们观察到PTSD患者在控制脑容量的情况下海马体明显更大。PTSD患者的海马体白质体积更大,但灰质体积没有差异。海马体体积与创伤发生年龄和精神病理学水平呈正相关,尤其是外化行为。在年龄或性别方面未观察到与组别的交互作用。

结论

未来需要开展有创伤对照组和神经心理学测量的纵向研究,以进一步阐明年轻PTSD患者海马体与行为异常之间的关系。

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