De Bellis Michael D, Kuchibhatla Maragatha
Healthy Childhood Brain Development and Developmental Traumatology Research Program, Duke University Medical Center, Durham, North Carolina 27710, USA.
Biol Psychiatry. 2006 Oct 1;60(7):697-703. doi: 10.1016/j.biopsych.2006.04.035. Epub 2006 Aug 24.
The results of previous studies suggest structural brain differences in pediatric maltreatment-related posttraumatic stress disorder (PTSD) However, posterior fossa volumes were not examined, despite the consensus that the cerebellum is important in emotional and cognitive development. We investigated the relationship between structural volumes of the cerebellum hemispheres, vermis, brainstem, and clinical variables in pediatric maltreatment-related PTSD.
Fifty-eight psychotropic-naïve maltreated children and adolescents with DSM-IV PTSD were compared with two groups of pediatric subjects who had no DSM-IV criteria A trauma histories: 1) 13 with pediatric generalized anxiety disorder, and 2) 98 healthy non-abused children and adolescents. Subjects underwent a comprehensive psychiatric assessment and an anatomical magnetic resonance image brain scan.
Unadjusted means of the left, right, and total cerebellum were smaller in the PTSD group. The group differences remained significant in the left cerebellum, right cerebellum, and total cerebellum in the analyses adjusted for cerebral volume, sociodemographic, and IQ variables. Cerebellar volumes positively correlated with age of onset of the trauma that lead to PTSD and negatively correlated with the duration of the trauma that lead to PTSD. Cerebellar volumes were larger in boys versus girls, but there was no group x gender interaction. There were significant positive correlations between IQ measures and volumetric variables.
The results support cerebellar volume differences in maltreated children and adolescents with PTSD. Further studies are warranted.
先前研究结果提示，与儿童期受虐相关的创伤后应激障碍（PTSD）存在脑结构差异。然而，尽管人们一致认为小脑在情感和认知发展中很重要，但后颅窝体积并未得到研究。我们调查了与儿童期受虐相关的PTSD患者小脑半球、蚓部、脑干的结构体积与临床变量之间的关系。
将58名未接受过精神药物治疗的受虐儿童和青少年PTSD患者与两组无DSM-IV标准A创伤史的儿科受试者进行比较：1）13名患有儿童广泛性焦虑症的患者，以及2）98名健康、未受虐待的儿童和青少年。受试者接受了全面的精神评估和头颅解剖磁共振成像扫描。
PTSD组左、右小脑及小脑总体积的未校正均值较小。在针对脑容量、社会人口统计学和智商变量进行校正的分析中，PTSD组与对照组在左小脑、右小脑及小脑总体积方面仍存在显著差异。小脑体积与导致PTSD的创伤发作年龄呈正相关，与导致PTSD的创伤持续时间呈负相关。男孩的小脑体积大于女孩，但不存在组别×性别的交互作用。智商测量值与体积变量之间存在显著正相关。
研究结果支持患有PTSD的受虐儿童和青少年存在小脑体积差异。有必要开展进一步研究。
