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自我报告曾遭受童年期虐待的青少年的皮质纹状体边缘灰质形态。

Corticostriatal-limbic gray matter morphology in adolescents with self-reported exposure to childhood maltreatment.

作者信息

Edmiston Erin E, Wang Fei, Mazure Carolyn M, Guiney Joanne, Sinha Rajita, Mayes Linda C, Blumberg Hilary P

机构信息

Department of Psychiatry, Yale University School of Medicine, 300 George St, Ste 901, New Haven, CT 06511, USA.

出版信息

Arch Pediatr Adolesc Med. 2011 Dec;165(12):1069-77. doi: 10.1001/archpediatrics.2011.565.

Abstract

OBJECTIVE

To study the relationship between self-reported exposure to childhood maltreatment (CM) and cerebral gray matter (GM) morphology in adolescents without psychiatric diagnoses.

DESIGN

Associations were examined between regional GM morphology and exposure to CM (measured using a childhood trauma self-report questionnaire for physical, emotional, and sexual abuse and for physical and emotional neglect).

SETTING

University hospital.

PARTICIPANTS

Forty-two adolescents without psychiatric diagnoses.

MAIN OUTCOME MEASURES

Correlations between childhood trauma self-report questionnaire scores and regional GM volume were assessed in voxel-based analyses of structural magnetic resonance images. Relationships among GM volume, subtypes of exposure to CM, and sex were explored.

RESULTS

Childhood trauma self-report questionnaire total scores correlated negatively (P < .005) with GM volume in prefrontal cortex, striatum, amygdala, sensory association cortices, and cerebellum. Physical abuse, physical neglect, and emotional neglect were associated with rostral prefrontal reductions. Decreases in dorsolateral and orbitofrontal cortices, insula, and ventral striatum were associated with physical abuse. Decreases in cerebellum were associated with physical neglect. Decreases in dorsolateral, orbitofrontal, and subgenual prefrontal cortices, striatum, amygdala, hippocampus, and cerebellum were associated with emotional neglect. Decreases in the latter emotion regulation regions were also associated with childhood trauma self-report questionnaire scores in girls, while caudate reductions (which may relate to impulse dyscontrol) were seen in boys.

CONCLUSIONS

Exposure to CM was associated with corticostriatal-limbic GM reductions in adolescents. Even if adolescents reporting exposure to CM do not present with symptoms that meet full criteria for psychiatric disorders, they may have corticostriatal-limbic GM morphologic alterations that place them at risk for behavioral difficulties. Vulnerabilities may be moderated by sex and by subtypes of exposure to CM.

摘要

目的

研究在无精神疾病诊断的青少年中,自我报告的童年期受虐经历(CM)与脑灰质(GM)形态之间的关系。

设计

研究区域GM形态与CM暴露之间的关联(使用儿童期创伤自我报告问卷来测量身体、情感和性虐待以及身体和情感忽视)。

地点

大学医院。

参与者

42名无精神疾病诊断的青少年。

主要观察指标

在基于体素的结构磁共振图像分析中,评估儿童期创伤自我报告问卷得分与区域GM体积之间的相关性。探讨GM体积、CM暴露亚型和性别的关系。

结果

儿童期创伤自我报告问卷总分与前额叶皮质、纹状体、杏仁核、感觉联合皮质和小脑的GM体积呈负相关(P <.005)。身体虐待、身体忽视和情感忽视与前额叶前部体积减少有关。背外侧和眶额皮质、岛叶和腹侧纹状体体积减少与身体虐待有关。小脑体积减少与身体忽视有关。背外侧、眶额和膝下前额叶皮质、纹状体、杏仁核、海马体和小脑体积减少与情感忽视有关。在女孩中,后述情绪调节区域的体积减少也与儿童期创伤自我报告问卷得分有关,而在男孩中则观察到尾状核体积减少(这可能与冲动控制障碍有关)。

结论

CM暴露与青少年皮质纹状体 - 边缘系统GM减少有关。即使报告有CM暴露的青少年没有出现符合精神疾病完整标准的症状,他们可能也有皮质纹状体 - 边缘系统GM形态改变,这使他们面临行为困难的风险。脆弱性可能受性别和CM暴露亚型的影响。

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