Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK.
Schizophr Res. 2012 May;137(1-3):73-9. doi: 10.1016/j.schres.2012.01.035. Epub 2012 Feb 19.
Patients with psychosis have higher rates of childhood trauma, which is also associated with adverse effects on cognitive functions such as attention, concentration and mental speed, language, and verbal intelligence. Although the pathophysiological substrate for this association remains unclear, these cognitive deficits may represent the functional correlate of changes observed in relation to trauma exposure in structures such as the amygdala and the hippocampus. Interestingly, these structures are often reported as altered in psychosis. This study investigated the association between childhood trauma, cognitive function and amygdala and hippocampus volume, in first-episode psychosis. We investigated 83 patients with first-episode psychosis and 63 healthy controls. All participants underwent an MRI scan acquired with a GE Sigma 1.5-T system, and a standardized neuropsychological assessment of general cognition, memory, processing speed, executive function, visuo-spatial abilities, verbal intelligence, and language. In a subsample of the patients (N=45) information on childhood trauma was collected with the Childhood Experience of Care and Abuse Questionnaire (CECA.Q). We found that amygdala, but not hippocampus, volume was significantly smaller (p=0.001) in patients compared to healthy controls. There was a trend level interaction for hippocampus volume between group and sex (p=0.056). A history of childhood trauma was associated with both worse cognitive performance and smaller amygdala volume. This smaller amygdala appeared to mediate the relationship between childhood trauma and performance on executive function, language and verbal intelligence in patients with psychosis. This points to a complex relationship between childhood trauma exposure, cognitive function and amygdala volume in first-episode psychosis.
患有精神病的患者有更高的童年创伤发生率,这也与认知功能(如注意力、集中力和思维速度、语言和言语智力)的不良影响有关。尽管这种关联的病理生理基础尚不清楚,但这些认知缺陷可能代表了与杏仁核和海马体等结构中观察到的创伤暴露相关变化的功能相关性。有趣的是,这些结构经常在精神病中被报道为改变。本研究调查了首发精神病患者的童年创伤、认知功能与杏仁核和海马体体积之间的关系。我们调查了 83 名首发精神病患者和 63 名健康对照者。所有参与者均接受了 GE Sigma 1.5-T 系统采集的 MRI 扫描,并进行了一般认知、记忆、处理速度、执行功能、视空间能力、言语智力和语言的标准化神经心理学评估。在患者的一个亚组(N=45)中,使用儿童期经历问卷(CECA.Q)收集了有关儿童期创伤的信息。我们发现,与健康对照组相比,患者的杏仁核体积明显较小(p=0.001),但海马体体积没有显著差异。组间和性别间的海马体体积存在趋势水平交互作用(p=0.056)。童年创伤史与认知表现较差和杏仁核体积较小均有关。较小的杏仁核似乎介导了童年创伤与精神病患者执行功能、语言和言语智力表现之间的关系。这表明在首发精神病中,童年创伤暴露、认知功能和杏仁核体积之间存在复杂的关系。