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童年期性虐待后生殖器躯体感觉区皮质代表区减少。

Decreased cortical representation of genital somatosensory field after childhood sexual abuse.

机构信息

Institute of Medical Psychology, Charité University Medicine Berlin, Germany.

出版信息

Am J Psychiatry. 2013 Jun;170(6):616-23. doi: 10.1176/appi.ajp.2013.12070950.

Abstract

OBJECTIVE

Sexual dysfunction is a common clinical symptom in women who were victims of childhood sexual abuse. The precise mechanism that mediates this association remains poorly understood. The authors evaluated the relationship between the experience of childhood abuse and neuroplastic thinning of cortical fields, depending on the nature of the abusive experience.

METHOD

The authors used MRI-based cortical thickness analysis in 51 medically healthy adult women to test whether different forms of childhood abuse were associated with cortical thinning in areas critical to the perception and processing of specific behavior implicated in the type of abuse.

RESULTS

Exposure to childhood sexual abuse was specifically associated with pronounced cortical thinning in the genital representation field of the primary somatosensory cortex. In contrast, emotional abuse was associated with cortical thinning in regions relevant to self-awareness and self-evaluation.

CONCLUSIONS

Neural plasticity during development appears to result in cortical adaptation that may shield a child from the sensory processing of the specific abusive experience by altering cortical representation fields in a regionally highly specific manner. Such plastic reorganization may be protective for the child living under abusive conditions, but it may underlie the development of behavioral problems, such as sexual dysfunction, later in life.

摘要

目的

性机能障碍是遭受儿童期性虐待的女性常见的临床症状。介导这种关联的确切机制仍知之甚少。作者评估了童年虐待经历与皮质场神经可塑性变薄之间的关系,具体取决于虐待经历的性质。

方法

作者使用基于 MRI 的皮质厚度分析,对 51 名身体健康的成年女性进行了测试,以检验不同形式的儿童虐待是否与特定行为感知和处理关键区域的皮质变薄有关,这些行为与所经历的虐待类型有关。

结果

童年性虐待暴露与初级体感皮层生殖器代表区的明显皮质变薄有关。相比之下,情绪虐待与与自我意识和自我评价相关的区域的皮质变薄有关。

结论

发育过程中的神经可塑性似乎导致了皮质适应,这种适应可能通过以区域特异性很强的方式改变皮质代表区,从而使儿童免受特定虐待经历的感官处理。这种塑性重组可能对生活在虐待环境中的儿童具有保护作用,但它可能是日后行为问题(如性机能障碍)发展的基础。

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