Chaney Aisling, Carballedo Angela, Amico Francesco, Fagan Andrew, Skokauskas Norbert, Meaney James, Frodl Thomas
Department of Psychiatry, Institute of Neuroscience, Adelaide and Meath Hospital incorporating the National Children's Hospital (AMNCH), Dublin 24, University Dublin, Trinity College, Dublin, Dublin, Ireland.
Department of Radiology, Centre of Advanced Medical Imaging, St. James Hospital and Trinity College Dublin, Dublin, Ireland.
J Psychiatry Neurosci. 2014 Jan;39(1):50-9. doi: 10.1503/jpn.120208.
Childhood maltreatment has been found to play a crucial role in the development of psychiatric disorders. However, whether childhood maltreatment is associated with structural brain changes described for major depressive disorder (MDD) is still a matter of debate. The aim of this study was to investigate whether patients with MDD and a history of childhood maltreatment display more structural changes than patients without childhood maltreatment or healthy controls.
Patients with MDD and healthy controls with and without childhood maltreatment experience were investigated using high-resolution magnetic resonance imaging (MRI), and data were analyzed using voxel-based morphometry.
We studied 37 patients with MDD and 46 controls. Grey matter volume was significantly decreased in the hippocampus and significantly increased in the dorsomedial prefrontal cortex (DMPFC) and the orbitofrontal cortex (OFC) in participants who had experienced childhood maltreatment compared with those who had not. Patients displayed smaller left OFC and left DMPFC volumes than controls. No significant difference in hippocampal volume was evident between patients with MDD and healthy controls. In regression analyses, despite effects from depression, age and sex on the DMPFC, OFC and hippocampus, childhood maltreatment was found to independently affect these regions.
The retrospective assessment of childhood maltreatment; the natural problem that patients experienced more childhood maltreatment than controls; and the restrictions, owing to sample size, to investigating higher order interactions among factors are discussed as limitations.
These results suggest that early childhood maltreatment is associated with brain structural changes irrespective of sex, age and a history of depression.Thus, the study highlights the importance of childhood maltreatment when investigating brain structures.
童年期受虐已被发现对精神疾病的发展起着关键作用。然而，童年期受虐是否与重度抑郁症（MDD）所描述的脑结构变化相关仍存在争议。本研究的目的是调查有童年期受虐史的MDD患者是否比无童年期受虐的患者或健康对照表现出更多的结构变化。
对有或无童年期受虐经历的MDD患者和健康对照进行高分辨率磁共振成像（MRI）检查，并使用基于体素的形态学分析数据。
我们研究了37例MDD患者和46例对照。与未经历童年期受虐的参与者相比，经历过童年期受虐的参与者海马灰质体积显著减少，背内侧前额叶皮质（DMPFC）和眶额皮质（OFC）灰质体积显著增加。患者的左侧OFC和左侧DMPFC体积比对照小。MDD患者和健康对照之间海马体积无显著差异。在回归分析中，尽管抑郁、年龄和性别对DMPFC、OFC和海马有影响，但发现童年期受虐独立影响这些区域。
童年期受虐的回顾性评估；患者比对照经历更多童年期受虐这一自然问题；以及由于样本量限制而无法研究因素之间的高阶相互作用等均作为局限性进行了讨论。
这些结果表明，童年期早期受虐与脑结构变化相关，与性别、年龄和抑郁史无关。因此，该研究突出了在研究脑结构时童年期受虐的重要性。
