De Bellis Michael D, Hooper Stephen R, Chen Steven D, Provenzale James M, Boyd Brian D, Glessner Christopher E, MacFall James R, Payne Martha E, Rybczynski Robert, Woolley Donald P
Duke University School of Medicine.
Dev Psychopathol. 2015 Nov;27(4 Pt 2):1555-76. doi: 10.1017/S0954579415000942.
Magnetic resonance imaging studies of maltreated children with posttraumatic stress disorder (PTSD) suggest that maltreatment-related PTSD is associated with adverse brain development. Maltreated youth resilient to chronic PTSD were not previously investigated and may elucidate neuromechanisms of the stress diathesis that leads to resilience to chronic PTSD. In this cross-sectional study, anatomical volumetric and corpus callosum diffusion tensor imaging measures were examined using magnetic resonance imaging in maltreated youth with chronic PTSD (N = 38), without PTSD (N = 35), and nonmaltreated participants (n = 59). Groups were sociodemographically similar. Participants underwent assessments for strict inclusion/exclusion criteria and psychopathology. Maltreated youth with PTSD were psychobiologically different from maltreated youth without PTSD and nonmaltreated controls. Maltreated youth with PTSD had smaller posterior cerebral and cerebellar gray matter volumes than did maltreated youth without PTSD and nonmaltreated participants. Cerebral and cerebellar gray matter volumes inversely correlated with PTSD symptoms. Posterior corpus callosum microstructure in pediatric maltreatment-related PTSD differed compared to maltreated youth without PTSD and controls. The group differences remained significant when controlling for psychopathology, numbers of Axis I disorders, and trauma load. Alterations of these posterior brain structures may result from a shared trauma-related mechanism or an inherent vulnerability that mediates the pathway from chronic PTSD to comorbidity.
对患有创伤后应激障碍(PTSD)的受虐儿童进行的磁共振成像研究表明,与虐待相关的PTSD与不良的大脑发育有关。此前尚未对能抵御慢性PTSD的受虐青少年进行研究,而这类研究可能会阐明导致对慢性PTSD具有恢复力的应激素质的神经机制。在这项横断面研究中,使用磁共振成像对患有慢性PTSD的受虐青少年(N = 38)、未患PTSD的受虐青少年(N = 35)和未受虐参与者(n = 59)进行了解剖体积和胼胝体扩散张量成像测量。各组在社会人口统计学方面相似。参与者接受了严格的纳入/排除标准评估和精神病理学评估。患有PTSD的受虐青少年在心理生物学方面与未患PTSD的受虐青少年及未受虐对照组不同。患有PTSD的受虐青少年的大脑后部和小脑灰质体积比未患PTSD的受虐青少年和未受虐参与者更小。大脑和小脑灰质体积与PTSD症状呈负相关。与未患PTSD的受虐青少年和对照组相比,与儿童虐待相关的PTSD患者的胼胝体后部微观结构有所不同。在控制精神病理学、轴I障碍数量和创伤负荷后,组间差异仍然显著。这些大脑后部结构的改变可能是由共同的创伤相关机制或内在易感性导致的,这种内在易感性介导了从慢性PTSD到共病的途径。