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童年创伤对情感性和非情感性精神障碍工作记忆的影响。

Effects of childhood trauma on working memory in affective and non-affective psychotic disorders.

作者信息

Quidé Yann, O'Reilly Nicole, Rowland Jesseca E, Carr Vaughan J, Elzinga Bernet M, Green Melissa J

机构信息

School of Psychiatry, University of New South Wales, Randwick, NSW, Australia.

Schizophrenia Research Institute, Randwick, NSW, Australia.

出版信息

Brain Imaging Behav. 2017 Jun;11(3):722-735. doi: 10.1007/s11682-016-9548-z.

Abstract

Childhood trauma is a significant risk factor for the development of psychotic disorders, and may influence executive brain functions. We thus set out to investigate the long-term effects of childhood trauma exposure on brain function of adult chronic patients diagnosed with schizophrenia, schizoaffective disorder and (psychotic) bipolar-I disorder while performing a standard 2/0-back working memory task. Participants were 50 cases diagnosed with schizophrenia/schizoaffective disorder (SCZ), 42 cases with bipolar-I disorder (BD), and 47 healthy controls (HC). Among this sample, 56 clinical cases (SCZ = 32; BD = 24) and 17 HC reported significant levels of childhood trauma, while 36 clinical cases (SCZ = 18; BD = 18) and 30 HC did not. Effects of childhood trauma on working memory-related brain activation were examined in combined samples of clinical cases (independently of diagnosis) relative to HCs, as well as within each diagnostic category. Case-control analyses revealed increased activation of the left inferior parietal lobule as a main effect of trauma exposure. In addition, trauma exposure interacted with a diagnosis of SCZ or BD to reveal trauma-related increased activation in the cuneus in clinical cases and decreased activation in this region in controls. Disorder-specific functional alterations were also evident in the SCZ sample, but not BD. Childhood trauma exposure elicits aberrant function of parietal regions involved in working memory performance regardless of clinical status, as well as task-relevant visual regions that participates to attentional processes. Childhood trauma may therefore contribute to alterations in attention in SCZ and BD while performing an n-back working memory task.

摘要

童年创伤是精神障碍发展的一个重要风险因素,并且可能影响大脑的执行功能。因此,我们着手研究童年期遭受创伤对成年慢性精神分裂症、分裂情感性障碍和(精神病性)双相I型障碍患者脑功能的长期影响,同时让他们执行标准的2/0-back工作记忆任务。参与者包括50例被诊断为精神分裂症/分裂情感性障碍(SCZ)的患者、42例双相I型障碍(BD)患者和47名健康对照者(HC)。在这个样本中,56例临床病例(SCZ = 32;BD = 24)和17名健康对照者报告有显著程度的童年创伤,而36例临床病例(SCZ = 18;BD = 18)和30名健康对照者则没有。相对于健康对照者,我们在临床病例的合并样本(不考虑诊断)以及每个诊断类别中,研究了童年创伤对与工作记忆相关的大脑激活的影响。病例对照分析显示,作为创伤暴露的主要影响,左侧顶下小叶的激活增加。此外,创伤暴露与SCZ或BD的诊断相互作用,显示临床病例中楔叶与创伤相关的激活增加,而对照组中该区域的激活减少。特定疾病的功能改变在SCZ样本中也很明显,但在BD样本中不明显。无论临床状态如何,童年创伤暴露都会引发参与工作记忆表现的顶叶区域以及参与注意力过程的与任务相关的视觉区域的异常功能。因此,童年创伤可能在执行n-back工作记忆任务时导致SCZ和BD患者的注意力改变。

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