Department of Child & Adolescent Psychiatry,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK.
Department of Neuroimaging,Institute of Psychiatry, Psychology & Neuroscience,King's College London,London,UK.
Psychol Med. 2018 Apr;48(6):1034-1046. doi: 10.1017/S0033291717002392. Epub 2017 Nov 10.
Childhood abuse is associated with abnormalities in brain structure and function. Few studies have investigated abuse-related brain abnormalities in medication-naïve, drug-free youth that also controlled for psychiatric comorbidities by inclusion of a psychiatric control group, which is crucial to disentangle the effects of abuse from those associated with the psychiatric conditions.
Cortical volume (CV), cortical thickness (CT) and surface area (SA) were measured in 22 age- and gender-matched medication-naïve youth (aged 13-20) exposed to childhood abuse, 19 psychiatric controls matched for psychiatric diagnoses and 27 healthy controls. Both region-of-interest (ROI) and whole-brain analyses were conducted.
For the ROI analysis, the childhood abuse group compared with healthy controls only, had significantly reduced CV in bilateral cerebellum and reduced CT in left insula and right lateral orbitofrontal cortex (OFC). At the whole-brain level, relative to healthy controls, the childhood abuse group showed significantly reduced CV in left lingual, pericalcarine, precuneus and superior parietal gyri, and reduced CT in left pre-/postcentral and paracentral regions, which furthermore correlated with greater abuse severity. They also had increased CV in left inferior and middle temporal gyri relative to healthy controls. Abnormalities in the precuneus, temporal and precentral regions were abuse-specific relative to psychiatric controls, albeit at a more lenient level. Groups did not differ in SA.
Childhood abuse is associated with widespread structural abnormalities in OFC-insular, cerebellar, occipital, parietal and temporal regions, which likely underlie the abnormal affective, motivational and cognitive functions typically observed in this population.
童年期虐待与大脑结构和功能的异常有关。很少有研究调查过未经药物治疗且无毒品的青少年中与虐待相关的大脑异常，这些研究还通过纳入精神病对照组来控制精神病共病，这对于厘清虐待的影响与与精神状况相关的影响至关重要。
对 22 名年龄和性别匹配的未经药物治疗的青少年（年龄 13-20 岁）进行了皮质体积（CV）、皮质厚度（CT）和皮质表面积（SA）测量，这些青少年经历过童年期虐待，19 名精神病对照组匹配了精神病诊断，27 名健康对照组。进行了基于感兴趣区域（ROI）和全脑分析。
对于 ROI 分析，与健康对照组相比，仅童年期虐待组的双侧小脑 CV 明显降低，左侧岛叶和右侧外侧眶额皮质（OFC）的 CT 明显降低。在全脑水平上，与健康对照组相比，童年期虐待组的左侧舌回、距状回、楔前叶和顶下小叶的 CV 明显降低，左侧额中回和旁中央区的 CT 明显降低，且 CV 和 CT 异常程度与虐待严重程度相关。与健康对照组相比，他们的左侧颞下回和中回的 CV 也增加了。与精神病对照组相比，在楔前叶、颞叶和中央前回的异常是虐待特有的，尽管程度较轻。各组的 SA 没有差异。
童年期虐待与 OFC-岛叶、小脑、枕叶、顶叶和颞叶的广泛结构异常有关，这些异常可能是该人群中常见的异常情感、动机和认知功能的基础。
