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创伤后应激障碍、社交焦虑障碍和儿童创伤:海马亚区体积的差异。

Posttraumatic stress disorder, social anxiety disorder and childhood trauma: Differences in hippocampal subfield volume.

机构信息

South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa.

South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa.

出版信息

Psychiatry Res Neuroimaging. 2019 Feb 28;284:45-52. doi: 10.1016/j.pscychresns.2018.12.015. Epub 2018 Dec 31.

Abstract

Volume-based hippocampal findings in Social Anxiety Disorder (SAD) and Posttraumatic Stress Disorder (PTSD) have been inconsistent, with very little investigation of hippocampal subfields. We assessed the effects of early childhood trauma on hippocampal subfields in participants with SAD with and without early childhood trauma and PTSD, compared to healthy controls. The sample comprised 26 participants SAD with early childhood trauma, 22 participants with SAD without early childhood trauma, 17 with PTSD secondary to early childhood trauma and 25 control participants. We used Freesurfer version 6 to determine hippocampal subfield volumes. Findings included significant reduction in right parasubiculum volume between the PTSD group secondary to early childhood trauma and the SAD group without early childhood trauma, as well as a significant reduction in left HATA (Hippocampal Amygdala Transition Area) volume between PTSD with early childhood trauma compared to controls, as well as compared to SAD with early childhood trauma. These findings did withstand correction for multiple resting using the false discovery rate. Our findings of an association of reduced volumes in the parasubiculum and HATA regions with PTSD secondary to childhood trauma are interesting. Further work should investigate whether parasubiculum and HATA regional volume reductions in PTSD are a specific effect of early childhood trauma or a specific manifestation of PTSD pathology. Further work should also be undertaken to determine if hippocampal subfield atrophy is associated with SAD in the setting of early childhood maltreatment.

摘要

基于体积的海马研究发现,社交焦虑症(SAD)和创伤后应激障碍(PTSD)患者的海马体积存在不一致性,很少对海马亚区进行研究。我们评估了童年期早期创伤对伴有和不伴有童年期早期创伤的 SAD 患者以及 PTSD 患者的海马亚区的影响,并与健康对照组进行了比较。该样本包括 26 名伴有童年期早期创伤的 SAD 患者、22 名无童年期早期创伤的 SAD 患者、17 名由童年期早期创伤引起的 PTSD 患者和 25 名健康对照组。我们使用 Freesurfer 版本 6 来确定海马亚区的体积。研究结果包括,与无童年期早期创伤的 SAD 组相比,童年期早期创伤所致 PTSD 组右侧副海马体积显著减少,与对照组相比,童年期早期创伤所致 PTSD 组左侧 HATA(海马杏仁核过渡区)体积显著减少,与童年期早期创伤所致 SAD 组相比也是如此。这些发现经得起使用错误发现率进行的多次休息校正。我们发现副海马和 HATA 区域体积减少与童年期创伤后 PTSD 之间存在关联,这一发现很有趣。进一步的研究应该调查副海马和 HATA 区域体积减少是否是童年期创伤的 PTSD 特异性效应,还是 PTSD 病理的特异性表现。还应该进一步开展工作,以确定在童年期虐待的背景下,海马亚区萎缩是否与 SAD 有关。

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