1 Department of Psychiatry, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
2 Department of Psychiatry, ARCHI, Sydney Medical School Northern, The University of Sydney, Sydney, NSW, Australia.
Aust N Z J Psychiatry. 2019 May;53(5):447-457. doi: 10.1177/0004867418824021. Epub 2019 Feb 2.
Mood disorders are more common among girls and typically emerge during adolescence. The precise reasons for this are unknown, but among the many mechanisms implicated are stress-induced hippocampal structural changes during this developmental stage. The hippocampus is a complex structure comprised of subfields that develop differentially and respond variably to stress and childhood adversity, both of which are risk factors for mood disorders. To better understand vulnerability to mood disorders, we investigated a cohort of adolescent girls and determined volumetric changes in their hippocampal subfields to elucidate the potential effects of childhood trauma.
Of the 229 participants, 201 girls (aged 12-17 years) fulfilled our analysis inclusion criteria. Of these, 76 had been exposed to higher emotional trauma (emotional abuse or neglect). The girls underwent high-resolution structural magnetic resonance imaging scans, and hippocampal subfield volumes were measured using FreeSurfer. We compared hippocampal subfield volumes in those exposed to higher emotional trauma and those exposed to minimal emotional trauma, at three time-points of adolescent development: early (12-13 years), mid (14-15 years) and late (16-17 years).
Mid-adolescent girls exposed to higher emotional trauma had significantly smaller left CA3 volumes than minimal emotional trauma girls ( p = 0.028). Within the minimal emotional trauma group, mid-adolescents had significantly larger left CA3 volumes than early ( p = 0.034) and late ( p = 0.036) adolescents. Within the higher emotional trauma group, early adolescents had significantly larger left CA3 volumes than late adolescents ( p = 0.036).
In our exploratory study, we observed higher emotional trauma-induced volume changes in the left CA3 hippocampal subfield, which varied depending on age, and may ultimately produce deficits in behavioural, cognitive and emotional processes. We propose that these changes (1) may provide a mechanism through which vulnerability to mood disorders may be increased in adolescent girls, and (2) may signal the best times to implement targeted prevention interventions.
情绪障碍在女孩中更为常见,通常在青春期出现。其确切原因尚不清楚,但涉及的许多机制包括在这个发育阶段应激诱导的海马结构变化。海马体是一个由亚区组成的复杂结构,这些亚区在发育过程中表现出不同的分化和对压力和儿童逆境的不同反应,而这两者都是情绪障碍的风险因素。为了更好地理解易患情绪障碍的原因,我们对一组青春期女孩进行了研究,并确定了她们海马亚区的体积变化,以阐明童年创伤的潜在影响。
在 229 名参与者中,有 201 名女孩(年龄 12-17 岁)符合我们的分析纳入标准。其中,有 76 名女孩经历过更高的情绪创伤(情绪虐待或忽视)。这些女孩接受了高分辨率结构磁共振成像扫描,并使用 FreeSurfer 测量了海马亚区的体积。我们比较了在青春期发展的三个时间点(早期[12-13 岁]、中期[14-15 岁]和晚期[16-17 岁])暴露于更高情绪创伤和最小情绪创伤的女孩的海马亚区体积。
暴露于更高情绪创伤的青春期中期女孩的左侧 CA3 体积明显小于最小情绪创伤的女孩(p=0.028)。在最小情绪创伤组中,青春期中期女孩的左侧 CA3 体积明显大于早期(p=0.034)和晚期(p=0.036)青少年。在更高情绪创伤组中,早期青少年的左侧 CA3 体积明显大于晚期青少年(p=0.036)。
在我们的探索性研究中,我们观察到左侧 CA3 海马亚区因更高的情绪创伤而导致的体积变化,这种变化因年龄而异,最终可能导致行为、认知和情绪过程的缺陷。我们提出,这些变化(1)可能为易患情绪障碍的女性增加提供了一种机制,(2)可能表明实施有针对性预防干预的最佳时机。