Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Key Laboratory of Mental Disorder's Management of Zhejiang Province, Hangzhou, Zhejiang, China.
Faculty of Clinical Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
J Psychiatr Res. 2019 May;112:12-17. doi: 10.1016/j.jpsychires.2019.02.014. Epub 2019 Feb 25.
Both major depressive disorder (MDD) and childhood trauma have been linked with brain structural changes. As childhood trauma is more highly prevalent in MDD patients, previous morphometric findings in MDD therefore might have been confounded by childhood trauma. This study aimed to differentiate the impact of childhood trauma from the influence of MDD diagnosis on gray matter volume (GMV). Seventy-eight subjects were recruited into four study groups (n = 16, MDD patients with childhood trauma exposures, CTE/MDD; n = 14, MDD patients without CTE, non-CTE/MDD; n = 24, healthy controls with CTE, CTE/HC; and n = 24, HCs without CTE, non-CTE/HC). All participants underwent high-resolution structural magnetic resonance scans. Voxel-based morphometry was used to investigate GM alterations, and a 2 × 2 analysis of variance was performed to identify the main effects of diagnosis, childhood trauma, and their interactions. The main effects of diagnosis displayed abnormal GMV located in the left superior parietal lobule (MDD < HC) and right middle occipital gyrus (MDD > HC). While the left dorsolateral prefrontal cortex (DLPFC) volume revealed a significant main effect of childhood trauma, as shown by decreased GMV of the left DLPFC in subjects with CTE, regardless of diagnosis. A negative correlation was also found between the left DLPFC volume and emotional neglect in individuals reporting CTE. The present findings suggest that decreased GMV of the left DLPFC is a function of childhood trauma rather than MDD, which may represent the biological risk for developing MDD.
重性抑郁障碍（MDD）和儿童期创伤均与脑结构改变有关。由于儿童期创伤在 MDD 患者中更为普遍，因此以前 MDD 的形态计量学发现可能受到了儿童期创伤的影响。本研究旨在区分儿童期创伤的影响和 MDD 诊断对灰质体积（GMV）的影响。招募了 78 名受试者进入四个研究组（n = 16，有儿童期创伤暴露的 MDD 患者，CTE/MDD；n = 14，无 CTE 的 MDD 患者，非 CTE/MDD；n = 24，有 CTE 的健康对照者，CTE/HC；n = 24，无 CTE 的健康对照者，非 CTE/HC）。所有参与者均接受了高分辨率结构磁共振扫描。使用基于体素的形态计量学来研究 GM 改变，并进行了 2 × 2 方差分析，以确定诊断、儿童期创伤及其相互作用的主要影响。诊断的主要影响显示了位于左侧顶叶上回（MDD < HC）和右侧中枕叶（MDD > HC）的异常 GMV。虽然左侧背外侧前额叶皮层（DLPFC）的体积显示出儿童期创伤的显著主要影响，表现为 CTE 受试者的左侧 DLPFC 体积减小，但无论诊断如何。还发现了个体报告的 CTE 与左侧 DLPFC 体积之间的负相关。本研究结果表明，左侧 DLPFC 的 GMV 减少是儿童期创伤的功能，而不是 MDD，这可能代表了发展为 MDD 的生物学风险。
