Milani Ana Carolina Coelho, Foerster Bernd, Cogo-Moreira Hugo, Farias Thiago Michel de Brito, Salido Francisco, Carrete Henrique, Mello Marcelo Feijo, Jackowski Andrea Parolin
1Department of Psychiatry, Federal University of São Paulo, Sao Paulo, Brazil.
2Department of Radiology, Federal University of São Paulo, Sao Paulo, Brazil.
Chronic Stress (Thousand Oaks). 2018 Mar 14;2:2470547018763359. doi: 10.1177/2470547018763359. eCollection 2018 Jan-Dec.
The anterior cingulate gyrus is involved in the extinction of conditioned fear responses and is implicated in the pathophysiology of posttraumatic stress disorder. The expression of N-acetylaspartate and choline may be altered in the anterior cingulate gyri of children and adolescents with posttraumatic stress disorder.
We conducted a proton magnetic resonance spectroscopy study, longitudinally investigating N-acetylaspartate/creatine and choline/creatine ratios in the anterior cingulate gyri of children and adolescents, aged from 8 to 12 years, who had been exposed to various forms of violence or were non-trauma control. Based on baseline posttraumatic stress symptoms ("sub-clinical"), participants were divided into two groups: posttraumatic stress (n = 19) and control (n = 19). Proton magnetic resonance spectroscopy scans were repeated a year later in trauma exposed participants. Trauma assessments included the Childhood Trauma Questionnaire.
Exploratory analyses revealed a significant negative correlation between follow-up anterior cingulate gyrus N-acetylaspartate/creatine and Childhood Trauma Questionnaire scores in posttraumatic stress (r = -0.62, p = 0.01) but not control group (r = 0.16, p = 0.66). However, we found no significant differences in anterior cingulate gyrus N-acetylaspartate/creatine or choline/creatine between posttraumatic stress and control. In addition, there were no significant effects of time, group, or time-by-group interactions.
In this pediatric population, anterior cingulate gyrus N-acetylaspartate/creatine and choline/creatine were not affected by posttraumatic stress and on average these metabolites remained stable over time. However, the study provided intriguing preliminary evidence revealing that participants suffering from posttraumatic stress at baseline have shown, a year later, reduced anterior cingulate gyrus N-acetylaspartate/creatine among those with high trauma severity. This pilot evidence warrants replication in future studies to confirm these findings and to determine the longitudinal effects and interactions between childhood posttraumatic stress and trauma.
前扣带回参与条件性恐惧反应的消退，并与创伤后应激障碍的病理生理学有关。创伤后应激障碍儿童和青少年的前扣带回中N-乙酰天门冬氨酸和胆碱的表达可能会发生改变。
我们进行了一项质子磁共振波谱研究，纵向调查了8至12岁曾遭受各种形式暴力或作为非创伤对照的儿童和青少年前扣带回中的N-乙酰天门冬氨酸/肌酸和胆碱/肌酸比率。根据基线创伤后应激症状（“亚临床”），参与者被分为两组：创伤后应激组（n = 19）和对照组（n = 19）。一年后对遭受创伤的参与者重复进行质子磁共振波谱扫描。创伤评估包括儿童创伤问卷。
探索性分析显示，创伤后应激组随访时前扣带回N-乙酰天门冬氨酸/肌酸与儿童创伤问卷得分之间存在显著负相关（r = -0.62，p = 0.01），而对照组无此相关性（r = 0.16，p = 0.66）。然而，我们发现创伤后应激组和对照组在前扣带回N-乙酰天门冬氨酸/肌酸或胆碱/肌酸方面无显著差异。此外，时间、组间或时间与组间交互作用均无显著影响。
在这个儿科人群中，前扣带回N-乙酰天门冬氨酸/肌酸和胆碱/肌酸不受创伤后应激影响，并且这些代谢物平均随时间保持稳定。然而，该研究提供了有趣的初步证据，表明基线时患有创伤后应激的参与者在一年后，在创伤严重程度高的人群中前扣带回N-乙酰天门冬氨酸/肌酸降低。这一初步证据值得在未来研究中重复验证，以证实这些发现，并确定儿童创伤后应激与创伤之间的纵向影响和相互作用。
