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左侧海马亚区 CA1 体积较小与重度抑郁症患者自述的儿童期躯体和/或性虐待有关:一项初步研究。

Smaller left hippocampal subfield CA1 volume is associated with reported childhood physical and/or sexual abuse in major depression: A pilot study.

机构信息

Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China; Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States.

Department of Psychiatry, Columbia University, New York, NY, United States; Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, United States.

出版信息

J Affect Disord. 2020 Jul 1;272:348-354. doi: 10.1016/j.jad.2020.03.169. Epub 2020 Apr 30.

Abstract

BACKGROUND

Smaller hippocampal volumes are reported in adults with major depressive disorder (MDD) and in reported childhood abuse. The hippocampus is a complex structure with distinct functional subfields. We sought to examine the effect of MDD diagnosis and childhood abuse on hippocampal subfields.

METHODS

Forty-one MDD participants (17 reported abuse and 24 did not) and 46 healthy volunteers (HV) (2 reported abuse) underwent T1- weighted structural magnetic resonance imaging (MRI) and clinical characterization in a retrospective design. A subfield segmentation program was used to measure the whole and subfield hippocampal volumes. Linear mixed-effects models were fitted for group comparisons.

RESULTS

No main effect of diagnosis interaction effect between diagnosis and subfield region was observed. However, a comparison of abused MDD vs. HVs showed a group by region interaction. A significant interaction between childhood abuse and region was observed. Effects were confined to the left side of the brain, and post hoc, exploratory region-specific tests indicated smaller left CA1 volume in abused MDD compared with non-abused MDD. In addition, smaller amygdala volume was found in all MDD compared with HVs.

LIMITATIONS

We did not have a sample of healthy volunteers with reported childhood abuse.

CONCLUSIONS

The diagnosis of pure MDD may not be sufficient to exert effects on hippocampal volumes, indicating the importance of taking into account childhood trauma in studies on psychopathological mechanisms. Left CA1 might be the hippocampal subfield most relevant to reported childhood abuse. Smaller amygdala volume may be related to MDD diagnosis independent of childhood abuse.

摘要

背景

有研究报道,重度抑郁症(MDD)患者和有童年期虐待经历的患者的海马体体积较小。海马体是一个具有明显功能亚区的复杂结构。我们试图研究 MDD 诊断和童年期虐待对海马体亚区的影响。

方法

在回顾性设计中,我们对 41 名 MDD 患者(17 名有报告的虐待史,24 名无报告的虐待史)和 46 名健康对照者(2 名有报告的虐待史)进行了 T1 加权结构磁共振成像(MRI)和临床特征检查。使用亚区分割程序测量整个海马体和亚区的体积。使用线性混合效应模型进行组间比较。

结果

未观察到诊断与亚区区域之间的主要效应和诊断与亚区区域之间的交互效应。然而,对受虐待的 MDD 与 HV 之间的比较显示,存在组与区域的交互作用。观察到童年期虐待与区域之间存在显著的交互作用。这些影响仅限于大脑的左侧,并且事后探索性区域特异性检验表明,受虐待的 MDD 的左侧 CA1 体积小于非受虐待的 MDD。此外,与 HV 相比,所有 MDD 的杏仁核体积都较小。

局限性

我们没有有报告的童年期虐待史的健康志愿者样本。

结论

单纯的 MDD 诊断可能不足以对海马体体积产生影响,这表明在研究心理病理机制时,考虑童年创伤的重要性。左侧 CA1 可能是与报告的童年期虐待最相关的海马体亚区。较小的杏仁核体积可能与 MDD 诊断有关,而与童年期虐待无关。

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