Cusimano Michael D, Zhang Stanley, Huang Grace, Wolfe David, Carpino Melissa
Injury Prevention Research Office, Division of Neurosurgery, St. Michael's Hospital, Toronto, Ontario, Canada.
Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Neurotrauma Rep. 2020 Dec 10;1(1):241-252. doi: 10.1089/neur.2020.0032. eCollection 2020.
Nearly 50,000 Canadian children live in foster care. Compared with their peers, foster children experience greater independence and decreased guidance, predisposing them to harmful exposures such as traumatic brain injury (TBI), illicit drugs, and alcohol. Foster children also report a higher level of childhood abuse compared with the general population. This study aimed to: 1) investigate substance/alcohol use disorder, adverse childhood events (ACE), TBI, aggression levels, and the difference between normalized percentages of brain regions of interest (ROIs) in a sample of Canadian youths with and without foster care history; 2) determine the prevalence of substance/alcohol use disorder, ACE, and aggression levels within individuals with foster care history when stratified by likelihood of TBI; and 3) determine the significant correlates of elevated aggression levels within this population. Participants completed standardized questionnaires that measured the prevalence of TBI, substance and alcohol use disorder, ACE, and aggression. Magnetic resonance imaging (MRI) was used to measure differences in brain ROI. Regression and network analysis were used to study interactions between variables. Seventy-four participants (51 individuals with foster care history and 23 age-matched controls from the general population) completed standardized questionnaires. Fifty-five of these individuals (39 foster participants and 16 controls) underwent brain MRI. Foster participants had higher prevalence of substance use disorder ( < 0.001), alcohol use disorder ( = 0.003), ACE ( < 0.001), and elevated aggression levels ( < 0.001) than healthy controls. No significant difference was found among brain ROI. The prevalence of TBI in foster participants was 65%. Foster participants with moderate or high likelihood of TBI exposure had higher levels of drug use and aggression than those with no or low likelihood of exposure. Brain volumes were not associated with substance/alcohol use disorder or ACE. No significant associations were found between aggression levels and the studied variables.
近5万名加拿大儿童生活在寄养机构中。与同龄人相比，寄养儿童有更大的独立性且受到的指导减少，这使他们更容易遭受如创伤性脑损伤（TBI）、非法药物和酒精等有害暴露。与普通人群相比，寄养儿童报告的童年虐待水平也更高。本研究旨在：1）调查有和没有寄养经历的加拿大青年样本中的物质/酒精使用障碍、童年不良事件（ACE）、TBI、攻击水平以及感兴趣脑区（ROI）标准化百分比之间的差异；2）按TBI可能性分层，确定有寄养经历个体中物质/酒精使用障碍、ACE和攻击水平的患病率；3）确定该人群中攻击水平升高的显著相关因素。参与者完成了测量TBI、物质和酒精使用障碍、ACE以及攻击患病率的标准化问卷。磁共振成像（MRI）用于测量脑ROI的差异。回归分析和网络分析用于研究变量之间的相互作用。74名参与者（51名有寄养经历的个体和23名来自普通人群的年龄匹配对照）完成了标准化问卷。其中55人（39名寄养参与者和16名对照）接受了脑部MRI检查。与健康对照相比，寄养参与者的物质使用障碍（<0.001）、酒精使用障碍（=0.003）、ACE（<0.001）和攻击水平升高（<0.001）的患病率更高。在脑ROI之间未发现显著差异。寄养参与者中TBI的患病率为65%。有中度或高度TBI暴露可能性的寄养参与者比没有或低暴露可能性的参与者有更高的药物使用和攻击水平。脑容量与物质/酒精使用障碍或ACE无关。在攻击水平与所研究变量之间未发现显著关联。
