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早期创伤暴露与惊恐障碍诊断对皮质厚度的交互作用。

The interaction effect of early trauma exposure and a diagnosis of panic disorder on cortical thickness.

机构信息

Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea; Clinical Counseling Psychology Graduate School, CHA University, Seongnam, South Korea.

Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea.

出版信息

J Affect Disord. 2021 May 1;286:259-266. doi: 10.1016/j.jad.2021.03.008. Epub 2021 Mar 8.

Abstract

BACKGROUND

Early trauma (ET) is a risk factor for adult psychiatric disorders. ET exposure is known to cause structural brain alterations, particularly in the fronto-temporo-limbic circuitry. ET-related effects on brain development may differ based on individual characteristics and cause different psychiatric outcomes. We investigated the interaction effect of ET exposure and panic disorder (PD) on cortical thickness.

METHODS

Sixty-six participants with PD and 66 healthy controls were enrolled. High-resolution T1-weighted images were acquired, and a whole-brain vertex-based analysis was performed to estimate cortical thickness. The Early Trauma Inventory Self Report-Short Form, Anxiety Sensitivity Inventory-Revised, Panic Disorder Severity Scale, Beck Depression Inventory-II, and Beck Anxiety Inventory were administered.

RESULTS

There was a significant interaction between ET exposure and PD on the mean cortical thickness in the bilateral insula and right pars triangularis. An exploratory correlational analysis revealed a positive correlation between the mean cortical thickness in the left insula and severity of anxiety sensitivity to cardiovascular symptoms in participants with PD.

LIMITATIONS

Our findings may be affected by recall bias because this study is limited by its retrospective cross-sectional design.

CONCLUSIONS

Our findings suggest that ET exposure may affect brain structures differently based on a diagnosis of PD. Furthermore, individual variations in brain alterations after ET may confer trait vulnerability that triggers the development of PD. Future longitudinal studies are warranted to elucidate the neurobiological mechanisms underlying ET and psychiatric outcomes.

摘要

背景

早期创伤(ET)是成年期精神障碍的一个风险因素。已知 ET 暴露会导致大脑结构改变,特别是在额颞眶额边缘回路中。ET 对大脑发育的影响可能因个体特征而异,并导致不同的精神科结局。我们研究了 ET 暴露和惊恐障碍(PD)对皮质厚度的交互作用。

方法

纳入 66 名 PD 患者和 66 名健康对照者。采集高分辨率 T1 加权图像,并进行全脑顶点分析以估计皮质厚度。采用早期创伤清单自我报告简表、焦虑敏感量表修订版、惊恐障碍严重程度量表、贝克抑郁量表第二版和贝克焦虑量表进行评估。

结果

在双侧岛叶和右侧三角部的平均皮质厚度方面,ET 暴露和 PD 之间存在显著的交互作用。探索性相关分析显示,PD 患者左岛叶的平均皮质厚度与心血管症状焦虑敏感性的严重程度呈正相关。

局限性

由于本研究受到回顾性横断面设计的限制,我们的发现可能受到回忆偏差的影响。

结论

我们的研究结果表明,ET 暴露可能会根据 PD 的诊断而对大脑结构产生不同的影响。此外,ET 后大脑改变的个体差异可能会导致特质易感性,从而引发 PD 的发展。未来需要进行纵向研究,以阐明 ET 和精神科结局的神经生物学机制。

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