Neuroscience Training Program, University of Wisconsin, Madison (Keding, Cisler, Herringa); Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin, Madison (Keding, Heyn, Russell, Cisler, Herringa); Department of Computer Science, University of Wisconsin, Madison (Zhu); and Department of Psychology, Harvard University, Cambridge, Mass. (McLaughlin).
Am J Psychiatry. 2021 Nov;178(11):1026-1036. doi: 10.1176/appi.ajp.2021.20081192. Epub 2021 Aug 19.
Childhood abuse represents one of the most potent risk factors for developing psychopathology, especially in females. Evidence suggests that exposure to early-life adversity may be related to advanced maturation of emotion processing neural circuits. However, it remains unknown whether abuse is related to early circuit maturation and whether maturation patterns depend on the presence of psychopathology.
A multisite sample of 234 girls (ages 8-18 years) completed clinical assessment, maltreatment histories, and high-resolution T-weighted structural MRI. Girls were stratified by abuse history and internalizing disorder diagnosis into typically developing (no abuse/no diagnosis), resilient (abuse/no diagnosis), and susceptible (abuse/current diagnosis) groups. Machine learning models of normative brain development were aggregated in a stacked generalization framework trained to predict chronological age using gray matter volume in whole-brain, emotion, and language circuit parcellations. Brain age gap estimations (BrainAGEs; predicted age minus true chronological age) were calculated as indices of relative circuit maturation.
Childhood abuse was related to reduced BrainAGE (delayed maturation) specific to emotion circuits. Delayed emotion circuit BrainAGE was further related to increased hyperarousal symptoms. Childhood physical neglect was associated with increased whole-brain BrainAGE (advanced maturation). Neural contributors to emotion circuit BrainAGE differed in girls with and without an internalizing diagnosis, especially in the lateral prefrontal, parietal, and insular cortices and the hippocampus.
Abuse exposure in girls is associated with a delayed structural maturation pattern specific to emotion circuitry, a potentially adaptive mechanism enhancing threat generalization. Physical neglect, on the other hand, is associated with a broader brain-wide pattern of advanced structural maturation. The differential influence of fronto-parietal cortices and the hippocampus on emotion circuit maturity in resilient girls may represent neurodevelopmental markers of reduced psychiatric risk following abuse.
童年虐待是发展精神病理学的最有力风险因素之一，尤其是在女性中。有证据表明，早期生活逆境的暴露可能与情绪处理神经回路的成熟有关。然而，目前尚不清楚虐待是否与早期回路成熟有关，以及成熟模式是否取决于精神病理学的存在。
一个由 234 名女孩（年龄 8-18 岁）组成的多地点样本完成了临床评估、虐待史和高分辨率 T 加权结构磁共振成像。根据虐待史和内化障碍诊断，女孩分为典型发育（无虐待/无诊断）、有弹性（虐待/无诊断）和易受影响（虐待/当前诊断）组。使用整个大脑、情绪和语言回路分区的灰质体积，通过规范性大脑发育的机器学习模型在堆叠泛化框架中进行聚合，该框架经过训练可使用灰质体积预测年龄。大脑年龄差距估计值（BrainAGE；预测年龄减去真实年龄）被计算为相对回路成熟度的指标。
童年虐待与情绪回路特定的 BrainAGE 降低有关（成熟延迟）。情绪回路延迟的 BrainAGE 与过度唤醒症状增加进一步相关。童年身体忽视与全脑 BrainAGE 增加有关（成熟提前）。与有无内化诊断的女孩相比，情绪回路 BrainAGE 的神经贡献者不同，特别是在外侧前额叶、顶叶和岛叶皮质以及海马体中。
女孩的虐待暴露与情绪回路特定的结构成熟模式延迟有关，这是一种增强威胁泛化的潜在适应性机制。另一方面，身体忽视与广泛的全脑结构成熟模式有关。在有弹性的女孩中，前额叶-顶叶皮质和海马体对情绪回路成熟的差异影响可能代表了虐待后精神风险降低的神经发育标志物。
