Department of Behavioral Medicine, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan; Department of Clinical and Cognitive Neuroscience, School of Medicine, Toyama University, Toyama, Japan.
Department of Clinical and Cognitive Neuroscience, School of Medicine, Toyama University, Toyama, Japan.
Front Neuroendocrinol. 2022 Apr;65:100994. doi: 10.1016/j.yfrne.2022.100994. Epub 2022 Mar 21.
Adverse childhood experiences (ACEs) may leave long-lasting neurobiological scars, increasing the risk of developing mental disorders in later life. However, no review has comprehensively integrated existing evidence across the fields: hypothalamic-pituitary-adrenal axis, immune/inflammatory system, neuroimaging, and genetics/epigenetics. We thus systematically reviewed previous meta-analyses towards an integrative account of ACE-related neurobiological alterations. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, a total of 27 meta-analyses until October 2021 were identified. This review found that individuals with ACEs possess blunted cortisol response to psychosocial stressors, low-grade inflammation evinced by increased C-reactive protein levels, exaggerated amygdalar response to emotionally negative information, and diminished hippocampal gray matter volume. Importantly, these alterations were consistently observed in those with and without psychiatric diagnosis. These findings were integrated and discussed in a schematic model of ACE-related neurobiological alterations. Future longitudinal research based on multidisciplinary approach is imperative for ACE-related mental disorders' prevention and treatment.
不良的童年经历 (ACEs) 可能会在神经生物学上留下持久的创伤,增加日后患上精神障碍的风险。然而,目前尚无综述全面综合了不同领域的现有证据:下丘脑-垂体-肾上腺轴、免疫/炎症系统、神经影像学和遗传学/表观遗传学。因此,我们系统地回顾了之前的荟萃分析,以综合阐述 ACE 相关的神经生物学改变。根据系统评价和荟萃分析的首选报告项目 (PRISMA) 指南,共确定了截至 2021 年 10 月的 27 项荟萃分析。本综述发现,经历 ACE 的个体在面对社会心理压力源时皮质醇反应迟钝,C 反应蛋白水平升高表明低度炎症,对情绪消极信息的杏仁核反应增强,海马灰质体积减小。重要的是,这些改变在有和没有精神科诊断的个体中均观察到。这些发现以 ACE 相关神经生物学改变的示意图模型进行了整合和讨论。基于多学科方法的未来纵向研究对于 ACE 相关精神障碍的预防和治疗至关重要。