精神分裂症患者的童年创伤与认知缺陷：由眶额皮层 H 形脑沟体积介导。
Childhood trauma and cognitive deficits in patients with schizophrenia: mediation by orbitofrontal cortex H-shaped sulci volume.
机构信息
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian).
From the Peking University Huilongguan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, P. R. China (L. Wang, Yin, Feng, Zhou, Huang, Zhang, Chen, Fan, S. Tan, Z. Wang, B. Tian, Y. Tan); the Department of Pharmacy, Peking University First Hospital, Beijing, P.R. China (Cui); the Department of Psychiatry, Yale University School of Medicine, New Haven, CT (Luo, Li); the Institute of Biomedicine and Translational Medicine, Department of Physiology, Faculty of Medicine, University of Tartu, Tartu, Estonia (L. Tian)
出版信息
J Psychiatry Neurosci. 2022 Jun 2;47(3):E209-E217. doi: 10.1503/jpn.210178. Print 2022 May-Jun.
BACKGROUND
A line of evidence has shown that childhood trauma and patterns of H-shaped sulci in the orbitofrontal cortex (OFC) are associated with cognitive deficits in patients with schizophrenia. Studies have also suggested that childhood trauma is associated with OFC volumetrics. This study investigated the interrelationship between childhood trauma, OFC H-shaped sulci volume and cognitive function in patients with first-episode schizophrenia. We hypothesized that OFC H-shaped sulci volume would mediate the relationship between childhood trauma and cognitive function in patients with first-episode schizophrenia.
METHODS
We recruited patients with first-episode schizophrenia ( = 63) and healthy controls ( = 48), and quantified OFC H-shaped sulci volumes with 3.0 T high-resolution MRI. We assessed cognitive function and childhood trauma experiences using the MATRICS Consensus Cognitive Battery (MCCB) and the Childhood Trauma Questionnaire (CTQ).
RESULTS
Patients with first-episode schizophrenia had smaller left OFC H-shaped sulci volumes, more severe childhood trauma experiences and worse cognitive function than healthy controls. CTQ total score and emotional and physical neglect subscores were negatively correlated with left OFC H-shaped sulci volume. CTQ total score and emotional neglect and sexual abuse subscores were negatively correlated with cognitive function in patients with first-episode schizophrenia. Interestingly, the CTQ total score and physical neglect subscore were positively correlated with cognitive function in healthy controls. Left OFC H-shaped sulci volume played a mediating role in CTQ emotional neglect subscore, CTQ total score and MCCB composite score.
LIMITATIONS
The small sample size and retrospective design need to be considered.
CONCLUSION
Childhood trauma might contribute to cognitive deficits in patients with first-episode schizophrenia by affecting left OFC H-shaped sulci volume. This finding can help in the design of strategies to improve cognitive function in patients with first-episode schizophrenia.
背景
有证据表明，童年创伤和眶额皮质（OFC）H 形沟的模式与精神分裂症患者的认知缺陷有关。研究还表明，童年创伤与 OFC 体积有关。本研究调查了首发精神分裂症患者童年创伤、OFC H 形沟体积与认知功能之间的相互关系。我们假设 OFC H 形沟体积将介导首发精神分裂症患者童年创伤与认知功能之间的关系。
方法
我们招募了首发精神分裂症患者（n=63）和健康对照组（n=48），并使用 3.0T 高分辨率 MRI 量化 OFC H 形沟体积。我们使用 MATRICS 共识认知电池（MCCB）和童年创伤问卷（CTQ）评估认知功能和童年创伤经历。
结果
首发精神分裂症患者的左 OFC H 形沟体积较小，童年创伤经历更严重，认知功能更差，与健康对照组相比。CTQ 总分和情感忽视及躯体忽视子量表与左 OFC H 形沟体积呈负相关。CTQ 总分和情感忽视及性虐待子量表与首发精神分裂症患者的认知功能呈负相关。有趣的是，CTQ 总分和躯体忽视子量表与健康对照组的认知功能呈正相关。左 OFC H 形沟体积在 CTQ 情感忽视子量表、CTQ 总分和 MCCB 综合评分中起中介作用。
局限性
需要考虑样本量小和回顾性设计的局限性。
结论
童年创伤可能通过影响左 OFC H 形沟体积导致首发精神分裂症患者认知缺陷。这一发现有助于设计改善首发精神分裂症患者认知功能的策略。
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