Brain Dynamics Centre, The Westmead Institute for Medical Research, University of Sydney, Westmead, New South Wales, Australia.
Discipline of Psychiatry, Sydney Medical School, Westmead, New South Wales, Australia.
JAMA Netw Open. 2023 Jan 3;6(1):e2253082. doi: 10.1001/jamanetworkopen.2022.53082.
More than 10% of children experience sexual, physical, or emotional abuse, and abuse experienced during sensitive neurodevelopmental periods is associated with a greater risk of psychiatric disorders.
To investigate the extent to which a history of abuse is associated with alterations in the intrinsic functional connectome of the adult brain independent from the restriction of associated psychiatric conditions.
DESIGN, SETTING, AND PARTICIPANTS: This cohort study assessed data from 768 adult participants from the greater Sydney, Australia, area who were included in the study without diagnostic restrictions and categorized based on a history of childhood sexual, physical, and/or emotional abuse. Data were collected from January 1, 2009, to December 31, 2015; data analysis was performed from October 1, 2020, to March 31, 2022.
Outcomes were structured psychiatric interview responses, self-report of the frequency and extent of various types of negative experiences in childhood and adolescence, and intrinsic functional connectivity derived from 5 functional magnetic resonance imaging tasks and estimated among 436 brain regions, comprising intranetwork and internetwork connectivity of 8 large-scale brain networks.
Among the 647 individuals with usable data (330 female [51.0%]; mean [SD] age, 33.3 [12.0] years; age range, 18.2-69.2 years), history of abuse was associated with greater likelihood of a current psychiatric illness (odds ratio, 4.55; 95% CI, 3.07-6.72; P < .001) and with greater depressive, anxiety, and stress symptoms (mean difference, 20.4; 95% CI, 16.1-24.7; P < .001). An altered connectome signature of higher connectivity within somatomotor, dorsal, and ventral attention networks and between these networks and executive control and default mode networks was observed in individuals with a history of abuse experienced during childhood (n = 127) vs those without a history of abuse (n = 442; mean difference, 0.07; 95% CI, 0.05-0.08; familywise, Bonferroni-corrected P = .01; Cohen d = 0.82) and compared with those who experienced abuse in adolescence (n = 78; mean difference, 0.06; 95% CI, 0.04-0.08]; familywise, Bonferroni-corrected P < .001; Cohen d = 0.68). Connectome alterations were not observed for those who experienced abuse in adolescence. Connectivity of this signature was transdiagnostic and independent of the nature and frequency of abuse, sex, or current symptomatic state.
Findings highlight the associations of exposure to abuse before and during adolescence with the whole-brain functional connectome. The experience of child abuse was found to be associated with physiologic changes in intrinsic connectivity, independent of psychopathology, in a way that may affect functioning of systems responsible for perceptual processing and attention.
超过 10%的儿童经历过性、身体或情感虐待，而在敏感的神经发育期间经历的虐待与更高的精神疾病风险相关。
研究在不受相关精神疾病限制的情况下，虐待史与成人大脑内在功能连接体的改变之间的关联程度。
设计、地点和参与者：本队列研究评估了来自澳大利亚大悉尼地区的 768 名成年参与者的数据，这些参与者在研究中没有诊断限制，并根据儿童期性、身体和/或情感虐待的历史进行分类。数据收集于 2009 年 1 月 1 日至 2015 年 12 月 31 日；数据分析于 2020 年 10 月 1 日至 2022 年 3 月 31 日进行。
结局是结构化的精神科访谈反应、自我报告的童年和青春期各种类型的负面经历的频率和程度，以及从 5 个功能磁共振成像任务中得出的内在功能连接体，并在 436 个大脑区域中进行了估计，包括 8 个大的大脑网络的内部和网络间连接体。
在 647 名具有可用数据的个体中（330 名女性[51.0%]；平均[标准差]年龄为 33.3[12.0]岁；年龄范围为 18.2-69.2 岁），虐待史与当前精神疾病的发生几率更高相关（优势比，4.55；95%置信区间，3.07-6.72；P < .001），抑郁、焦虑和压力症状也更严重（平均差异，20.4；95%置信区间，16.1-24.7；P < .001）。与没有虐待史的 442 名参与者相比（n = 442；平均差异，0.07；95%置信区间，0.05-0.08；家庭加权，Bonferroni 校正 P = .01；Cohen d = 0.82），以及与青春期经历过虐待的 78 名参与者相比（n = 78；平均差异，0.06；95%置信区间，0.04-0.08；家庭加权，Bonferroni 校正 P < .001；Cohen d = 0.68），有虐待史的个体的内在网络、背侧注意网络和腹侧注意网络之间的连接体存在更高的连接体特征。在青春期经历过虐待的个体中没有观察到连接体的改变。这种特征的连接是跨诊断的，与虐待的性质和频率、性别或当前症状状态无关。
研究结果强调了在青春期之前和期间经历虐待与全脑功能连接体之间的关联。虐待的经历与内在连通性的生理变化有关，而与精神病理学无关，这可能会影响负责感知处理和注意力的系统的功能。
