Department of Radiology, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, People's Republic of China.
Department of Intensive Care Unit, the Affiliated Yixing Hospital of Jiangsu University, Wuxi, People's Republic of China.
Eur J Psychotraumatol. 2023;14(2):2216624. doi: 10.1080/20008066.2023.2216624.
Losing an only child (Shidu) is a grievous traumatic event that may affect brain structure, even if it does not lead to psychiatric disorders. However, longitudinal changes in brain structure and their relationship to subclinical psychiatric symptoms (SPS) have not been well investigated in Shidu parents without any psychiatric disorders (SDNP).
This study aimed to investigate cross-sectional and longitudinal changes in cortical thickness and surface area in SDNP, and to explore their relationship with SPS.
A total of 50 SDNP and 40 matched healthy controls (HC) were enrolled. All participants underwent structural MRI scans and clinical assessment at baseline and at the 5-year follow-up. Differences in brain structural phenotypes (cortical thickness, surface area, and their annual rate of change) between the SDNP and HC groups were compared using FreeSurfer. Correlations between significant brain structural phenotypes and SPS in the SDNP group were evaluated using multiple linear regressions.
The SDNP group showed a smaller surface area in the left inferior parietal cortex than the HC group at baseline and follow-up. The SDNP group showed slower rates of cortical thinning and surface area loss in several brain regions than the HC group from baseline to follow-up. Moreover, slower rates of cortical thinning in the left insula, superior frontal cortex, and superior temporal cortex were associated with greater reductions in avoidance, depression, and trauma re-experiencing symptoms scores over time in the SDNP group, respectively.
Shidu trauma-induced structural abnormalities in the inferior parietal cortex may persist over time and be independent of the severity of psychiatric symptoms. The expansion of prefrontal, temporal, and insular cortex implicated in emotional regulation may contribute to improvements in psychiatric symptoms in Shidu parents.
失去独生子（失独）是一种严重的创伤性事件，即使不会导致精神障碍，也可能影响大脑结构。然而，在没有任何精神障碍的失独父母（SDNP）中，尚未很好地研究脑结构的纵向变化及其与亚临床精神症状（SPS）的关系。
本研究旨在探讨 SDNP 的皮质厚度和表面积的横断面和纵向变化，并探讨其与 SPS 的关系。
共纳入 50 名 SDNP 和 40 名匹配的健康对照（HC）。所有参与者在基线和 5 年随访时均接受结构 MRI 扫描和临床评估。使用 FreeSurfer 比较 SDNP 组和 HC 组之间脑结构表型（皮质厚度、表面积及其年度变化率）的差异。使用多元线性回归评估 SDNP 组中显著脑结构表型与 SPS 之间的相关性。
SDNP 组在基线和随访时的左侧顶下小叶的表面积均小于 HC 组。与 HC 组相比，SDNP 组从基线到随访期间，多个脑区的皮质变薄和表面积损失速度较慢。此外，左侧岛叶、额上回和颞上回的皮质变薄速度较慢与 SDNP 组回避、抑郁和创伤再体验症状评分随时间的降低呈正相关。
失独创伤引起的顶下小叶结构异常可能会随着时间的推移而持续存在，且与精神症状的严重程度无关。参与情绪调节的额、颞和岛叶的扩张可能有助于改善失独父母的精神症状。
