Joseph Judith, Buss Claudia, Knop Andrea, de Punder Karin, Winter Sibylle M, Spors Birgit, Binder Elisabeth, Haynes John-Dylan, Heim Christine
Charité Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Medical Psychology, Berlin, Germany.
Development, Health, and Disease Research Program, Department of Pediatrics, University of California, Irvine, Orange, CA, USA.
Neurobiol Stress. 2023 Sep 23;27:100576. doi: 10.1016/j.ynstr.2023.100576. eCollection 2023 Nov.
Childhood maltreatment profoundly alters trajectories of brain development, promoting markedly increased long-term health risks and impaired intellectual development. However, the immediate impact of maltreatment on brain development in children and the extent to which altered global brain volume contributes to intellectual development in children with maltreatment experience is currently unknown. We here utilized MRI data obtained from children within 6 months after the exposure to maltreatment to assess the association of maltreatment severity with global brain volume changes. We further assessed the association between maltreatment severity and intellectual development and tested for the mediating effect of brain volume on this association.
We used structural MRI (3T) in a sample of 49 children aged 3-5 years with maltreatment exposure, i.e. emotional and physical abuse and/or neglect within 6 months, to characterize intracranial and tissue-specific volumes. Maltreatment severity was coded using the Maternal Interview for the Classification of Maltreatment. IQ was tested at study entry and after one year using the Snijders Oomen Nonverbal Test.
Higher maltreatment severity was significantly correlated with smaller intracranial volume ( = -.393, = .008), which was mainly driven by lower total brain volume ( = -.393, = .008), which in turn was primarily due to smaller gray matter volume ( = -.454, = .002). Furthermore, smaller gray matter volume was associated with lower IQ at study entry (r = -.548, < .001) and predicted IQ one year later (r = -.493, = .004.). The observed associations were independent of potential confounding variables, including height, socioeconomic status, age and sex.
We provide evidence that greater maltreatment severity in early childhood is related to smaller brain size at a very young age with significant consequences for intellectual ability, likely setting a path for far-reaching long-term disadvantages. Insights into the molecular and neural processes that underlie the impact of maltreatment on brain structure and function are urgently needed to derive mechanism-driven targets for early intervention.
童年期虐待会深刻改变大脑发育轨迹，显著增加长期健康风险并损害智力发育。然而，虐待对儿童大脑发育的即时影响以及大脑总体积改变在有虐待经历的儿童智力发育中所起作用的程度目前尚不清楚。我们在此利用在遭受虐待后6个月内从儿童获取的MRI数据来评估虐待严重程度与大脑总体积变化之间的关联。我们进一步评估了虐待严重程度与智力发育之间的关联，并测试了脑容量在此关联中的中介作用。
我们对49名3至5岁有虐待经历（即在6个月内遭受情感和身体虐待及/或忽视）的儿童样本使用了结构MRI（3T）来表征颅内和组织特异性体积。使用《虐待分类的母亲访谈》对虐待严重程度进行编码。在研究开始时和一年后使用斯尼德斯·奥门非言语测试对智商进行测试。
更高的虐待严重程度与更小的颅内体积显著相关（r = -0.393，P = 0.008），这主要由更小的全脑体积驱动（r = -0.393，P = 0.008），而全脑体积变小又主要是由于灰质体积更小（r = -0.454，P = 0.002）。此外，更小的灰质体积与研究开始时较低的智商相关（r = -0.548，P < 0.001），并能预测一年后的智商（r = -0.493，P = 0.004）。观察到的关联独立于潜在的混杂变量，包括身高、社会经济地位、年龄和性别。
我们提供的证据表明，幼儿期更严重的虐待与非常年幼时更小的脑容量有关，对智力能力有重大影响，可能为深远的长期不利状况奠定了基础。迫切需要深入了解虐待对大脑结构和功能影响背后的分子和神经过程，以得出机制驱动的早期干预靶点。
