Developmental traumatology Part II: Brain development
Developmental traumatology Part II: Brain development
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DOI：
10.1016/s0006-3223(99)00045-1
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发表时间：
1999-05-15
影响因子：
10.6
通讯作者：
Ryan, ND
中科院分区：
文献类型：
--
作者：
De Bellis, MD;Keshavan, MS;Ryan, ND
背景资料：以前的调查表明，被诊断为创伤后应激障碍（PTSD）的虐待儿童的生物应激系统的改变证据。在童年创伤经历中，儿茶酚胺能神经递质和类固醇激素水平的增加可能会对大脑发育产生不利影响。方法：在这项研究中，44名患有PTSD的虐待儿童和青少年以及61名匹配的对照组进行了全面的精神和神经心理评估以及解剖磁共振成像（MRI）脑扫描。结果：PTSD受试者的颅内和大脑体积小于对照组。调整颅内体积后，胼胝体和中后部的总中矢状面积仍然较小;而右、左和总侧脑室的比例大于对照组。脑容量与创伤后应激障碍创伤的发病年龄呈显著正相关，与虐待持续时间呈负相关。侵入性思维、回避、过度觉醒或分离症状与脑室容积呈正相关，与脑容量、总胼胝体和区域测量呈负相关。诊断效果的显著性别显示，与PTSD受虐待的女性相比，PTSD受虐待的男性胼胝体al-ea减少更大，脑容量减少的趋势更大。预测减少海马体积在成人PTSD中没有看到在这些subjects.Conclusions：这些数据表明，压倒性的压力虐待的经验，在童年与不利的大脑发育。生物精神病学1999;45：1271-1284（C）1999年生物精神病学学会。
Background: Previous investigations suggest that maltreated children with a diagnosis of posttraumatic stress disorder (PTSD) evidence alterations of biological stress systems. Increased levels of catecholaminergic neurotransmitters and steroid hormones during traumatic experiences in childhood could conceivably adversely affect brain development.Methods: In this study, 44 maltreated children and adolescents with PTSD and 61 matched controls underwent comprehensive psychiatric and neuropsychological assessments and an anatomical magnetic resonance imaging (MRI) brain scan.Results: PTSD subjects had smaller intracranial and cerebral volumes than marched controls, The total midsagittal area of corpus callosum and middle and posterior regions remained smaller; while right, left, and total lateral ventricles were proportionally larger than controls, after adjustment for intracranial volume. Brain volume robustly and positively correlated with age of onset of PTSD trauma and negatively correlated with duration of abuse. Symptoms of intrusive thoughts, avoidance, hyperarousal or dissociation correlated positively with ventricular volume, and negatively with brain volume and total corpus callosum and regional measures, Significant gender by diagnosis effect revealed greater corpus callosum al-ea reduction in maltreated males with PTSD and a trend for greater cerebral volume reduction than maltreated females with PTSD. The predicted decrease in hippocampal volume seen in adult PTSD was not seen in these subjects.Conclusions: These data suggest that the overwhelming stress of maltreatment experiences in childhood is associated with adverse brain development. Biol Psychiatry 1999;45:1271-1284 (C) 1999 Society of Biological Psychiatry.