Childhood trauma associated with smaller hippocampal volume in women with major depression
Childhood trauma associated with smaller hippocampal volume in women with major depression
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DOI：
10.1176/appi.ajp.159.12.2072
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发表时间：
2002-12-01
影响因子：
17.7
通讯作者：
Bremner, JD
中科院分区：
文献类型：
--
作者：
Vythilingam, M;Heim, C;Bremner, JD
目的：较小的海马体体积仅在单相严重抑郁障碍的部分研究中被报道，而不是全部。生命早期的严重应激也与较小的海马体体积和下丘脑-垂体-肾上腺轴的持续变化有关。然而，先前抑郁症患者的海马体形态计量学研究既没有报告也没有对照儿童早期创伤病史。在这项研究中，测量了有和没有童年虐待的抑郁症女性和健康的非虐待对照对象的海马区和对照脑区的体积。方法：研究参与者是32名患有当前单相严重抑郁障碍的女性-21名有青春期前身体和/或性虐待史，11名没有青春期前虐待史-14名健康的未受虐待的女性志愿者。结果：有儿童期虐待的抑郁受试者的左侧海马体平均体积比非虐待受试者小18%，左侧海马体体积比健康受试者小15%。三组受试者右侧海马区体积相似。结论：患有重度抑郁障碍的成年女性仅在儿童期有严重和长期的身体和/或性虐待病史时，其海马体体积较小。抑郁症受试者中未被报道的儿童期虐待史可以部分解释先前关于严重抑郁障碍的研究中海马体体积发现的不一致。
Objective: Smaller hippocampal volume has been reported only in some but not all studies of unipolar major depressive disorder. Severe stress early in life has also been associated with smaller hippocampal volume and with persistent changes in the hypothalamic-pituitary-adrenal axis. However, prior hippocampal morphometric studies in depressed patients have neither reported nor controlled for a history of early childhood trauma. In this study, the volumes of the hippocampus and of control brain regions were measured in depressed women with and without childhood abuse and in healthy nonabused comparison subjects.Method: Study participants were 32 women with current unipolar major depressive disorder-21 with a history of prepubertal physical and/or sexual abuse and 11 without a history of prepubertal abuse-and 14 healthy nonabused female volunteers. The volumes of the whole hippocampus, temporal lobe, and whole brain were measured on coronal MRI scans by a single rater who was blind to the subjects' diagnoses.Results: The depressed subjects with childhood abuse had an 18% smaller mean left hippocampal volume than the nonabused depressed subjects and a 15% smaller mean left hippocampal volume than the healthy subjects. Right hippocampal volume was similar across the three groups. The right and left hippocampal volumes in the depressed women without abuse were similar to those in the healthy subjects.Conclusions: A smaller hippocampal volume in adult women with major depressive disorder was observed exclusively in those who had a history of severe and prolonged physical and/or sexual abuse in childhood. An unreported history of childhood abuse in depressed subjects could in part explain the inconsistencies in hippocampal volume findings in prior studies in major depressive disorder.