Limbic Scars: Long-Term Consequences of Childhood Maltreatment Revealed by Functional and Structural Magnetic Resonance Imaging
Limbic Scars: Long-Term Consequences of Childhood Maltreatment Revealed by Functional and Structural Magnetic Resonance Imaging
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DOI：
10.1016/j.biopsych.2011.10.021
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发表时间：
2012-02-15
影响因子：
10.6
通讯作者：
Kugel, Harald
中科院分区：
文献类型：
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作者：
Dannlowski, Udo;Stuhrmann, Anja;Kugel, Harald
背景资料：童年时期的虐待是晚年患抑郁症和创伤后应激障碍的一个很大的风险因素。在本研究中，我们调查了这种关联的神经生物学基础。由于抑郁症和创伤后应激障碍都与杏仁核对负面刺激的反应性增加以及海马灰质体积减少有关，我们推测童年虐待会导致之前遭受虐待但健康的成年人出现类似的功能和结构改变。方法：通过公告和报纸公告招募了148名健康受试者，并仔细筛查了精神疾病。杏仁核的反应性是通过功能性磁共振成像和一种情绪化的面孔匹配范式来测量的，这种范式专门设计用于激活杏仁核对威胁相关面孔的反应。使用基于体素的形态测量来研究形态学改变。儿童期虐待进行了评估，由25项儿童期创伤问卷（CTQ）。结果：我们观察到一个强有力的关联CTQ分数与杏仁核的反应，以威胁相关的面部表情。形态计量学分析显示，CTQ得分高的受试者的海马、小脑、眶额皮质、前扣带回和尾状核的灰质体积减少。这两个协会没有特质焦虑，抑郁水平，年龄，智力，教育，或最近的压力生活events.Conclusions：童年虐待与显着的功能和结构的变化，甚至几十年后在成年。这些变化与抑郁症和创伤后应激障碍中描述的结果非常相似。因此，目前的研究结果可能表明，边缘系统高反应性和海马体积减少可能是儿童期逆境经历和情绪障碍发展之间的中介。
Background: Childhood maltreatment represents a strong risk factor for the development of depression and posttraumatic stress disorder (PTSD) in later life. In the present study, we investigated the neurobiological underpinnings of this association. Since both depression and PTSD have been associated with increased amygdala responsiveness to negative stimuli as well as reduced hippocampal gray matter volume, we speculated that childhood maltreatment results in similar functional and structural alterations in previously maltreated but healthy adults.Methods: One hundred forty-eight healthy subjects were enrolled via public notices and newspaper announcements and were carefully screened for psychiatric disorders. Amygdala responsiveness was measured by means of functional magnetic resonance imaging and an emotional face-matching paradigm particularly designed to activate the amygdala in response to threat-related faces. Voxel-based morphometry was used to study morphological alterations. Childhood maltreatment was assessed by the 25-item Childhood Trauma Questionnaire (CTQ).Results: We observed a strong association of CTQ scores with amygdala responsiveness to threat-related facial expressions. The morphometric analysis yielded reduced gray matter volumes in the hippocampus, insula, orbitofrontal cortex, anterior cingulate gyrus, and caudate in subjects with high CTQ scores. Both of these associations were not influenced by trait anxiety, depression level, age, intelligence, education, or more recent stressful life events.Conclusions: Childhood maltreatment is associated with remarkable functional and structural changes even decades later in adulthood. These changes strongly resemble findings described in depression and PTSD. Therefore, the present results might suggest that limbic hyperresponsiveness and reduced hippocampal volumes could be mediators between the experiences of adversities during childhood and the development of emotional disorders.