Structural and Functional Brain Abnormalities Associated With Exposure to Different Childhood Trauma Subtypes: A Systematic Review of Neuroimaging Findings.
Structural and Functional Brain Abnormalities Associated With Exposure to Different Childhood Trauma Subtypes: A Systematic Review of Neuroimaging Findings.
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DOI：
10.3389/fpsyt.2018.00329
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发表时间：
2018
影响因子：
4.7
通讯作者：
Van Den Eede F
中科院分区：
文献类型：
--
作者：
Cassiers LLM;Sabbe BGC;Schmaal L;Veltman DJ;Penninx BWJH;Van Den Eede F
背景：童年创伤亚型：性虐待、身体虐待、情感虐待和忽视可能对大脑产生持续到成年的不同影响。目前还缺乏支持这些差异效应的神经影像学发现的系统综述。目的：本系统综述旨在总结关于创伤亚型对人脑的长期差异影响的对照神经影像学试验的发现。方法：系统检索2017年1月至2018年1月的PubMed和PsycINFO数据库的文献。通过人工检索选定论文的参考文献清单和通过初始数据库检索检索到的相关评论文章清单，确定了其他论文。然后由第一作者评估研究的合格性。只有原始的人类研究直接比较暴露和未暴露的个体的神经影像学结果明确的情感，身体或性童年虐待，同时控制其他亚型的影响。考虑到研究的数量和样本量，对提取的数据进行了视觉总结，以用于创伤亚型之间的比较是可行的神经影像学模式。结果：系统检索到25篇文献。在悲伤的自传体记忆回忆过程中，性虐待与奖励回路、生殖器感觉皮层和杏仁核的结构缺陷有关。情感虐待与额边缘社会情感网络异常相关。在被忽视的个体中，涉及多种功能的几个脑网络中的白质完整性和连通性受到干扰。其他异常，如额叶皮质体积减少，在所有虐待类型中都很常见。结论：有证据表明创伤亚型对人脑的长期差异影响。观察到的改变可能是由于暴露于威胁生活事件后对大脑的保护性适应和损伤。虽然很有希望，但目前的证据是不完整的，很少有大脑区域和神经成像模式在所有亚型中进行了研究。现有证据的可比性进一步受到研究人群性别、年龄和共病精神病理异质性的限制。未来的神经影像学研究应考虑到儿童创伤亚型的潜在差异作用。
Background: Childhood trauma subtypes sexual abuse, physical abuse, emotional maltreatment, and neglect may have differential effects on the brain that persist into adulthood. A systematic review of neuroimaging findings supporting these differential effects is as yet lacking. Objectives: The present systematic review aims to summarize the findings of controlled neuroimaging trials regarding long-term differential effects of trauma subtypes on the human brain. Methods: A systematic literature search was performed using the PubMed and PsycINFO databases from January 2017 up to and including January 2018. Additional papers were identified by a manual search in the reference lists of selected papers and of relevant review articles retrieved by the initial database search. Studies were then assessed for eligibility by the first author. Only original human studies directly comparing neuroimaging findings of exposed and unexposed individuals to well-defined emotional, physical or sexual childhood maltreatment while controlling for the effects of other subtypes were included. A visual summary of extracted data was made for neuroimaging modalities for which comparison between trauma subtypes was feasible, taking the studies' numbers and sample sizes into account. Results: The systematic literature search yielded 25 publications. Sexual abuse was associated with structural deficits in the reward circuit and genitosensory cortex and amygdalar hyperreactivity during sad autobiographic memory recall. Emotional maltreatment correlated with abnormalities in fronto-limbic socioemotional networks. In neglected individuals, white matter integrity and connectivity were disturbed in several brain networks involved in a variety of functions. Other abnormalities, such as reduced frontal cortical volume, were common to all maltreatment types. Conclusions: There is some evidence for long-term differential effects of trauma subtypes on the human brain. The observed alterations may result from both protective adaptation of and damage to the brain following exposure to threatening life events. Though promising, the current evidence is incomplete, with few brain regions and neuroimaging modalities having been investigated in all subtypes. The comparability of the available evidence is further limited by the heterogeneity of study populations regarding gender, age and comorbid psychopathology. Future neuroimaging studies should take this potentially differential role of childhood trauma subtypes into account.
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通讯作者：
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