Trauma, PTSD, and the Developing Brain.

Trauma, PTSD, and the Developing Brain.
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DOI:
10.1007/s11920-017-0825-3
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发表时间:
2017-08-19
影响因子:
6.7
通讯作者:
Herringa RJ
Herringa RJ
中科院分区:
医学2区
文献类型:
--
作者:
Herringa RJ

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创伤后应激障碍(PTSD)在青少年中很常见,而且使人衰弱。与成人 PTSD 相比,人们对儿科 PTSD 的神经生物学以及神经发育如何改变知之甚少。这篇综述总结了最近儿科创伤后应激障碍 (PTSD) 的神经影像学研究,并讨论了对未来研究的影响。儿童创伤后应激障碍(PTSD)的特点是支持威胁处理和情绪调节的神经回路结构和功能异常。此外,横断面研究表明,与正常发育的青少年相比,患有创伤后应激障碍的青少年的额边缘发育异常。例子包括随着年龄的增长,海马体积下降、杏仁核反应性增加以及杏仁核-前额叶耦合下降。儿童创伤后应激障碍 (PTSD) 的特点是额边缘回路明显异常和发育异常。值得注意的是,随着年龄的增长,额边缘发育异常可能会导致威胁反应性增加和情绪调节能力减弱。需要对儿科 PTSD 进行纵向研究来描述个体结果,并确定当前的治疗是否能够恢复健康的神经发育。
PTSD in youth is common and debilitating. In contrast to adult PTSD, relatively little is known about the neurobiology of pediatric PTSD, nor how neurodevelopment may be altered. This review summarizes recent neuroimaging studies in pediatric PTSD and discusses implications for future study. Pediatric PTSD is characterized by abnormal structure and function in neural circuitry supporting threat processing and emotion regulation. Furthermore, cross-sectional studies suggest that youth with PTSD have abnormal frontolimbic development compared to typically developing youth. Examples include declining hippocampal volume, increasing amygdala reactivity, and declining amygdala-prefrontal coupling with age. Pediatric PTSD is characterized by both overt and developmental abnormalities in frontolimbic circuitry. Notably, abnormal frontolimbic development may contribute to increasing threat reactivity and weaker emotion regulation as youth age. Longitudinal studies of pediatric PTSD are needed to characterize individual outcomes and determine whether current treatments are capable of restoring healthy neurodevelopment.
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