Effect of Early Adversity and Childhood Internalizing Symptoms on Brain Structure in Young Men.
Effect of Early Adversity and Childhood Internalizing Symptoms on Brain Structure in Young Men.
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DOI：
10.1001/jamapediatrics.2015.1486
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发表时间：
2015-10
期刊：
影响因子：
26.1
通讯作者：
Barker, Edward D.
中科院分区：
文献类型：
--
作者：
Jensen, Sarah K. G.;Dickie, Erin W.;Schwartz, Deborah H.;Evans, C. John;Dumontheil, Iroise;Paus, Tomas;Barker, Edward D.
早期逆境是一个重要的风险因素，与内化症状和大脑结构改变有关。评估早期逆境和儿童内化症状（即抑郁、焦虑）对皮质灰质（GM）体积的直接影响，以及早期逆境通过内化症状水平的增加间接与皮质灰质（GM）体积变化相关的程度。在英国一个以社区为基础的出生队列中，对生命前6年的逆境、童年和青春期早期的内化症状以及青春期晚期（18-21岁）大脑结构改变之间的关联进行了一项前瞻性调查（雅芳父母和儿童纵向研究）。该队列的参与者包括494对母子，自母亲怀孕以来一直受到监测（估计分娩日期在1991年4月1日至1992年12月31日之间）。本研究的数据收集时间为1991年4月1日至2010年11月30日；神经影像学数据于2010年9月1日至2012年11月30日收集，本研究的数据分析于2013年1月25日至2015年2月15日进行。风险因素是儿童生命前6年的逆境（包括产前暴露）和儿童7至13岁之间的内化症状。童年早期的逆境。主要结果是通过青春期晚期收集的t1加权磁共振图像测量先前与重度抑郁症相关的皮质区域的GM体积。在该分析中纳入的494名年轻男性中，早期逆境与前扣带皮层GM体积降低（β = - 0.18; P = 0.01）和楔前叶GM体积升高（β = 0.18; P = 0.009）直接相关。儿童期内化症状与右侧额上回GM体积降低相关（β = - 0.20; P = 0.002）。早期逆境也与较高水平的内化症状相关（β = 0.37; P < .001），而内化症状又与额上回体积较低相关（即间接影响）（β = - 0.08; 95% CI, - 0.14至- 0.01;P = .02）。生命早期的逆境与较高水平的内化症状以及大脑结构的改变有关。早期的逆境与大脑结构的变化直接相关，也与内化症状水平的增加有关。这些发现可能表明，除了抑郁症的影响外，通常归因于抑郁症的一些结构变异可能与早期的逆境有关。
Early adversity is an important risk factor that relates to internalizing symptoms and altered brain structure. To assess the direct effects of early adversity and child internalizing symptoms (ie, depression, anxiety) on cortical gray matter (GM) volume, as well as the extent to which early adversity associates with variation in cortical GM volume indirectly via increased levels of internalizing symptoms. A prospective investigation of associations between adversity within the first 6 years of life, internalizing symptoms during childhood and early adolescence, and altered brain structure in late adolescence (age, 18-21 years) was conducted in a community-based birth cohort in England (Avon Longitudinal Study of Parents and Children). Participants from the cohort included 494 mother-son pairs monitored since the mothers were pregnant (estimated date of delivery between April 1, 1991, and December 31, 1992). Data collection for the present study was conducted between April 1, 1991, and November 30, 2010; the neuroimaging data were collected between September 1, 2010, and November 30, 2012, and data analyses for the present study occurred between January 25, 2013, and February 15, 2015. Risk factors were adversity within the first 6 years of the child’s life (including prenatal exposure) and the child’s internalizing symptoms between age 7 and 13 years. Early childhood adversity. The main outcome was GM volume of cortical regions previously associated with major depression measured through T1-weighted magnetic resonance images collected in late adolescence. Among 494 young men included in this analysis, early adversity was directly associated with lower GM volumes in the anterior cingulate cortex (β = −.18; P = .01) and higher GM volume in the precuneus (β = .18; P = .009). Childhood internalizing symptoms were associated with lower GM volume in the right superior frontal gyrus (β = −.20; P = .002). Early adversity was also associated with higher levels of internalizing symptoms (β = .37; P < .001), which, in turn, were associated with lower superior frontal gyrus volume (ie, an indirect effect) (β = −.08; 95% CI, −0.14 to −0.01; P = .02). Adversity early in life was associated with higher levels of internalizing symptoms as well as with altered brain structure. Early adversity was related to variation in brain structure both directly and via increased levels of internalizing symptoms. These findings may suggest that some of the structural variation often attributed to depression might be associated with early adversity in addition to the effect of depression.
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