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      Association between childhood trauma and brain anatomy in women with post-traumatic stress disorder, women with borderline personality disorder, and healthy women Translated title: Asociación entre trauma infantil y anatomía cerebral en mujeres con trastorno de estrés postraumático, mujeres con trastorno de personalidad limítrofe y mujeres sanas Translated title: 创伤后应激障碍女性, 边缘型人格障碍女性和健康女性中童年期创伤与大脑解剖结构之间的关联

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          ABSTRACT

          Background

          Childhood trauma (CT) is associated with altered brain anatomy. These neuroanatomical changes might be more pronounced in individuals with a psychiatric disorder. Post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD) are more prevalent in individuals with a history of CT.

          Objective

          In this study, we examined limbic and total brain volumes in healthy women with and without a history of CT and in females with PTSD or BPD and a history of CT to see whether neuroanatomical changes are a function of psychopathology or CT.

          Method

          In total, 128 women ( N = 70 healthy controls without CT, N = 25 healthy controls with CT, N = 14 individuals with PTSD, and N = 19 individuals with BPD) were recruited. A T1-weighted anatomical MRI was acquired from all participants for Freesurfer-based assessment of total brain, hippocampus, and amygdala volumes. Severity of CT was assessed with a clinical interview and the Childhood Trauma Questionnaire. Group differences in hippocampal and amygdala volumes (adjusted for total brain volume) and total brain volume (adjusted for height) were characterized by analysis of covariance.

          Results

          Volume of the total brain, hippocampus, and amygdala did not differ between the four groups (p > .05). CT severity correlated negatively with total brain volume across groups ( r = −0.20; p = .029).

          Conclusions

          CT was associated with reduced brain volume but PTSD or BPD was not. The association between CT and reduced brain volume as a global measure of brain integrity suggests a common origin for vulnerability to psychiatric disorders later in life.

          HIGHLIGHTS

          • No group differences (healthy women with and without CT, women with BPD and CT, women with PTSD and CT) in hippocampal, amygdala, and total brain volume.

          • Significant negative association between CT severity with total brain volume and depressive symptoms with hippocampal volumes.

          Translated abstract

          Antecedentes: El trauma infantil (TI) se asocia con alteraciones en la anatomía cerebral. Estos cambios neuroanatómicos pueden ser más pronunciados en individuos con trastornos psiquiátricos. El trastorno de estrés postraumático (TEPT) y el trastorno de personalidad limítrofe (TPL) son más prevalentes en individuos con historia de TI.

          Objetivo: En este estudio, examinamos los volúmenes límbico y cerebral total en mujeres sanas con y sin historia de TI y mujeres con TEPT o TPL e historia de TI para ver si los cambios neuroanatómicos son una función de la psicopatología o del TI.

          Método: En total, 128 mujeres ( N= 70 controles sanas sin TI, N= 25 controles sanas con TI, N= 14 individuos con TEPT y N= 19 individuos con TPL) fueron reclutadas. Se obtuvo una RNM anatómica ponderada en T1 de todas las participantes para la evaluación basada en Freesurfer de los volúmenes totales del cerebro, hipocampo y amígdala. La severidad del TI fue evaluada con una entrevista clínica y con el Cuestionario de Trauma Infantil. Las diferencias grupales en los volúmenes del hipocampo y amígdala (ajustadas por el volumen cerebral total) y el volumen cerebral total (ajustadas por altura) se caracterizaron mediante análisis de covarianza.

          Resultados: El volumen total del cerebro, hipocampo y amígdala no difirieron entre los cuatro grupos ( p > .05). La severidad del TI se correlacionó negativamente con el volumen cerebral total en todos los grupos ( r = −0.20; p =.29).

          Conclusiones: El TI estuvo asociado a un volumen cerebral reducido, pero el TEPT o TPL no se asociaron. La asociación entre TI y volumen cerebral disminuido como una medida global de la integridad cerebral sugiere un origen común de vulnerabilidad a los trastornos psiquiátricos más adelante en la vida.

          Translated abstract

          背景:童年期创伤 (CT) 与大脑解剖结构的改变有关。这些神经解剖学变化在患有精神障碍的个体中可能更为明显。创伤后应激障碍 (PTSD) 和边缘型人格障碍 (BPD) 在有 CT 历史的个体中更为普遍。

          目的:在本研究中, 我们考查了有和没有 CT 历史的健康女性以及有 CT 历史的PTSD 或 BPD 女性患者的边缘系统和总脑容量, 以确定神经解剖学变化是精神病理学还是 CT 的一个函数。

          方法:总共招募了 128 名女性 ( N= 70 名没有 CT 的健康对照, N= 25 名有 CT 的健康对照, N= 14 名PTSD 患者和 N= 19 名BPD 患者) 。从所有参与者处获取 T1 加权解剖 MRI, 用于基于 Freesurfer 的全脑, 海马和杏仁核体积评估。 CT 严重程度通过临床访谈和童年期创伤问卷进行评估。通过协方差分析来刻画海马和杏仁核体积 (控制总脑容量) 和总脑容量 (控制身高) 的组间差异。

          结果:四组之间的总脑, 海马和杏仁核的体积没有差异 ( p> .05) 。 CT 严重程度与各组的总脑容量呈负相关 ( r = −0.20; p=.029) 。

          结论:CT 与脑容量减少有关, 但 PTSD 或 BPD 则不然。 CT 与作为大脑完整性整体测量的脑容量减少之间的关联, 提示这是日后生活中易感精神障碍的一个常见原因

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          Most cited references 66

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          Allele-specific FKBP5 DNA demethylation mediates gene-childhood trauma interactions.

          Although the fact that genetic predisposition and environmental exposures interact to shape development and function of the human brain and, ultimately, the risk of psychiatric disorders has drawn wide interest, the corresponding molecular mechanisms have not yet been elucidated. We found that a functional polymorphism altering chromatin interaction between the transcription start site and long-range enhancers in the FK506 binding protein 5 (FKBP5) gene, an important regulator of the stress hormone system, increased the risk of developing stress-related psychiatric disorders in adulthood by allele-specific, childhood trauma-dependent DNA demethylation in functional glucocorticoid response elements of FKBP5. This demethylation was linked to increased stress-dependent gene transcription followed by a long-term dysregulation of the stress hormone system and a global effect on the function of immune cells and brain areas associated with stress regulation. This identification of molecular mechanisms of genotype-directed long-term environmental reactivity will be useful for designing more effective treatment strategies for stress-related disorders.
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            Whole brain segmentation: automated labeling of neuroanatomical structures in the human brain.

            We present a technique for automatically assigning a neuroanatomical label to each voxel in an MRI volume based on probabilistic information automatically estimated from a manually labeled training set. In contrast to existing segmentation procedures that only label a small number of tissue classes, the current method assigns one of 37 labels to each voxel, including left and right caudate, putamen, pallidum, thalamus, lateral ventricles, hippocampus, and amygdala. The classification technique employs a registration procedure that is robust to anatomical variability, including the ventricular enlargement typically associated with neurological diseases and aging. The technique is shown to be comparable in accuracy to manual labeling, and of sufficient sensitivity to robustly detect changes in the volume of noncortical structures that presage the onset of probable Alzheimer's disease.
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              The link between childhood trauma and depression: insights from HPA axis studies in humans.

              Childhood trauma is a potent risk factor for developing depression in adulthood, particularly in response to additional stress. We here summarize results from a series of clinical studies suggesting that childhood trauma in humans is associated with sensitization of the neuroendocrine stress response, glucocorticoid resistance, increased central corticotropin-releasing factor (CRF) activity, immune activation, and reduced hippocampal volume, closely paralleling several of the neuroendocrine features of depression. Neuroendocrine changes secondary to early-life stress likely reflect risk to develop depression in response to stress, potentially due to failure of a connected neural circuitry implicated in emotional, neuroendocrine and autonomic control to compensate in response to challenge. However, not all of depression is related to childhood trauma and our results suggest the existence of biologically distinguishable subtypes of depression as a function of childhood trauma that are also responsive to differential treatment. Other risk factors, such as female gender and genetic dispositions, interfere with components of the stress response and further increase vulnerability for depression. Similar associations apply to a spectrum of other psychiatric and medical disorders that frequently coincide with depression and are aggravated by stress. Taken together, this line of evidence demonstrates that psychoneuroendocrine research may ultimately promote optimized clinical care and help prevent the adverse outcomes of childhood trauma.
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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8198
                2000-8066
                22 September 2021
                2021
                22 September 2021
                : 12
                : 1
                Affiliations
                [a ]Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Klinik Für Psychiatrie Und Psychotherapie, Campus Benjamin Franklin; , Berlin, Germany
                [b ]Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität Zu Berlin, and Berlin Institute of Health, Institute of Medical Psychology; , Berlin, Germany
                [c ]Clinical Psychology and Psychotherapy, Department of Education and Psychology, Freie Universität; , Berlin, Germany
                [d ]Department of Cognitive Psychology, Institute of Cognitive Neuroscience, Faculty of Psychology, Ruhr University Bochum; , Bochum, Germany
                [e ]Department of Pediatrics, University of California, Irvine, CA, USA; Development, Health and Disease Research Program, University of California; , Irvine, CA, USA
                Author notes
                CONTACT Catarina Rosada catarina.rosada@ 123456charite.de Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt Universität Zu Berlin, and Berlin Institute of Health, Institute of Medical Psychology; , Campus Benjamin Franklin (CBF), Hindenburgdamm 30, Berlin 12203, Germany
                Article
                1959706
                10.1080/20008198.2021.1959706
                8462923
                © 2021 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Page count
                Figures: 3, Tables: 2, References: 68, Pages: 1
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                Research Article
                Basic Research Article

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