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Sheppard M, Rasgado-Toledo J, Duncan N, Elliott R, Garza-Villarreal EA, Muhlert N. Noradrenergic Alterations Associated with Early Life Stress. Neurosci Biobehav Rev 2024:105832. [PMID: 39084582 DOI: 10.1016/j.neubiorev.2024.105832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/14/2024] [Accepted: 07/27/2024] [Indexed: 08/02/2024]
Abstract
Significant stress in childhood or adolescence is linked to both structural and functional changes in the brain in human and analogous animal models. In addition, neuromodulators, such as noradrenaline (NA), show life-long alterations in response to these early life stressors, which may impact upon the sensitivity and time course of key adrenergic activities, such as rapid autonomic stress responses (the 'fight or flight response'). The locus-coeruleus noradrenergic (LC-NA) network, a key stress-responsive network in the brain, displays numerous changes in response to significant early- life stress. Here, we review the relationship between NA and the neurobiological changes associated with early life stress and set out future lines of research that can illuminate how brain circuits and circulating neurotransmitters adapt in response to childhood stressors.
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Affiliation(s)
- Megan Sheppard
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, UK.
| | - Jalil Rasgado-Toledo
- Institute of Neurobiology, Universidad Nacional de México campus Juriquilla, Queretaro, Mexico
| | - Niall Duncan
- Graduate Institute of Mind, Brain and Consciousness, Taipei Medical University, Taiwan
| | - Rebecca Elliott
- Division of Psychology and Mental Health, University of Manchester, Manchester UK
| | | | - Nils Muhlert
- Division of Psychology, Communication and Human Neuroscience, The University of Manchester, Manchester, UK
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Ysbæk-Nielsen AT. Exploring volumetric abnormalities in subcortical L-HPA axis structures in pediatric generalized anxiety disorder. Nord J Psychiatry 2024; 78:402-410. [PMID: 38573199 DOI: 10.1080/08039488.2024.2335980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 03/22/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Pediatric generalized anxiety disorder (GAD) is debilitating and increasingly prevalent, yet its etiology remains unclear. Some believe the disorder to be propagated by chronic dysregulation of the limbic-hypothalamic-pituitary-adrenal (L-HPA) axis, but morphometric studies of implicated subcortical areas have been largely inconclusive. Recognizing that certain subcortical subdivisions are more directly involved in L-HPA axis functioning, this study aims to detect specific abnormalities in these critical areas. METHODS Thirty-eight MRI scans of preschool children with (n = 15) and without (n = 23) GAD underwent segmentation and between-group volumetric comparisons of the basolateral amygdala (BLA), ventral hippocampal subiculum (vSC), and mediodorsal medial magnocellular (MDm) area of the thalamus. RESULTS Children with GAD displayed significantly larger vSC compared to healthy peers, F(1, 31) = 6.50, pFDR = .048. On average, children with GAD presented with larger BLA and MDm, Fs(1, 31) ≥ 4.86, psFDR ≤ .054. Exploratory analyses revealed right-hemispheric lateralization of all measures, most notably the MDm, F(1, 31) = 8.13, pFDR = .024, the size of which scaled with symptom severity, r = .83, pFDR = .033. CONCLUSION The BLA, vSC, and MDm are believed to be involved in the regulation of anxiety and stress, both individually and collectively through the excitation and inhibition of the L-HPA axis. All were found to be enlarged in children with GAD, perhaps reflecting hypertrophy related to hyperexcitability, or early neuronal overgrowth. Longitudinal studies should investigate the relationship between these early morphological differences and the long-term subcortical atrophy previously observed.
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Oshri A, Reck AJ, Carter SE, Uddin LQ, Geier CF, Beach SRH, Brody GH, Kogan SM, Sweet LH. Racial Discrimination and Risk for Internalizing and Externalizing Symptoms Among Black Youths. JAMA Netw Open 2024; 7:e2416491. [PMID: 38865126 PMCID: PMC11170300 DOI: 10.1001/jamanetworkopen.2024.16491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/11/2024] [Indexed: 06/13/2024] Open
Abstract
Importance Racial discrimination is a psychosocial stressor associated with youths' risk for psychiatric symptoms. Scarce data exist on the moderating role of amygdalar activation patterns among Black youths in the US. Objective To investigate the association between racial discrimination and risk for psychopathology moderated by neuroaffective processing. Design, Setting, and Participants This cohort study used longitudinal self-report and functional magnetic resonance imaging (fMRI) data from Black youth participants in the US from the Adolescent Brain Cognitive Development (ABCD) study. Data were analyzed from January 2023 to May 2024. Exposures At time 1 of the current study (12 months after baseline), youths self-reported on their experiences of interpersonal racial discrimination and their feelings of marginalization. Amygdalar response was measured during an emotionally valenced task that included blocks of faces expressing either neutral or negative emotion. Main Outcomes and Measures At 24 and 36 months after baseline, youths reported their internalizing (anxiety and depressive symptoms) and externalizing symptoms (aggression and rule-breaking symptoms). Results A total of 1596 youths were a mean (SD) age of 10.92 (0.63) years, and 803 were female (50.3%). Families in the study had a mean annual income range of $25 000 to $34 999. Two factors were derived from factor analysis: interpersonal racial discrimination and feelings of marginalization (FoM). Using structural equation modeling in a linear regression, standardized β coefficients were obtained. Neural response to faces expressing negative emotion within the right amygdala significantly moderated the association between FoM and changes in internalizing symptoms (β = -0.20; 95% CI, -0.32 to -0.07; P < .001). The response to negative facial emotion within the right amygdala significantly moderated the association between FoM and changes in externalizing symptoms (β = 0.24; 95% CI, 0.04 to 0.43; P = .02). Left amygdala response to negative emotion significantly moderated the association between FoM and changes in externalizing symptoms (β = -0.16; 95% CI, -0.32 to -0.01; P = .04). Conclusions and Relevance In this cohort study of Black adolescents in the US, findings suggest that amygdala function in response to emotional stimuli can both protect and intensify the affective outcomes of feeling marginalized on risk for psychopathology, informing preventive interventions aimed at reducing the adverse effects of racism on internalizing and externalizing symptoms among Black youths.
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Affiliation(s)
- Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens
| | - Ava Jane Reck
- Department of Human Development and Family Science, University of Georgia, Athens
| | | | - Lucina Q. Uddin
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
| | - Charles F. Geier
- Department of Human Development and Family Science, University of Georgia, Athens
| | - Steven R. H. Beach
- Center of Family Research, University of Georgia, Athens
- Department of Psychology, University of Georgia, Athens
| | - Gene H. Brody
- Center of Family Research, University of Georgia, Athens
| | - Steven M. Kogan
- Department of Human Development and Family Science, University of Georgia, Athens
- Center of Family Research, University of Georgia, Athens
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Vasupanrajit A, Maes M, Jirakran K, Tunvirachaisakul C. Complex Intersections Between Adverse Childhood Experiences and Negative Life Events Impact the Phenome of Major Depression. Psychol Res Behav Manag 2024; 17:2161-2178. [PMID: 38826678 PMCID: PMC11144407 DOI: 10.2147/prbm.s458257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 04/27/2024] [Indexed: 06/04/2024] Open
Abstract
Background There is evidence that adverse childhood experiences (ACEs) and negative life events (NLEs) are associated with major depression (MDD). Purpose To determine whether ACEs affect all features of mild MDD, including suicidal tendencies, brooding, neuroticism, insomnia, cognitive deficits, severity of depression and anxiety, and cognitive deficits, and whether NLEs mediate these effects. Sample of the Study and Methods This study examines a cohort of 118 academic students, namely 74 students who satisfied the DSM-5-TR criteria for MDD and 44 normal control students. We assessed brooding, neuroticism, suicidal ideation and attempts, and the severity of depression, anxiety, insomnia, and the Stroop tests. Results One validated factor could be extracted from brooding, neuroticism, current suicidal behaviors, and the severity of depression, anxiety, and insomnia, labeled the phenome of depression. A large part of the variance in the phenome of depression (55.0%) was explained by the combined effects of self-, relationships, and academic-related NLEs in conjunction with ACEs, including family dysfunction and abuse and neglect (both physical and emotional). The latter ACEs significantly interacted (moderating effect) with NLEs to impact the depression phenome. Although sexual abuse did not have direct effects on the phenome, its effects were mediated by NLEs. We discovered that increased sexual abuse, physical and emotional abuse and neglect, and ACEs related to family dysfunction predicted 22.5% of the variance in NLEs. Up to 18.5% of the variance in the Stroop test scores was explained by sexual abuse and the phenome of depression. The latter mediated the effects of NLEs and abuse, neglect, and family dysfunction on the Stroop test scores. Conclusion Complex intersections between ACEs and NLEs impact the phenome of depression, which comprises neuroticism, brooding, suicidal tendencies, and the severity of insomnia, anxiety, and depression, while sexual abuse together with other ACEs and NLEs may impact cognitive interference inhibition.
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Affiliation(s)
- Asara Vasupanrajit
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ph.D.Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ph.D.Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, People’s Republic of China
- Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, People’s Republic of China
- Center of Excellence in Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Cognitive Fitness and Biopsychological Technology Research Unit, Faculty of Medicine Chulalongkorn University, Bangkok, Thailand
- Department of Psychiatry, Medical University of Plovdiv, Plovdiv, Bulgaria
- Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria
- Kyung Hee University, Seoul, Republic of Korea
| | - Ketsupar Jirakran
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ph.D.Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence for Maximizing Children’s Developmental Potential, Department of Pediatric, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Chavit Tunvirachaisakul
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Ph.D.Program in Mental Health, Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
- Center of Excellence in Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Sequeira SL, Silk JS, Jones NP, Forbes EE, Hanson JL, Hallion LS, Ladouceur CD. Pathways to adolescent social anxiety: Testing interactions between neural social reward function and perceived social threat in daily life. Dev Psychopathol 2024:1-16. [PMID: 38801123 DOI: 10.1017/s0954579424001068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Recent theories suggest that for youth highly sensitive to incentives, perceiving more social threat may contribute to social anxiety (SA) symptoms. In 129 girls (ages 11-13) oversampled for shy/fearful temperament, we thus examined how interactions between neural responses to social reward (vs. neutral) cues (measured during anticipation of peer feedback) and perceived social threat in daily peer interactions (measured using ecological momentary assessment) predict SA symptoms two years later. No significant interactions emerged when neural reward function was modeled as a latent factor. Secondary analyses showed that higher perceived social threat was associated with more severe SA symptoms two years later only for girls with higher basolateral amygdala (BLA) activation to social reward cues at baseline. Interaction effects were specific to BLA activation to social reward (not threat) cues, though a main effect of BLA activation to social threat (vs. neutral) cues on SA emerged. Unexpectedly, interactions between social threat and BLA activation to social reward cues also predicted generalized anxiety and depression symptoms two years later, suggesting possible transdiagnostic risk pathways. Perceiving high social threat may be particularly detrimental for youth highly sensitive to reward incentives, potentially due to mediating reward learning processes, though this remains to be tested.
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Affiliation(s)
| | - Jennifer S Silk
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Neil P Jones
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erika E Forbes
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jamie L Hanson
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lauren S Hallion
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
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Cánepa ET, Berardino BG. Epigenetic mechanisms linking early-life adversities and mental health. Biochem J 2024; 481:615-642. [PMID: 38722301 DOI: 10.1042/bcj20230306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/22/2024] [Accepted: 04/24/2024] [Indexed: 05/15/2024]
Abstract
Early-life adversities, whether prenatal or postnatal exposure, have been linked to adverse mental health outcomes later in life increasing the risk of several psychiatric disorders. Research on its neurobiological consequences demonstrated an association between exposure to adversities and persistent alterations in the structure, function, and connectivity of the brain. Consistent evidence supports the idea that regulation of gene expression through epigenetic mechanisms are involved in embedding the impact of early-life experiences in the genome and mediate between social environments and later behavioral phenotypes. In addition, studies from rodent models and humans suggest that these experiences and the acquired risk factors can be transmitted through epigenetic mechanisms to offspring and the following generations potentially contributing to a cycle of disease or disease risk. However, one of the important aspects of epigenetic mechanisms, unlike genetic sequences that are fixed and unchangeable, is that although the epigenetic markings are long-lasting, they are nevertheless potentially reversible. In this review, we summarize our current understanding of the epigenetic mechanisms involved in the mental health consequences derived from early-life exposure to malnutrition, maltreatment and poverty, adversities with huge and pervasive impact on mental health. We also discuss the evidence about transgenerational epigenetic inheritance in mammals and experimental data suggesting that suitable social and pharmacological interventions could reverse adverse epigenetic modifications induced by early-life negative social experiences. In this regard, these studies must be accompanied by efforts to determine the causes that promote these adversities and that result in health inequity in the population.
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Affiliation(s)
- Eduardo T Cánepa
- Laboratorio de Neuroepigenética y Adversidades Tempranas, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and IQUIBICEN, CONICET, Buenos Aires, Argentina
| | - Bruno G Berardino
- Laboratorio de Neuroepigenética y Adversidades Tempranas, Departamento de Química Biológica, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and IQUIBICEN, CONICET, Buenos Aires, Argentina
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Chen S, Yin Y, Zhang Y, Jiang W, Hou Z, Yuan Y. Childhood abuse influences clinical features of major depressive disorder by modulating the functional network of the right amygdala subregions. Asian J Psychiatr 2024; 93:103946. [PMID: 38330856 DOI: 10.1016/j.ajp.2024.103946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/16/2024] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
Childhood trauma and the amygdala play essential roles in major depressive disorder (MDD) mechanisms. However, the neurobiological mechanism among them remains unclear. Therefore, we explored the relationship among the amygdala subregion's abnormal functional connectivity (FC), clinical features, and childhood trauma in MDD. We obtained resting-state functional magnetic resonance imaging (fMRI) in 115 MDD patients and 91 well-matched healthy controls (HC). Amygdala subregions were defined according to the Human Brainnetome Atlas. The case vs. control difference in FCs was extracted. After controlling for age, sex, and education years, the mediations between the detected abnormal FCs and clinical features were analyzed, including the onset age of MDD and the Hamilton Depression Scale-24 (HAMD-24) reductive rate. Compared with HC subjects, we found, only the right amygdala subregions, namely the right medial amygdala (mAmyg.R) and the right lateral amygdala (lAmyg.R), showed a significant decrease in whole-brain FCs in MDD patients. Only childhood abuse experiences were significantly associated with amygdala subregion connectivity and clinical features in MDD patients. Additionally, The FCs between the mAmyg.R and extensive frontal, temporal, and subcortical regions mediated between the early life abuses and disease onset or treatment outcome. The findings indicate that the abnormal connectivity of the right amygdala subregions is involved in MDD's pathogenesis and clinical characteristics.
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Affiliation(s)
- Suzhen Chen
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yingying Yin
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yuqun Zhang
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, China
| | - Wenhao Jiang
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Zhenghua Hou
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yonggui Yuan
- Department of Psychosomatics, ZhongDa Hospital, School of Medicine, Southeast University, Nanjing, China; Jiangsu Provincial Key Laboratory of Critical Care Medicine, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.
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Nakhid D, Patel D, McMorris CA, Gibbard WB, Tortorelli C, Pei J, Lebel C. Limbic brain subregions associated with mental health symptoms in youth with and without prenatal alcohol exposure. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2023; 47:2033-2044. [PMID: 38226747 DOI: 10.1111/acer.15181] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/20/2023] [Accepted: 08/24/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) can result in reduced brain volume and an increased risk of mental health challenges. Limbic brain structures such as the hippocampus, thalamus, and amygdala often exhibit smaller volumes in youth with PAE, and similar volume reductions are observed in unexposed youth with symptoms of depression, bipolar disorder, anxiety, and schizophrenia. However, the role of volume reductions in these brain regions in mental health challenges remains unclear for individuals with PAE. METHODS Thirty-four youth with PAE and 72 unexposed youth aged 7-16 years completed a T1-weighted magnetic resonance imaging scan. FreeSurfer was used to process and extract volumes for hippocampal subfields, thalamic subnuclei, and amygdalar subnuclei. Depression and anxiety symptoms were measured using the Behavioral Assessment System for Children (BASC-2/3-PRS), the Children's Depression Inventory, and the Multidimensional Anxiety Scale for Children. We tested whether limbic subregion volumes differed between youth with and those without PAE and whether volumes were associated with depression and/or anxiety symptoms, controlling for age and gender. RESULTS Multiple hippocampal and thalamic subregions, but not amygdalar subnuclei, were smaller in individuals with PAE. Multiple group-brain interactions were observed for depression symptoms and subregion volumes. Negative associations between anxiety and limbic subregions were observed across groups. CONCLUSIONS These findings show extensive volume reductions in the hippocampus and thalamus in youth with PAE. PAE also appears to disrupt the association between depression symptoms and limbic subregions in youth, which may have implications for interventions in these individuals. Anxiety symptoms in youth with and without PAE are similarly associated with limbic volumes.
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Affiliation(s)
- Daphne Nakhid
- Neuroscience, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Darpal Patel
- Neuroscience, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
| | - Carly A McMorris
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Werklund School of Education, School and Applied Child Psychology, University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - W Ben Gibbard
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
- Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Christina Tortorelli
- Department of Child Studies and Social Work, Mount Royal University, Calgary, Alberta, Canada
| | - Jacqueline Pei
- Department of Educational Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Catherine Lebel
- Alberta Children's Hospital Research Institute (ACHRI), University of Calgary, Calgary, Alberta, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
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Duprey EB, Handley ED, Wyman PA, Ross AJ, Cerulli C, Oshri A. Child maltreatment and youth suicide risk: A developmental conceptual model and implications for suicide prevention. Dev Psychopathol 2023; 35:1732-1755. [PMID: 36097812 PMCID: PMC10008764 DOI: 10.1017/s0954579422000414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Experiences of child abuse and neglect are risk factors for youth suicidal thoughts and behaviors. Accordingly, suicide risk may emerge as a developmental process that is heavily influenced by the rearing environment. We argue that a developmental, theoretical framework is needed to guide future research on child maltreatment and youth (i.e., adolescent and emerging adult) suicide, and to subsequently inform suicide prevention efforts. We propose a developmental model that integrates principles of developmental psychopathology and current theories of suicide to explain the association between child maltreatment and youth suicide risk. This model bears significant implications for future research on child maltreatment and youth suicide risk, and for suicide prevention efforts that target youth with child maltreatment experiences.
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Affiliation(s)
- Erinn B. Duprey
- Children’s Institute, University of Rochester, Rochester, NY, USA
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Elizabeth D. Handley
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Peter A. Wyman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Andrew J. Ross
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Catherine Cerulli
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- The Susan B. Anthony Center, University of Rochester, Rochester, NY, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
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Wronski ML, Geisler D, Bernardoni F, Seidel M, Bahnsen K, Doose A, Steinhäuser JL, Gronow F, Böldt LV, Plessow F, Lawson EA, King JA, Roessner V, Ehrlich S. Differential alterations of amygdala nuclei volumes in acutely ill patients with anorexia nervosa and their associations with leptin levels. Psychol Med 2023; 53:6288-6303. [PMID: 36464660 PMCID: PMC10358440 DOI: 10.1017/s0033291722003609] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 10/24/2022] [Accepted: 11/02/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND The amygdala is a subcortical limbic structure consisting of histologically and functionally distinct subregions. New automated structural magnetic resonance imaging (MRI) segmentation tools facilitate the in vivo study of individual amygdala nuclei in clinical populations such as patients with anorexia nervosa (AN) who show symptoms indicative of limbic dysregulation. This study is the first to investigate amygdala nuclei volumes in AN, their relationships with leptin, a key indicator of AN-related neuroendocrine alterations, and further clinical measures. METHODS T1-weighted MRI scans were subsegmented and multi-stage quality controlled using FreeSurfer. Left/right hemispheric amygdala nuclei volumes were cross-sectionally compared between females with AN (n = 168, 12-29 years) and age-matched healthy females (n = 168) applying general linear models. Associations with plasma leptin, body mass index (BMI), illness duration, and psychiatric symptoms were analyzed via robust linear regression. RESULTS Globally, most amygdala nuclei volumes in both hemispheres were reduced in AN v. healthy control participants. Importantly, four specific nuclei (accessory basal, cortical, medial nuclei, corticoamygdaloid transition in the rostral-medial amygdala) showed greater volumetric reduction even relative to reductions of whole amygdala and total subcortical gray matter volumes, whereas basal, lateral, and paralaminar nuclei were less reduced. All rostral-medially clustered nuclei were positively associated with leptin in AN independent of BMI. Amygdala nuclei volumes were not associated with illness duration or psychiatric symptom severity in AN. CONCLUSIONS In AN, amygdala nuclei are altered to different degrees. Severe volume loss in rostral-medially clustered nuclei, collectively involved in olfactory/food-related reward processing, may represent a structural correlate of AN-related symptoms. Hypoleptinemia might be linked to rostral-medial amygdala alterations.
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Affiliation(s)
- Marie-Louis Wronski
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Daniel Geisler
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Fabio Bernardoni
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Maria Seidel
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Klaas Bahnsen
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Arne Doose
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Jonas L. Steinhäuser
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Franziska Gronow
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Institute of Medical Psychology, Charité University Medicine Berlin, Berlin, Germany
| | - Luisa V. Böldt
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Charité University Medicine Berlin, Berlin, Germany
| | - Franziska Plessow
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Elizabeth A. Lawson
- Neuroendocrine Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Joseph A. King
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Stefan Ehrlich
- Translational Developmental Neuroscience Section, Division of Psychological and Social Medicine and Developmental Neurosciences, Faculty of Medicine, TU Dresden, Dresden, Germany
- Eating Disorder Treatment and Research Center, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany
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Machlin L, Egger HL, Stein CR, Navarro E, Carpenter KLH, Goel S, Patel KK, Copeland WE, Sheridan MA. Distinct Associations of Deprivation and Threat With Alterations in Brain Structure in Early Childhood. J Am Acad Child Adolesc Psychiatry 2023; 62:885-894.e3. [PMID: 36775117 PMCID: PMC10412726 DOI: 10.1016/j.jaac.2023.02.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 11/30/2022] [Accepted: 02/03/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVE The dimensional model of adversity and psychopathology hypothesizes deprivation and threat impact distinct neurobiological pathways, such as brain structure. This hypothesis has not been examined longitudinally or in young children. This study tested longitudinal associations between threat and deprivation measured in preschool and brain structure in childhood. It was hypothesized that threat would be associated with amygdala and hippocampal subcortical volume and deprivation would be associated with cortical thickness in association cortex. METHOD The study included T1-weighted scans from 72 children (5-10 years old, 54.2% female participants). Threat was measured by the presence of domestic violence, sexual abuse, physical abuse, or neighborhood violence. Deprivation was measured by the presence of neglect. Associations of deprivation or threat with brain structure were examined controlling for other dimension (deprivation or threat) and nuisance covariates using whole-brain vertex-wise analyses. Subcortical volume was extracted, and the same associations were examined using multiple regression. RESULTS Threat was associated with widespread decreases in cortical surface area across the prefrontal cortex and other regions. Threat was not associated with amygdala or hippocampal volume. Deprivation was associated with increased thickness in occipital cortex, insula, and cingulate. CONCLUSION Results suggest distinct associations of deprivation and threat on brain structure in early childhood. Threat is associated with widespread differences in surface area, and deprivation is associated with differences in cortical thickness. These observations are consistent with work in adolescence and adulthood and reflect how dimensions of adversity differentially impact neural structure.
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12
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Antoniou G, Lambourg E, Steele JD, Colvin LA. The effect of adverse childhood experiences on chronic pain and major depression in adulthood: a systematic review and meta-analysis. Br J Anaesth 2023; 130:729-746. [PMID: 37087334 PMCID: PMC10251130 DOI: 10.1016/j.bja.2023.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Revised: 02/23/2023] [Accepted: 03/04/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Adverse childhood experiences have been linked to increased multimorbidity, with physical and mental health consequences throughout life. Chronic pain is often associated with mood disorders, such as major depressive disorder (MDD); both have been linked to adverse childhood experiences. It is unclear how the effect of adverse childhood experiences on neural processing impacts on vulnerability to chronic pain, MDD, or both, and whether there are shared mechanisms. We aimed to assess evidence for central neural changes associated with adverse childhood experiences in subjects with chronic pain, MDD, or both using systematic review and meta-analysis. METHODS Electronic databases were systematically searched for neuroimaging studies of adverse childhood experiences, with chronic pain, MDD, or both. Two independent reviewers screened title, abstracts, and full text, and assessed quality. After extraction of neuroimaging data, activation likelihood estimate meta-analysis was performed to identify significant brain regions associated with these comorbidities. RESULTS Forty-nine of 2414 studies were eligible, of which 43 investigated adverse childhood experiences and MDD and six investigated adverse childhood experiences and chronic pain. None investigated adverse childhood experiences, chronic pain, and MDD together. Functional and structural brain abnormalities were identified in the superior frontal, lingual gyrus, hippocampus, insula, putamen, superior temporal, inferior temporal gyrus, and anterior cerebellum in patients with MDD exposed to adverse childhood experiences. In addition, brain function abnormalities were identified for patients with MDD or chronic pain and exposure to adverse childhood experiences in the cingulate gyrus, inferior parietal lobule, and precuneus in task-based functional MRI studies. CONCLUSIONS We found that adverse childhood experiences exposure can result in different functional and structural brain alterations in adults with MDD or chronic pain compared with those without adverse childhood experiences. SYSTEMATIC REVIEW PROTOCOL PROSPERO CRD42021233989.
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Affiliation(s)
- Georgia Antoniou
- Division of Population Health and Genomics, Medical Research Institute, University of Dundee, Dundee, UK.
| | - Emilie Lambourg
- Division of Population Health and Genomics, Medical Research Institute, University of Dundee, Dundee, UK
| | - J Douglas Steele
- Division of Imaging Science and Technology, Medical School, University of Dundee, Dundee, UK
| | - Lesley A Colvin
- Division of Population Health and Genomics, Medical Research Institute, University of Dundee, Dundee, UK
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13
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Kahhale I, Buser NJ, Madan CR, Hanson JL. Quantifying numerical and spatial reliability of hippocampal and amygdala subdivisions in FreeSurfer. Brain Inform 2023; 10:9. [PMID: 37029203 PMCID: PMC10082143 DOI: 10.1186/s40708-023-00189-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 03/24/2023] [Indexed: 04/09/2023] Open
Abstract
On-going, large-scale neuroimaging initiatives can aid in uncovering neurobiological causes and correlates of poor mental health, disease pathology, and many other important conditions. As projects grow in scale with hundreds, even thousands, of individual participants and scans collected, quantification of brain structures by automated algorithms is becoming the only truly tractable approach. Here, we assessed the spatial and numerical reliability for newly deployed automated segmentation of hippocampal subfields and amygdala nuclei in FreeSurfer 7. In a sample of participants with repeated structural imaging scans (N = 928), we found numerical reliability (as assessed by intraclass correlations, ICCs) was reasonable. Approximately 95% of hippocampal subfields had "excellent" numerical reliability (ICCs ≥ 0.90), while only 67% of amygdala subnuclei met this same threshold. In terms of spatial reliability, 58% of hippocampal subfields and 44% of amygdala subnuclei had Dice coefficients ≥ 0.70. Notably, multiple regions had poor numerical and/or spatial reliability. We also examined correlations between spatial reliability and person-level factors (e.g., participant age; T1 image quality). Both sex and image scan quality were related to variations in spatial reliability metrics. Examined collectively, our work suggests caution should be exercised for a few hippocampal subfields and amygdala nuclei with more variable reliability.
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14
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Hanson JL, Adkins DJ, Nacewicz BM, Barry KR. Impact of Socioeconomic Status on Amygdala and Hippocampus Subdivisions in Children and Adolescents. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.10.532071. [PMID: 36993362 PMCID: PMC10054998 DOI: 10.1101/2023.03.10.532071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Socioeconomic status (SES) in childhood can impact behavioral and brain development. Past work has consistently focused on the amygdala and hippocampus, two brain areas critical for emotion and behavioral responding. While there are SES differences in amygdala and hippocampal volumes, there are many unanswered questions in this domain connected to neurobiological specificity, and for whom these effects may be more pronounced. We may be able to investigate some anatomical subdivisions of these brain areas, as well as if relations with SES vary by participant age and sex. No work to date has however completed these types of analyses. To overcome these limitations, here, we combined multiple, large neuroimaging datasets of children and adolescents with information about neurobiology and SES (N=2,765). We examined subdivisions of the amygdala and hippocampus and found multiple amygdala subdivisions, as well as the head of the hippocampus, were related to SES. Greater volumes in these areas were seen for higher-SES youth participants. Looking at age- and sex-specific subgroups, we tended to see stronger effects in older participants, for both boys and girls. Paralleling effects for the full sample, we see significant positive associations between SES and volumes for the accessory basal amygdala and head of the hippocampus. We more consistently found associations between SES and volumes of the hippocampus and amygdala in boys (compared to girls). We discuss these results in relation to conceptions of "sex-as-a-biological variable" and broad patterns of neurodevelopment across childhood and adolescence. These results fill in important gaps on the impact of SES on neurobiology critical for emotion, memory, and learning.
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15
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Chang YH, Yang MH, Yao ZF, Tsai MC, Hsieh S. The Mediating Role of Brain Structural Imaging Markers in Connecting Adverse Childhood Experiences and Psychological Resilience. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020365. [PMID: 36832494 PMCID: PMC9955761 DOI: 10.3390/children10020365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/02/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
The impact of adverse childhood experiences (ACEs) on brain structure has been noticed. Resilience has been considered a protective characteristic from being mentally ill; however, the link between ACEs, psychological resilience, and brain imaging remains untested. A total of 108 participants (mean age 22.92 ± 2.43 years) completed the ACEs questionnaire and the Resilience Scale for Adults (RSA), with five subscales: personal strength (RSA_ps), family cohesion (RSA_fc), social resources (RSA_sr), social competence (RSA_sc), and future structured style (RSA_fss), and Magnetic Resonance Imaging (MRI) to acquire imaging data, and the fusion-independent component analysis was employed to determine multimodal imaging components. The results showed a significantly negative association between ACE subscales and RSA_total score (ps < 0.05). The parallel mediation model showed significant indirect mediation of mean gray matter volumes in the regions of the middle frontal gyrus, superior frontal gyrus, posterior cingulate, superior temporal gyrus, middle temporal gyrus, postcentral gyrus, middle temporal gyrus, and precuneus between childhood maltreatment and RSA_sr and RSA_sc. (ps < 0.05). This study highlighted the ACEs effect on gray matter volumes in the regions of the middle frontal gyrus, superior frontal gyrus, posterior cingulate, superior temporal gyrus, middle temporal gyrus, postcentral gyrus, middle temporal gyrus, and precuneus leading to decreased psychological resilience.
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Affiliation(s)
- Yun-Hsuan Chang
- Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Psychology, National Cheng Kung University, Tainan 70101, Taiwan
- Institute of Genomics and Bioinformatics, College of Life Sciences, National Chung Hsing University, Taichung 40227, Taiwan
| | - Meng-Heng Yang
- Department of Psychology, National Cheng Kung University, Tainan 70101, Taiwan
| | - Zai-Fu Yao
- College of Education, National Tsing Hua University, Hsinchu City, 30013, Taiwan
- Research Center for Education and Mind Sciences, National Tsing Hua University, Hsinchu City 30013, Taiwan
- Basic Psychology Group, Department of Educational Psychology and Counseling, National Tsing Hua University, Hsinchu City 30013, Taiwan
- Department of Kinesiology, National Tsing Hua University, Hsinchu City 30013, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Medical Humanities and Social Medicine, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: (M.-C.T.); (S.H.)
| | - Shulan Hsieh
- Department of Psychology, National Cheng Kung University, Tainan 70101, Taiwan
- Institute of Allied Health Sciences, National Cheng Kung University, Tainan 70101, Taiwan
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan
- Correspondence: (M.-C.T.); (S.H.)
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16
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Hansen M, Simon KR, Strack J, He X, Noble KG, Merz EC. Socioeconomic disparities in sleep duration are associated with cortical thickness in children. Brain Behav 2023; 13:e2859. [PMID: 36575851 PMCID: PMC9927856 DOI: 10.1002/brb3.2859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/11/2022] [Accepted: 12/06/2022] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Disrupted sleep has been consistently linked with lower academic achievement and worse mental health in children. Less is understood about sleep as a potential factor underlying socioeconomic differences in brain morphometry in children. The goals of this study were to investigate the associations among socioeconomic factors, sleep duration, and brain morphometry in children, and to examine the roles of the sleep environment and family routines in these associations. METHODS Participants were 5- to 9-year-old children from socioeconomically diverse families (N = 94; 61% female). Parents reported on children's weekday and weekend sleep durations, sleep environment, and family routines. High-resolution, T1-weighted structural magnetic resonance imaging (MRI) data were acquired. Analyses focused on cortical thickness, cortical surface area, and amygdala and hippocampal volume. RESULTS Results indicated that lower family income-to-needs ratio and parental education were significantly associated with shorter weekday sleep duration in children. Shorter weekday sleep duration was significantly associated with reduced thickness in the left middle temporal, right postcentral, and right superior frontal cortices and smaller basolateral but not centromedial amygdala volume. Family routines significantly mediated the associations of family income-to-needs ratio and parental education with weekday sleep duration in children. CONCLUSION These results contribute to our understanding of sleep factors as proximal mechanisms through which socioeconomic context may alter neural development during childhood.
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Affiliation(s)
- Melissa Hansen
- Department of PsychologyColorado State UniversityFort CollinsColoradoUSA
| | - Katrina R. Simon
- Department of Human DevelopmentTeachers College, Columbia UniversityNew YorkUSA
| | - Jordan Strack
- Department of PsychologyColorado State UniversityFort CollinsColoradoUSA
| | - Xiaofu He
- Department of PsychiatryColumbia University Irving Medical CenterNew YorkUSA
| | - Kimberly G. Noble
- Department of Human DevelopmentTeachers College, Columbia UniversityNew YorkUSA
| | - Emily C. Merz
- Department of PsychologyColorado State UniversityFort CollinsColoradoUSA
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17
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Sun W, Kang X, Dong X, Zeng Z, Zou Q, Su M, Zhang K, Liu G, Yu G. Effect of transcranial direct current stimulation on postpartum depression: A study protocol for a randomized controlled trial. Front Psychol 2023; 14:990162. [PMID: 36874857 PMCID: PMC9976935 DOI: 10.3389/fpsyg.2023.990162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/09/2023] [Indexed: 02/17/2023] Open
Abstract
Postpartum depression (PPD) is a complex combination of physiological, emotional, and behavioral alterations associated with postpartum chemical, social, and psychological variations. It does harm to the relationship between family members that could potentially last for years. However, standard depression treatments are not ideal for PPD, and the outcomes of these treatments are debatable. Transcranial direct current stimulation (tDCS) is an emerging technology that could provide patients with PPD with a safe and non-pharmacological treatment. tDCS can relieve depression by directly stimulating the prefrontal cortex through the excitatory effect of the anode. It may also ease depression indirectly by promoting the production and release of the neurotransmitter GABA. The mechanism of tDCS makes it an ideal therapeutic approach to treat PPD, although it has not been widely used, and its effect has not been evaluated systematically and effectively. A double-blind, randomized controlled trial will be conducted involving 240 tDCS-naive patients with PPD, who will be randomly divided into two groups. One group will receive routine clinical treatment and care with active tDCS, and the other group will receive routine clinical treatment and care with sham tDCS. Each group of patients will receive a 3-week intervention during which they will receive 20 min of active or sham tDCS 6 days per week. The Montgomery-Åsberg Depression Rating Scale will be administered before the intervention as a baseline and on each weekend throughout the intervention phase. Before and after the intervention, the Perceived Stress Scale and the Positive and Negative Affect Schedule will be evaluated. Side effects and abnormal reactions will be recorded during each treatment. As antidepressants are banned in the study, the results will not be affected by drugs and will therefore be more accurate. Nonetheless, this experiment will be conducted in a single center as a small sample experiment. Therefore, future studies are required to confirm the effectiveness of tDCS in treating PPD.
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Affiliation(s)
- Weiming Sun
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,The First Clinical Medical School, Nanchang University, Nanchang, Jiangxi, China
| | - Xizhen Kang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,The First Clinical Medical School, Nanchang University, Nanchang, Jiangxi, China
| | - Xiangli Dong
- Department of Psychosomatic Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zijian Zeng
- The First Clinical Medical School, Nanchang University, Nanchang, Jiangxi, China.,Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Qing Zou
- The First Clinical Medical School, Nanchang University, Nanchang, Jiangxi, China.,Department of Psychosomatic Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Meixiang Su
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,The First Clinical Medical School, Nanchang University, Nanchang, Jiangxi, China
| | - Ke Zhang
- Nanchang Key Laboratory of Medical and Technology Research, Nanchang University, Nanchang, Jiangxi, China
| | - Guanxiu Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,The First Clinical Medical School, Nanchang University, Nanchang, Jiangxi, China
| | - Guohua Yu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.,The First Clinical Medical School, Nanchang University, Nanchang, Jiangxi, China
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18
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Picci G, Taylor BK, Killanin AD, Eastman JA, Frenzel MR, Wang YP, Stephen JM, Calhoun VD, Wilson TW. Left amygdala structure mediates longitudinal associations between exposure to threat and long-term psychiatric symptomatology in youth. Hum Brain Mapp 2022; 43:4091-4102. [PMID: 35583310 PMCID: PMC9374891 DOI: 10.1002/hbm.25904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/14/2022] [Accepted: 04/17/2022] [Indexed: 12/04/2022] Open
Abstract
Traumatic experiences during childhood can have profound effects on stress sensitive brain structures (e.g., amygdala and hippocampus) and the emergence of psychiatric symptoms. Recent theoretical and empirical work has delineated dimensions of trauma (i.e., threat and deprivation) as having distinct neural and behavioral effects, although there are few longitudinal examinations. A sample of 243 children and adolescents were followed for three time points, with each assessment approximately 1 year apart (ages 9–15 years at Time 1; 120 males). Participants or their caregiver reported on youths' threat exposure, perceived stress (Time 1), underwent a T1‐weighted structural high‐resolution MRI scan (Time 2), and documented their subsequent psychiatric symptoms later in development (Time 3). The primary findings indicate that left amygdala volume, in particular, mediated the longitudinal association between threat exposure and subsequent internalizing and externalizing symptomatology. Greater threat exposure related to reduced left amygdala volume, which in turn differentially predicted internalizing and externalizing symptoms. Decreased bilateral hippocampal volume was related to subsequently elevated internalizing symptoms. These findings suggest that the left amygdala is highly threat‐sensitive and that stress‐related alterations may partially explain elevated psychopathology in stress‐exposed adolescents. Uncovering potential subclinical and/or preclinical predictive biomarkers is essential to understanding the emergence, progression, and eventual targeted treatment of psychopathology following trauma exposure.
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Affiliation(s)
- Giorgia Picci
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Brittany K Taylor
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA.,Department of Pharmacology & Neuroscience, Creighton University, Omaha, Nebraska, USA
| | - Abraham D Killanin
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA.,College of Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jacob A Eastman
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Michaela R Frenzel
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA
| | - Yu-Ping Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, Louisiana, USA
| | | | - Vince D Calhoun
- Mind Research Network, Albuquerque, New Mexico, USA.,Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, Emory University, Atlanta, Georgia, USA
| | - Tony W Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, Nebraska, USA.,Department of Pharmacology & Neuroscience, Creighton University, Omaha, Nebraska, USA
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19
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Luo L, Yang T, Zheng X, Zhang X, Gao S, Li Y, Stamatakis EA, Sahakian B, Becker B, Lin Q, Kendrick KM. Altered centromedial amygdala functional connectivity in adults is associated with childhood emotional abuse and predicts levels of depression and anxiety. J Affect Disord 2022; 303:148-154. [PMID: 35157948 DOI: 10.1016/j.jad.2022.02.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Childhood maltreatment is significantly associated with greater occurrence of mental disorders in adulthood such as depression and anxiety. As a key node of the limbic system, the amygdala is engaged in emotional processing and regulation and is dysfunctional in many psychiatric disorders. The present study aimed at exploring the association between childhood maltreatment and amygdala-based functional networks and their potential contributions to depression and anxiety. METHODS Totally 90 Chinese healthy volunteers participated in a resting-state fMRI experiment. Levels of childhood maltreatment experience were assessed using the Childhood Trauma Questionnaire (CTQ-SF) as well as levels of depression and anxiety. Associations between CTQ-SF scores and bilateral amygdala gray matter volume and resting-state functional connectivity (RSFC) of the amygdala and selected regions of interest were analyzed using multiple regression analyses with sex and age as covariates. A subsequent moderation analysis was performed to identify whether associations were predictive of depression and anxiety levels. RESULTS Childhood maltreatment was significantly negatively associated with RSFC between left amygdala and anterior insula. Further sub-region analyses revealed that this negative association only occurred for the left centromedial amygdala subregion, which subsequently moderated the relationship between levels of childhood emotional abuse and depression / anxiety. LIMITATIONS No psychiatric patients were involved and specific neural associations with different childhood maltreatment subtypes need to be examined in future studies. CONCLUSION The present findings provide evidence for altered RSFC of centromedial amygdala and the anterior insula associated with childhood maltreatment and which moderate levels of depression and anxiety in adulthood.
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Affiliation(s)
- Lizhu Luo
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China; Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| | - Ting Yang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Xiaoxiao Zheng
- The Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Xindi Zhang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Shan Gao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Yunge Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Emmanuel A Stamatakis
- Division of Anaesthesia, University of Cambridge, Cambridge, CB2 0QQ, UK; Department of Clinical Neurosciences, University of Cambridge, Cambridge, CB2 0QQ, UK
| | - Barbara Sahakian
- Department of Psychiatry, University of Cambridge, Cambridge, CB2 0SZ, UK
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Qiyuan Lin
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China.
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, 611731, China.
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20
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Nogovitsyn N, Addington J, Souza R, Placsko TJ, Stowkowy J, Wang J, Goldstein BI, Bray S, Lebel C, Taylor VH, Kennedy SH, MacQueen G. Childhood trauma and amygdala nuclei volumes in youth at risk for mental illness. Psychol Med 2022; 52:1192-1199. [PMID: 32940197 DOI: 10.1017/s0033291720003177] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Adults with significant childhood trauma and/or serious mental illness may exhibit persistent structural brain changes within limbic structures, including the amygdala. Little is known about the structure of the amygdala prior to the onset of SMI, despite the relatively high prevalence of trauma in at-risk youth. METHODS Data were gathered from the Canadian Psychiatric Risk and Outcome study. A total of 182 youth with a mean age of 18.3 years completed T1-weighted MRI scans along with clinical assessments that included questionnaires on symptoms of depression and anxiety. Participants also completed the Childhood Trauma and Abuse Scale. We used a novel subfield-specific amygdala segmentation workflow as a part of FreeSurfer 6.0 to examine amygdala structure. RESULTS Participants with higher trauma scores were more likely to have smaller amygdala volumes, particularly within the basal regions. Among various types of childhood trauma, sexual and physical abuse had the largest effects on amygdala subregions. Abuse-related differences in the right basal region mediated the severity of depression and anxiety symptoms, even though no participants met criteria for clinical diagnosis at the time of assessment. CONCLUSION The experience of physical or sexual abuse may leave detectable structural alterations in key regions of the amygdala, potentially mediating the risk of psychopathology in trauma-exposed youth.
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Affiliation(s)
- Nikita Nogovitsyn
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Roberto Souza
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Thea J Placsko
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Jacqueline Stowkowy
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - JianLi Wang
- Work & Mental health Research Unit, Institute of Mental Health Research, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Benjamin I Goldstein
- Centre for Youth Bipolar Disorder, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Departments of Psychiatry and Pharmacology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Signe Bray
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Catherine Lebel
- Department of Radiology, University of Calgary, Calgary, Alberta, Canada
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
- Child & Adolescent Imaging Research (CAIR) Program, Calgary, Alberta, Canada
| | - Valerie H Taylor
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Sidney H Kennedy
- Department of Psychiatry, University Health Network, Toronto, Ontario, Canada
- Department of Psychiatry, St. Michael's Hospital, Toronto, Ontario, Canada
- Arthur Sommer Rotenberg Chair in Suicide and Depression Studies, St. Michael's Hospital, Toronto, Ontario, Canada
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Glenda MacQueen
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
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21
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Picci G, Christopher-Hayes NJ, Petro NM, Taylor BK, Eastman JA, Frenzel MR, Wang YP, Stephen JM, Calhoun VD, Wilson TW. Amygdala and hippocampal subregions mediate outcomes following trauma during typical development: Evidence from high-resolution structural MRI. Neurobiol Stress 2022; 18:100456. [PMID: 35542044 PMCID: PMC9079354 DOI: 10.1016/j.ynstr.2022.100456] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 04/19/2022] [Accepted: 04/23/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Giorgia Picci
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Nicholas J. Christopher-Hayes
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Center for Mind and Brain, University of California Davis, Davis, CA, USA
| | - Nathan M. Petro
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Brittany K. Taylor
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
| | - Jacob A. Eastman
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Michaela R. Frenzel
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
| | - Yu-Ping Wang
- Department of Biomedical Engineering, Tulane University, New Orleans, LA, USA
| | | | - Vince D. Calhoun
- Mind Research Network, Albuquerque, NM, USA
- Tri-Institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - Tony W. Wilson
- Institute for Human Neuroscience, Boys Town National Research Hospital, Boys Town, NE, USA
- Department of Pharmacology & Neuroscience, Creighton University, Omaha, NE, USA
- Corresponding author. Boys Town National Research Hospital Institute for Human Neuroscience, 378 Bucher Circle, Boys Town, NE, 68010, USA.
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22
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A Review of Family Environment and Neurobehavioral Outcomes Following Pediatric Traumatic Brain Injury: Implications of Early Adverse Experiences, Family Stress, and Limbic Development. Biol Psychiatry 2022; 91:488-497. [PMID: 34772505 DOI: 10.1016/j.biopsych.2021.08.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/21/2021] [Accepted: 08/11/2021] [Indexed: 12/30/2022]
Abstract
Pediatric traumatic brain injury (TBI) is a public health crisis, with neurobehavioral morbidity observed years after an injury associated with changes in related brain structures. A substantial literature base has established family environment as a significant predictor of neurobehavioral outcomes following pediatric TBI. The neural mechanisms linking family environment to neurobehavioral outcomes have, however, received less empiric study in this population. In contrast, limbic structural differences as well as challenges with emotional adjustment and behavioral regulation in non-TBI populations have been linked to a multitude of family environmental factors, including family stress, parenting style, and adverse childhood experiences. In this article, we systematically review the more comprehensive literature on family environment and neurobehavioral outcomes in pediatric TBI and leverage the work in both TBI and non-TBI populations to expand our understanding of the underlying neural mechanisms. Thus, we summarize the extant literature on the family environment's role in neurobehavioral sequelae in children with TBI and explore potential neural correlates by synthesizing the wealth of literature on family environment and limbic development, specifically related to the amygdala. This review underscores the critical role of environmental factors, especially those predating the injury, in modeling recovery outcomes post-TBI in childhood, and discusses clinical and research implications across pediatric populations. Given the public health crisis of pediatric TBI, along with the context of sparse available medical interventions, a broader understanding of factors contributing to outcomes is warranted to expand the range of intervention targets.
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Kirsch DE, Lippard ET. Early life stress and substance use disorders: The critical role of adolescent substance use. Pharmacol Biochem Behav 2022; 215:173360. [PMID: 35219756 PMCID: PMC8983562 DOI: 10.1016/j.pbb.2022.173360] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 12/06/2021] [Accepted: 02/20/2022] [Indexed: 12/12/2022]
Abstract
Early life stress (ELS) is a well-established risk factor for many psychiatric and medical disorders, including substance use disorders (SUDs). The relationship between ELS and SUDs is complex and there are likely multiple pathways from ELS to adverse substance use outcomes. The association between ELS and substance use emerges in adolescence. Adolescence is a critical period in development during which substance exposure markedly increases risk for SUDs. Therefore, this review focuses on the literature supporting the hypothesis that ELS increases risk for the development of SUDs through its influence on adolescent substance use. We discuss studies substantiating the role of ELS in adolescent substance use and explore how internalizing and externalizing psychopathology may be antecedents of substance use in adolescence. We examine clinical work suggesting ELS sculpts the Hypothalamic-Pituitary-Adrenal (HPA) Axis and developing brain-particularly subcortical brain regions that underlie stress response, mesocorticolimbic brain systems associated with reward sensitivity, and prefrontal regions that underlie executive control-in a way that increases risk for adolescent substance use and SUDs. We further explore how substance use during adolescence alters structure and function of these same systems, and how brain changes following ELS and adolescent substance use may independently, additively, or interactively contribute to risk for addiction. We conclude by discussing how the current literature can inform interventions aimed at reducing risk for SUDs in individuals with a history of ELS.
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24
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Ho TC, King LS. Mechanisms of neuroplasticity linking early adversity to depression: developmental considerations. Transl Psychiatry 2021; 11:517. [PMID: 34628465 PMCID: PMC8501358 DOI: 10.1038/s41398-021-01639-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 09/11/2021] [Accepted: 09/23/2021] [Indexed: 12/17/2022] Open
Abstract
Early exposure to psychosocial adversity is among the most potent predictors of depression. Because depression commonly emerges prior to adulthood, we must consider the fundamental principles of developmental neuroscience when examining how experiences of childhood adversity, including abuse and neglect, can lead to depression. Considering that both the environment and the brain are highly dynamic across the period spanning gestation through adolescence, the purpose of this review is to discuss and integrate stress-based models of depression that center developmental processes. We offer a general framework for understanding how psychosocial adversity in early life disrupts or calibrates the biobehavioral systems implicated in depression. Specifically, we propose that the sources and nature of the environmental input shaping the brain, and the mechanisms of neuroplasticity involved, change across development. We contend that the effects of adversity largely depend on the developmental stage of the organism. First, we summarize leading neurobiological models that focus on the effects of adversity on risk for mental disorders, including depression. In particular, we highlight models of allostatic load, acceleration maturation, dimensions of adversity, and sensitive or critical periods. Second, we expound on and review evidence for the formulation that distinct mechanisms of neuroplasticity are implicated depending on the timing of adverse experiences, and that inherent within certain windows of development are constraints on the sources and nature of these experiences. Finally, we consider other important facets of adverse experiences (e.g., environmental unpredictability, perceptions of one's experiences) before discussing promising research directions for the future of the field.
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Affiliation(s)
- Tiffany C Ho
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, CA, USA.
| | - Lucy S King
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, New Orleans, LA, USA
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
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25
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Addiction as a brain disease revised: why it still matters, and the need for consilience. Neuropsychopharmacology 2021; 46:1715-1723. [PMID: 33619327 PMCID: PMC8357831 DOI: 10.1038/s41386-020-00950-y] [Citation(s) in RCA: 84] [Impact Index Per Article: 28.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/11/2020] [Accepted: 12/14/2020] [Indexed: 12/11/2022]
Abstract
The view that substance addiction is a brain disease, although widely accepted in the neuroscience community, has become subject to acerbic criticism in recent years. These criticisms state that the brain disease view is deterministic, fails to account for heterogeneity in remission and recovery, places too much emphasis on a compulsive dimension of addiction, and that a specific neural signature of addiction has not been identified. We acknowledge that some of these criticisms have merit, but assert that the foundational premise that addiction has a neurobiological basis is fundamentally sound. We also emphasize that denying that addiction is a brain disease is a harmful standpoint since it contributes to reducing access to healthcare and treatment, the consequences of which are catastrophic. Here, we therefore address these criticisms, and in doing so provide a contemporary update of the brain disease view of addiction. We provide arguments to support this view, discuss why apparently spontaneous remission does not negate it, and how seemingly compulsive behaviors can co-exist with the sensitivity to alternative reinforcement in addiction. Most importantly, we argue that the brain is the biological substrate from which both addiction and the capacity for behavior change arise, arguing for an intensified neuroscientific study of recovery. More broadly, we propose that these disagreements reveal the need for multidisciplinary research that integrates neuroscientific, behavioral, clinical, and sociocultural perspectives.
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26
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Tomasi D, Wiers CE, Manza P, Shokri-Kojori E, Michele-Vera Y, Zhang R, Kroll D, Feldman D, McPherson K, Biesecker C, Schwandt M, Diazgranados N, Koob GF, Wang GJ, Volkow ND. Accelerated Aging of the Amygdala in Alcohol Use Disorders: Relevance to the Dark Side of Addiction. Cereb Cortex 2021; 31:3254-3265. [PMID: 33629726 DOI: 10.1093/cercor/bhab006] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 02/07/2023] Open
Abstract
Here we assessed changes in subcortical volumes in alcohol use disorder (AUD). A simple morphometry-based classifier (MC) was developed to identify subcortical volumes that distinguished 32 healthy controls (HCs) from 33 AUD patients, who were scanned twice, during early and later withdrawal, to assess the effect of abstinence on MC-features (Discovery cohort). We validated the novel classifier in an independent Validation cohort (19 AUD patients and 20 HCs). MC-accuracy reached 80% (Discovery) and 72% (Validation). MC features included the hippocampus, amygdala, cerebellum, putamen, corpus callosum, and brain stem, which were smaller and showed stronger age-related decreases in AUD than HCs, and the ventricles and cerebrospinal fluid, which were larger in AUD and older participants. The volume of the amygdala showed a positive association with anxiety and negative urgency in AUD. Repeated imaging during the third week of detoxification revealed slightly larger subcortical volumes in AUD patients, consistent with partial recovery during abstinence. The steeper age-associated volumetric reductions in stress- and reward-related subcortical regions in AUD are consistent with accelerated aging, whereas the amygdalar associations with negative urgency and anxiety in AUD patients support its involvement in the "dark side of addiction".
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Affiliation(s)
- Dardo Tomasi
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | - Corinde E Wiers
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | - Peter Manza
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | | | - Yonga Michele-Vera
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | - Rui Zhang
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | - Danielle Kroll
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | - Dana Feldman
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | | | | | - Melanie Schwandt
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | - Nancy Diazgranados
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | - George F Koob
- National Institute on Drug Abuse, Bethesda, MD 21224, USA
| | - Gene-Jack Wang
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
| | - Nora D Volkow
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD 20892, USA
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27
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Oswald LM, Dunn KE, Seminowicz DA, Storr CL. Early Life Stress and Risks for Opioid Misuse: Review of Data Supporting Neurobiological Underpinnings. J Pers Med 2021; 11:315. [PMID: 33921642 PMCID: PMC8072718 DOI: 10.3390/jpm11040315] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 01/02/2023] Open
Abstract
A robust body of research has shown that traumatic experiences occurring during critical developmental periods of childhood when neuronal plasticity is high increase risks for a spectrum of physical and mental health problems in adulthood, including substance use disorders. However, until recently, relatively few studies had specifically examined the relationships between early life stress (ELS) and opioid use disorder (OUD). Associations with opioid use initiation, injection drug use, overdose, and poor treatment outcome have now been demonstrated. In rodents, ELS has also been shown to increase the euphoric and decrease antinociceptive effects of opioids, but little is known about these processes in humans or about the neurobiological mechanisms that may underlie these relationships. This review aims to establish a theoretical model that highlights the mechanisms by which ELS may alter opioid sensitivity, thereby contributing to future risks for OUD. Alterations induced by ELS in mesocorticolimbic brain circuits, and endogenous opioid and dopamine neurotransmitter systems are described. The limited but provocative evidence linking these alterations with opioid sensitivity and risks for OUD is presented. Overall, the findings suggest that better understanding of these mechanisms holds promise for reducing vulnerability, improving prevention strategies, and prescribing guidelines for high-risk individuals.
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Affiliation(s)
- Lynn M. Oswald
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA;
| | - Kelly E. Dunn
- Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21230, USA;
| | - David A. Seminowicz
- Department of Neural and Pain Sciences, School of Dentistry, University of Maryland, Baltimore, MD 21201, USA;
- Center to Advance Chronic Pain Research, University of Maryland, Baltimore, MD 21201, USA
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA;
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Kaul D, Schwab SG, Mechawar N, Matosin N. How stress physically re-shapes the brain: Impact on brain cell shapes, numbers and connections in psychiatric disorders. Neurosci Biobehav Rev 2021; 124:193-215. [PMID: 33556389 DOI: 10.1016/j.neubiorev.2021.01.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/20/2021] [Accepted: 01/31/2021] [Indexed: 12/16/2022]
Abstract
Severe stress is among the most robust risk factors for the development of psychiatric disorders. Imaging studies indicate that life stress is integral to shaping the human brain, especially regions involved in processing the stress response. Although this is likely underpinned by changes to the cytoarchitecture of cellular networks in the brain, we are yet to clearly understand how these define a role for stress in human psychopathology. In this review, we consolidate evidence of macro-structural morphometric changes and the cellular mechanisms that likely underlie them. Focusing on stress-sensitive regions of the brain, we illustrate how stress throughout life may lead to persistent remodelling of the both neurons and glia in cellular networks and how these may lead to psychopathology. We support that greater translation of cellular alterations to human cohorts will support parsing the psychological sequalae of severe stress and improve our understanding of how stress shapes the human brain. This will remain a critical step for improving treatment interventions and prevention outcomes.
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Affiliation(s)
- Dominic Kaul
- Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong 2522, Australia; Molecular Horizons, School of Chemistry and Molecular Biosciences, University of Wollongong, Northfields Ave, Wollongong 2522, Australia
| | - Sibylle G Schwab
- Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong 2522, Australia; Molecular Horizons, School of Chemistry and Molecular Biosciences, University of Wollongong, Northfields Ave, Wollongong 2522, Australia
| | - Naguib Mechawar
- Douglas Mental Health University Institute, 6875 LaSalle blvd, Verdun, Qc, H4H 1R3, Canada
| | - Natalie Matosin
- Illawarra Health and Medical Research Institute, Northfields Ave, Wollongong 2522, Australia; Molecular Horizons, School of Chemistry and Molecular Biosciences, University of Wollongong, Northfields Ave, Wollongong 2522, Australia; Max Planck Institute of Psychiatry, Kraepelinstrasse 2-10, 80804 Munich, Germany.
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29
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Aghamohammadi-Sereshki A, Coupland NJ, Silverstone PH, Huang Y, Hegadoren KM, Carter R, Seres P, Malykhin NV. Effects of childhood adversity on the volumes of the amygdala subnuclei and hippocampal subfields in individuals with major depressive disorder. J Psychiatry Neurosci 2021; 46:E186-E195. [PMID: 33497169 PMCID: PMC7955852 DOI: 10.1503/jpn.200034] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Reductions in total hippocampus volume have frequently been reported in MRI studies in major depressive disorder (MDD), but reports of differences in total amygdala volume have been inconsistent. Childhood maltreatment is an important risk factor for MDD in adulthood and may affect the volume of the hippocampus and amygdala. In the present study, we examined associations between the volumes of the amygdala subnuclei and hippocampal subfields and history of childhood maltreatment in participants with MDD. METHODS We recruited 35 patients who met the DSM-IV criteria for MDD and 35 healthy controls. We acquired MRI data sets on a 4.7 T Varian Inova scanner. We manually delineated the amygdala subnuclei (lateral, basal and accessory basal nuclei, and the cortical and centromedial groups) and hippocampal subfields (cornu ammonis, subiculum and dentate gyrus) using reliable volumetric methods. We assessed childhood maltreatment using the Childhood Trauma Questionnaire in participants with MDD. RESULTS In participants with MDD, a history of childhood maltreatment had significant negative associations with volume in the right amygdala, anterior hippocampus and total cornu ammonis subfield bilaterally. For volumes of the amygdala subnuclei, such effects were limited to the basal, accessory basal and cortical subnuclei in the right hemisphere, but they did not survive correction for multiple comparisons. We did not find significant effects of MDD or antidepressant treatment on volumes of the amygdala subnuclei. LIMITATIONS Our study was a cross-sectional study. CONCLUSION Our results provide evidence of negative associations between history of childhood maltreatment and volumes of medial temporal lobe structures in participants with MDD. This may help to identify potential mechanisms by which maltreatment leads to clinical impacts.
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Affiliation(s)
- Arash Aghamohammadi-Sereshki
- From the Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada (Aghamohammadi-Sereshki); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Coupland, Silverstone, Carter, Malykhin); the Department of Biomedical Engineering, University of Alberta, Edmonton, Alta., Canada (Huang, Carter, Seres, Malykhin); the Faculty of Nursing, University of Alberta, Edmonton, Alta., Canada (Hegadoren); and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alta., Canada (Malykhin)
| | - Nicholas J Coupland
- From the Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada (Aghamohammadi-Sereshki); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Coupland, Silverstone, Carter, Malykhin); the Department of Biomedical Engineering, University of Alberta, Edmonton, Alta., Canada (Huang, Carter, Seres, Malykhin); the Faculty of Nursing, University of Alberta, Edmonton, Alta., Canada (Hegadoren); and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alta., Canada (Malykhin)
| | - Peter H Silverstone
- From the Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada (Aghamohammadi-Sereshki); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Coupland, Silverstone, Carter, Malykhin); the Department of Biomedical Engineering, University of Alberta, Edmonton, Alta., Canada (Huang, Carter, Seres, Malykhin); the Faculty of Nursing, University of Alberta, Edmonton, Alta., Canada (Hegadoren); and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alta., Canada (Malykhin)
| | - Yushan Huang
- From the Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada (Aghamohammadi-Sereshki); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Coupland, Silverstone, Carter, Malykhin); the Department of Biomedical Engineering, University of Alberta, Edmonton, Alta., Canada (Huang, Carter, Seres, Malykhin); the Faculty of Nursing, University of Alberta, Edmonton, Alta., Canada (Hegadoren); and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alta., Canada (Malykhin)
| | - Kathleen M Hegadoren
- From the Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada (Aghamohammadi-Sereshki); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Coupland, Silverstone, Carter, Malykhin); the Department of Biomedical Engineering, University of Alberta, Edmonton, Alta., Canada (Huang, Carter, Seres, Malykhin); the Faculty of Nursing, University of Alberta, Edmonton, Alta., Canada (Hegadoren); and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alta., Canada (Malykhin)
| | - Rawle Carter
- From the Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada (Aghamohammadi-Sereshki); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Coupland, Silverstone, Carter, Malykhin); the Department of Biomedical Engineering, University of Alberta, Edmonton, Alta., Canada (Huang, Carter, Seres, Malykhin); the Faculty of Nursing, University of Alberta, Edmonton, Alta., Canada (Hegadoren); and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alta., Canada (Malykhin)
| | - Peter Seres
- From the Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada (Aghamohammadi-Sereshki); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Coupland, Silverstone, Carter, Malykhin); the Department of Biomedical Engineering, University of Alberta, Edmonton, Alta., Canada (Huang, Carter, Seres, Malykhin); the Faculty of Nursing, University of Alberta, Edmonton, Alta., Canada (Hegadoren); and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alta., Canada (Malykhin)
| | - Nikolai V Malykhin
- From the Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, Alta., Canada (Aghamohammadi-Sereshki); the Department of Psychiatry, University of Alberta, Edmonton, Alta., Canada (Coupland, Silverstone, Carter, Malykhin); the Department of Biomedical Engineering, University of Alberta, Edmonton, Alta., Canada (Huang, Carter, Seres, Malykhin); the Faculty of Nursing, University of Alberta, Edmonton, Alta., Canada (Hegadoren); and the Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alta., Canada (Malykhin)
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30
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Moss RA. Psychotherapy in pain management: New viewpoints and treatment targets based on a brain theory. AIMS Neurosci 2020; 7:194-207. [PMID: 32995484 PMCID: PMC7519970 DOI: 10.3934/neuroscience.2020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/30/2020] [Indexed: 11/24/2022] Open
Abstract
The current paper provides an explanation of neurophysiological pain processing based the Dimensional Systems Model (DSM), a theory of higher cortical functions in which the cortical column is considered the binary digit for all cortical functions. Within the discussion, novel views on the roles of the basal ganglia, cerebellum, and cingulate cortex are presented. Additionally, an applied Clinical Biopsychological Model (CBM) based on the DSM will be discussed as related to psychological treatment with chronic pain patients. Three specific areas that have not been adequately addressed in the psychological treatment of chronic pain patients will be discussed based on the CBM. The treatment approaches have been effectively used in a clinical setting. Conclusions focus on a call for researchers and clinicians to fully evaluate the value of both the DSM and CBM.
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Affiliation(s)
- Robert A. Moss
- North Mississippi Regional Pain Consultants, 4381 Eason Blvd., Tupelo, MS 38801 USA
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31
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Wymbs NF, Orr C, Albaugh MD, Althoff RR, O'Loughlin K, Holbrook H, Garavan H, Montalvo-Ortiz JL, Mostofsky S, Hudziak J, Kaufman J. Social supports moderate the effects of child adversity on neural correlates of threat processing. CHILD ABUSE & NEGLECT 2020; 102:104413. [PMID: 32065988 PMCID: PMC8060780 DOI: 10.1016/j.chiabu.2020.104413] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 01/29/2020] [Accepted: 02/05/2020] [Indexed: 06/02/2023]
Abstract
BACKGROUND Child abuse and other forms of adversity are associated with alterations in threat processing and emotion regulation brain circuits. OBJECTIVE The goal of the current investigation is to determine if the availability of positive social support can ameliorate the negative impact of adversity on these brain systems. PARTICIPANTS AND SETTING Subjects included 55 children ages 7-16 (X = 11.8, SD = 2.0). Approximately one-third of the cohort had no significant history of adversity, one-third had a history of moderate adversity, and one-third had a history of severe adversity. Brain imaging was conducted at the University of Vermont using a 3.0 T Philips scanner. METHODS The Emotional Go-NoGo task with fearful and calm facial stimuli was used to assess the neural correlates of threat processing and emotion regulation in children during functional magnetic resonance imaging (fMRI). Dimensional measures of anxiety, social supports, and children's adverse experiences were also obtained. RESULTS A conjunction analysis was used to test if trauma-related brain activation in responding to fearful vs. calm targets was impacted by social support. This approach identified multiple activation foci, including a cluster extending from the left amygdala to several other key brain regions involved in emotion regulation, including the orbitofrontal cortex, anterior cingulate cortex (ACC), anterior insula, nucleus accumbens, and frontal pole (Family Wise Error (FWE) correction, p < 0.05). CONCLUSIONS Greater social support may reduce the effect that adversity has on neural processing of threat stimuli, consistent with the protective role of positive supports in promoting resilience and recovery demonstrated in the literature.
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Affiliation(s)
- Nicholas F Wymbs
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA
| | - Catherine Orr
- Swinburne University of Technology, John St, Hawthorn, 3122, Australia; Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Matthew D Albaugh
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Robert R Althoff
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Kerry O'Loughlin
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Hannah Holbrook
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Hugh Garavan
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | | | - Stewart Mostofsky
- Center for Neurodevelopmental and Imaging Research, Kennedy Krieger Institute, 707 North Broadway, Baltimore, MD 21205, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA; Department of Neurology, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA
| | - James Hudziak
- Vermont Center for Children, Youth, and Families, Department of Psychiatry, University of Vermont, UHC Campus, Arnold 3, 1 South Prospect, Burlington, VT 05401, USA
| | - Joan Kaufman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, 1800 Orleans Street, Baltimore, MD 21287, USA; Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, 1741 Ashland Avenue, Baltimore, MD 21205, USA.
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Teicher MH, Khan A. Childhood Maltreatment, Cortical and Amygdala Morphometry, Functional Connectivity, Laterality, and Psychopathology. CHILD MALTREATMENT 2019; 24:458-465. [PMID: 31495193 PMCID: PMC8140519 DOI: 10.1177/1077559519870845] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Child maltreatment (CM) is the most important preventable risk factor for psychopathology and there is a pressing need to understand how CM gets 'under the skin' to markedly increase risk in some individuals as well as a comparable effort to identify factors associated with better than expected outcomes in other individuals. This special issue of Child Maltreatment provides a series of sophisticated studies on the neurobiological impact of CM, of which we have chosen 4 articles to comment on.The articles by Oshri et al., and Peveril, Sheridan, Busso & McLaughlin are amygdala centric and provide important new information on the impact of CM on the morphology and functional connectivity of this highly stress susceptible structure. The article by Demers et al., presents data from a longitudinal study that illustrates the potentially disruptive effects of CM on the association between maternal relationship quality, frontal cortical development and symptomatology. Finally, the De Bellis et al., study addresses the pressing question, which we have labeled the 'ecophenotype hypothesis', that postulates that maltreated and non-maltreated individuals with the same primary DSM diagnosis are clinically and neurobiologically distinct, and provides new evidence for a specific prefrontal cortical neurobiological abnormality in the maltreated subtype.
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Affiliation(s)
- Martin H Teicher
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA, and Harvard Medical School, Boston, MA, USA
| | - Alaptagin Khan
- Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA, and Harvard Medical School, Boston, MA, USA
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Koss KJ. Understanding the Neurobiological Implications of Maltreatment: A Commentary on the Special Issue. CHILD MALTREATMENT 2019; 24:452-457. [PMID: 31426661 DOI: 10.1177/1077559519869843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A large body of evidence demonstrates the deleterious effects of childhood maltreatment that span across multiple levels of functioning and throughout development. This commentary highlights the important research in this special issue of Child Maltreatment that advances our understanding of the neural and physiological implications of maltreatment. Throughout, the commentary calls attention to critical issues in the study of maltreatment and neurobiological processes for future work in this area.
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Affiliation(s)
- Kalsea J Koss
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
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Gonzalez A, Oshri A. Introduction to the Special Issue on Understanding Neurobiological Implication of Maltreatment: From Preschool to Emerging Adulthood. CHILD MALTREATMENT 2019; 24:335-339. [PMID: 31426654 DOI: 10.1177/1077559519869842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Andrea Gonzalez
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Offord Centre for Child Studies, Hamilton, Ontario, Canada
| | - Assaf Oshri
- Department of Human Development and Family Science, The Youth Development Institute, University of Georgia, Athens, GA, USA
- Neuroscience Faculty, Integrated Life Sciences, University of Georgia, Athens, GA, USA
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