The Characteristics Of HPA Axis Function And Brain Imaging In Healthy Adults With Childhood Trauma

ObjectiveChildhood trauma is a most common psychological stressor which has adverse effects on development of children and adolescents. Childhood trauma has became a major social public-health problem worldwide. It has been reported that childhood trauma is associated with the development of multiple psychiatric disorders and unfavorable behavior patterns in later life. Although this relationship has been demonstrated in plenty of epidemiologic studies, little is known about the biological mechanisms underlying this association. In this context, the aim of the present study was to explore the impacts of childhood trauma on HPA axis function and brain imaging in a group of healthy adults, trying to provide possible evidence about the potential biological vulnerability for developing mental disorders in subjects with childhood trauma.MethodsFirstly, a survey was carried out in a group of555university students by using childhood trauma questionnaire (CTQ), self-rating depression scale (SDS), self-rating anxiety scale(SAS), dysfunctional attitudes questionnaire (DAS), social support rating scale (SSRS), and Eysenck personality questionnaire (EPQ) to explore the prevalence and psychological characteristics of childhood trauma. Secondly, twenty-four young healthy adults with childhood trauma and24age-and sex-matched controls without childhood trauma were recruited. Each participant collected salivary samples in the morning at four time points: immediately upon awakening,30,45, and60min after awakening for the assessment of cortisol awakening response (CAR). The3D T1-weighted magnetic resonance imaging (MRI), diffusion tensor imaging, and blood oxygenation level dependent functional MRI data were obtained on a Philips3.0Tesla scanner. Voxel-based morphometry, voxel-based, and regional homogeneity (ReHo)-based analyses were conducted to compare the gray matter volume, white matter fractional anisotropy (FA), and resting-state ReHo values between two groups, respectively.Results1. A total of103out of555university students had self-reported childhood trauma exposures, the prevalence rate was18.6%, a proportion of43.7%of maltreated individuals experienced at least two forms of childhood trauma, and the most common aspect of childhood trauma was physical neglect. The type and prevalence of childhood trauma did not differ in sex. Subjects with childhood trauma reported higher scores of SDS, SAS, DAS, and P and N dimensions of EPQ; while lower scores of SSRS and E dimensions of EPQ.2. Individuals with childhood trauma showed elevated salivary cortisol levels at30,45min after awakening, as well as CAR area under the curve to ground (AUCg) and area under the curve increase (AUCi). CAR AUCg was positively correlated with CTQ emotional abuse and total scores.3. Adults with self-reported childhood trauma exhibited decreased gray matter volume in the right middle cingulate gyrus, left middle frontal gyrus, and left medial prefrontal cortex. Moreover, the whole brain linear regression analysis revealed that CTQ total score was inversely associated with gray matter volume in the right middle cingulate gyrus and left middle frontal gyrus; and CAR AUCg was correlated with gray matter reduction in the right middle cingulate gyrus in maltreated adults.4. White matter FA values were reduced in two regions that were mainly located in the genu and body of the corpus callosum and the left occipital fusiform gyrus in maltreated subjects.5. Finally, the comparison of resting-state fMRI showed decreased ReHo values in bilateral insula, left superior temporal gyrus, and right inferior parietal gyrus along with increased ReHo in posterior cingulate gyrus in individuals with childhood trauma.Conclusions1. The prevalence of childhood trauma is18.6%in university students, and individuals with childhood trauma show much more depression, anxiety, distorted cognition, personality deficits and less social supports.2. Childhood trauma is associated with hyperactivity of the HPA axis, gray matter atrophy, reduced white matter integrity, and abnormal baseline brain activities in adulthood. These effects are still evident even in the absence of current psychiatric or medical symptoms, which may represent the vulnerability for developing mental disorders after childhood trauma experiences.3. In addition, the present study also demonstrates that gray matter loss in the cingulate gyrus is related to increased cortisol levels in healthy adults with childhood trauma.11...