Intrinsic Brain Abnormalities In Early Adult Female MDD With Childhood Trauma:A Resting-state Functional Magnetic Resonance Imaging Study

【Objective】Based on previous studies,early adulthood,female and childhood trauma are risk factors for depression.The neural mechanism of the occurrence and development of depression is not yet clear.We attempted to explore changes in brain function in depression and childhood trauma using resting state MRI in early adult female.【Method】Using the childhood trauma questionnaire,we divided the depressed patients and healthy controls into 4 groups,which were the depression with childhood trauma,the depression without childhood trauma,the healthy control with childhood trauma and the healthy control without childhood trauma.All depressed subjects were evaluated by Hamilton Depression Scale(HAMD),and all subjects were evaluated by resting state functional magnetic resonance imaging(rs-f MRI).We used amplitude of low-frequency fluctuation(ALFF)to assess regional brain activity.In addition,functional connectivity(FC)analysis was conducted with the ALFF altered regions as seed regions to explore the functional connectivity patterns of regional brain regions.A total of 80 subjects were collected in this study,of which 6 subjects were excluded due to inability to complete MRI or excessive head movement.Finally,we collected 19 cases of depression with childhood trauma,15 cases of depression without childhood trauma,20 cases of healthy control with childhood trauma and 20 cases of healthy control without childhood trauma.【Result】(1)There was no significant difference in age and years of education among the four groups.There were significant differences in CTQ score,emotional abuse score,sexual abuse score,emotional neglect score and physical neglect score among the four groups.There was also no significant difference in HAMD scores between the depressed groups.(2)In the analysis of ALFF,we found that depression had a major effect on the decrease of ALFF values in the right precuneus(62 voxels).Childhood trauma has a major effect on the decreased of ALFF values in the right lingual gyrus(59 voxels)and the increased ALFF values in the left supplementary motor area(99 voxels)and the right supplementary motor area(148 voxels).Depression and childhood trauma have interactive effect on ALFF values in the right lower cerebellum(66 voxels).A separate effect analysis was performed on the right lower cerebellum to determine the influence of the two factors on brain function.In healthy control,ALFF values in the right lower cerebellum were higher in the group with childhood trauma than in the group without childhood trauma(p=0.001).However,in depression,there was no significant difference in the ALFF value of the right lower cerebellar with and without childhood trauma(p=0.170).In the case of childhood trauma,the ALFF value of depressed patients decreased in the right lower cerebellar compared with the healthy control(p=0.042).In the absence of childhood trauma,the ALFF value of depressed patients was higher than that of healthy controls in the right lower cerebellum(p=0.013).(3)We selected the regions with major and interactive effects of depression and childhood trauma on ALFF as seed for subsequent inter-regional functional connectivity(FC)analysis.In the analysis of FC,we found that depression had a major effect on decreased functional connectivity between the right precuneus(seed)and the right superior occipital gyrus.Childhood trauma has a major effect on enhancing functional connections between the left auxiliary motor area(seed)and the left and right superior parietal gyrus.Depression and childhood trauma have interactive effect on changes in functional connections between the left supplementary motor area(seed)and the left middle occipital gyrus.We performed a separate effect analysis on the functional connection between the left supplementary motor area and the left middle occipital gyrus to determine the changes of the two factors on the functional connection between the region.In depression,the functional connections between the left supplementary motor area and the left middle occipital gyrus were higher in the group with childhood trauma than in the group without childhood trauma(p < 0.001).In healthy control,the functional connection between the left supplementary motor area and the left middle occipital gyrus decreased in the group with childhood trauma compared with the group without childhood trauma(p=0.040).In the absence of childhood trauma,the functional connectivity between the left supplementary motor area and the left middle occipital gyrus was significantly lower in depressed patients than in healthy controls(p < 0.001).However,in the case of childhood trauma,there was no statistically significant difference between depressed patients and healthy controls in functional connectivity between left supplementary motor area and left middle occipital gyrus(p=0.061).(4)We used partial correlation analysis and Bonferroni correction to investigate the relationship between regional brain functional activity and CTQ scale scores.The ALFF value of the right lingual gyrus was negatively correlated with the score of affective neglect(r=-0.489,p <0.001)and the total score of CTQ(r=-0.463,p < 0.001).The ALFF value of the left supplementary motor area was positively correlated with the score of emotion neglect(r=0.415,p < 0.001)and the total score of CTQ(r=0.429,p < 0.001).The ALFF value of the right supplementary motor area was positively correlated with affective neglect score(r=0.614,p < 0.001),somatic neglect score(r=0.480,p < 0.001)and CTQ total score(r=0.567,p < 0.001).There was no significant correlation between the ALFF values of the right precuneus and the right lower cerebellum and CTQ scale scores.【Conclusion】Our results reveal how childhood trauma and depression alter patterns of regional brain activity and functional connectivity in early adult female.It provides new insights into the pathophysiological mechanisms of childhood trauma and depression.