胎儿期经历地震应激和抑郁症状对成年男性脑结构的影响

The effects of prenatal earthquake stress and depression on adulthood male brain structure

目的探讨胎儿期经历地震应激及抑郁情绪对成年男性脑结构的影响。方法于唐山调查胎儿期经历地震应激与未经历地震应激的男性受试者共956名,筛选符合各分组条件受试者共41名,分为应激抑郁组(n=10)、应激健康组(n=18)及对照组(n=13)。所有受试者均进行3.0 T MRI扫描采集T1加权成像,采用基于曲面的形态学方法分析影像学数据,评估大脑皮质灰质体积、厚度、表面积以及皮质下核团体积的变化。结果(1)3组年龄及HAMD17评分的差异有统计学意义(均P<0.01)。(2)脑结构比较(校正全脑体积):与对照组比较,应激健康组左侧额上回(t=3.889,P=0.031)灰质体积减小,左侧额上回(t=4.968,P=0.046)、左侧顶上叶和中央后回(t=4.362,P=0.015)、右侧顶上叶(t=4.212,P=0.010)皮质厚度降低;应激抑郁组左侧额上回(t=4.365,P=0.049)、左侧额上回和额中回(t=4.231,P=0.042)灰质体积减小,左侧额上回(t=4.878,P=0.012)、左侧顶上叶和中央后回(t=4.741,P=0.004)、右侧顶上叶(t=4.323,P=0.005)、右侧顶上叶和楔前叶(t=4.523,P=0.013)皮质厚度降低。与应激健康组比较,应激抑郁组左侧颞上回(t=4.386,P=0.027)皮质表面积减小。应激抑郁组右侧杏仁核(P=0.022)体积小于对照组。结论产前地震应激和抑郁情绪与成年男性脑结构改变有关,且产前地震应激较抑郁情绪对脑结构的影响明显,两者联合作用对成年男性脑结构的影响尤为显著。

Objective To investigate whether the male adulthood brain volumes changes are correlated to their prenatal earthquake stress experience or suffering depression after birth. Methods A total of 956 adult males born in Tangshan during the earthquake were visited, and finally 41 subjects were recruited with 10 subjects in the stress-depression group (experienced prenatal earthquake stress and developed depression after birth), 18 subjects in stress-health group (experienced prenatal earthquake stress but no history of mental disorders after birth), and 13 blank control. 3.0 T magnetic resonance imaging was conducted on all subjects to record T1-weighted imaging. The curved surface-based morphology approach was employed to analyze the images, and to assess the changes in cortical gray matter volume, cortical thickness, cortical surface area, and subcortical nuclear volume. Results (1) There was significant difference in the age and HAMD17 score among the three groups (P<0.01).(2) Compared with the blank control group and corrected by whole brain volume, the gray matter volume of the left superior frontal gyrus (t=3.889, P=0.031) was significantly smaller in the stress-health group;the cortical thickness of the left superior frontal gyrus (t=4.968, P=0.046), left superior parietal lobule, left postcentral gyrus (t=4.362, P=0.015), and the right superior parietal lobule (t=4.212, P=0.010) significantly reduced in the stress-health group;the gray matter volume of the left superior frontal gyrus (t=4.365, P=0.049), and the left superior and middle frontal gyrus (t=4.231, P=0.042) in the stress-depression group significantly reduced;the cortical thickness of left superior frontal gyrus (t=4.878, P=0.012), left superior parietal lobule, left postcentral gyrus (t=4.741, P=0.004), right superior parietal lobule (t=4.323, P=0.005), right superior parietal lobule and the right precuneus (t=4.523, P=0.013) significantly decreased in the stress-depression group. Furthermore, the cortical surface area of left superior temporal gyrus (t=4.386, P=0.027) in the stress-depression group is significantly smaller than the stress-health group. And the volume of the right amygdala (P=0.022) in the stress-depression group also decreased in comparison with the blank control group. Conclusions The prenatal earthquake stress and later developing depression after birth may result in the change of their adulthood brain volumes, probably with more contribution coming from the prenatal earthquake stress. The biggest change can be observed in the ones who have both factors as a synergistic effect.