By Tamara Mathias
Abuse during childhood may cause physical changes to the human brain that in turn may render adults more vulnerable to depression, research suggests.
In their study of people with major depressive disorder, two separate aspects of patients' history were both linked with alterations in brain structure: childhood maltreatment, and more severe and recurrent depression.
"It has been established for a very, very long time that childhood trauma is a major risk factor for the development of depression, and also that childhood trauma is associated with changes in the brain," study author Dr. Nils Opel from the University of Münster in Germany told Reuters Health in a phone call.
"What we did was to actually show that the alterations in the brain are directly connected to the clinical outcome. This is new."
The two-year observational study enrolled 110 patients, ages 18 to 60, who were hospitalized following a diagnosis of major depression. At the start, all participants had magnetic resonance imaging (MRI) of the brain and answered a questionnaire that assessed the level of maltreatment they experienced as children.
Over the next two years, more than two-thirds of participants experienced a relapse, according to a report online March 21 in Lancet Psychiatry.
The brain scans showed that abuse during childhood and recurring depression were linked to similar reductions in the surface area of the insular cortex - a part of the brain believed to help regulate emotion and self-awareness.
"I think the most important implication of our study is that we can show that traumatized patients differ from non-traumatized patients in a way that they are at increased risk for more recurrent depression and that they are also different in terms of brain structure and neurobiology," Opel said.
It's unclear, however, whether the findings will eventually lead to new treatment approaches.
Child and adolescent psychiatrist Dr. Morris Zwi, who recently retired from The Whittington Health NHS Trust in London, said that while the study results don't indicate whether changes in the brain observed can be reversed, they provide a starting point for more research.
"There is a lot of interest in brain plasticity at the moment, a concept about the potential for brain cells to regenerate or change to meet the needs of the affected brain," said Zwi, who was not involved in the study.
"This is why it is important to know whether the changes observed in association with trauma and depression are transitory or permanent, which this study cannot show."
Zwi said therapy, or drugs targeting changes to brain structure, may hold some promise for these patients.
Opel also sees potential in tailoring treatment to individual patients based on information from their brain scans.
"What would be great in future is if we could use these data to predict which patient might need intensified or specialized care and then come up with personalized treatment approaches," he said.
SOURCE: http://bit.ly/2VJQjr5 and http://bit.ly/2VJiI0t
Lancet Psychiatry 2019. (Reporting by Tamara Mathias in Bengaluru)
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