The mediating role of reduced amygdala subregion volume between childhood trauma and depression severity in patients with major depressive disorder
10.3760/cma.j.cn113661-20240806-00261
- VernacularTitle:杏仁核亚区体积减少在童年创伤与抑郁症抑郁严重程度间的中介作用
- Author:
Azi SHEN
1
;
Wenyue GONG
;
Yinghong HUANG
;
Yiwen WANG
;
Qiudong XIA
;
Kaiyu SHI
;
Qinghua ZHAI
;
Rui YAN
;
Qing LU
;
Zhijian YAO
Author Information
1. 南京大学医学院教学医院南京脑科医院,南京210029
- Publication Type:Journal Article
- Keywords:
Depressive disorder;
Amygdala;
Childhood trauma;
Subcortical segmentation
- From:
Chinese Journal of Psychiatry
2025;58(5):356-364
- CountryChina
- Language:Chinese
-
Abstract:
Objective:This study aims to explore the independent and interactive effects of childhood trauma (CT) and major depressive disorder (MDD) on amygdala subregion volumes and to examine whether volumetric changes in these subregions mediate the relationship between CT and depressive severity.Methods:A total of 129 MDD patients and 127 age- and sex-matched healthy controls were recruited from Nanjing Brain Hospital between October 2022 and November 2024. All participants underwent 3D-T 1 weighted MRI scans,and amygdala subregions were segmented using the FreeSurfer software. Depressive and anxiety symptoms were assessed with the 17-item Hamilton Depression Rating Scale (HAMD 17) and the Hamilton Anxiety Scale (HAMA),respectively. Childhood trauma exposure was evaluated via the Childhood Trauma Questionnaire (CTQ). Generalized linear models (GLM) were applied to analyze the main and interactive effects of MDD diagnosis (depression/healthy controls) and CT (presence/absence),adjusting for age,estimated intracranial volume,sex,medication history,and education years. Partial correlation and mediation analyses were conducted to explore associations between amygdala subregion volumes and clinical measures in MDD patients. Results:MDD diagnosis was independently associated with increased volumes in the right central nucleus ( Wald χ2=9.09, P=0.026) and medial nucleus ( Wald χ2=10.08, P=0.026). CT exposure was independently associated with reduced volumes in the right central nucleus ( Wald χ2=7.99, P=0.047) and medial nucleus ( Wald χ2=9.20, P=0.047). No significant interaction effects between MDD and CT were observed in any amygdala subregion. Mediation analysis revealed that reduced right medial nucleus volume partially mediated the relationship between total CTQ scores and depressive severity (proportion mediated: 26.69%,95% CI=0.002-0.060) and mediated the association between emotional neglect and depressive severity (proportion mediated: 26.75%,95% CI=0.006-0.150). Such mediating effects were not found for the right central nucleus. Conclusion:CT and MDD exhibit divergent patterns of influence on amygdala subregions. CT is linked to volumetric reductions,whereas MDD is associated with volumetric enlargement. Reduced volume of the right medial nucleus mediates the relationship between CT and depression severity.