Relations among maternal withdrawal in infancy, borderline features, suicidality/self-injury, and adult hippocampal volume: A 30-year longitudinal study.

The hippocampus plays an important role in stress regulation and has been the focus of research regarding the effects of early life stress on brain development. Much of this research has focused on severe forms of early adversity, particularly maltreatment. However, a handful of studies are now examining the effects of more subtle variations in quality of early caregiving on hippocampal development. In addition, both early caregiving and hippocampal volumes have been linked to psychopathology, particularly borderline personality disorder (BPD) and its associated features, such as suicidality. In the context of a 30-year longitudinal study, we assessed associations between maternal withdrawal in infancy, hippocampal volume, and BPD features in adulthood. Hippocampal volume was assessed among 18 adults (29.33 ±â€¯0.49 years) assessed for caregiving quality at 18 months (M =18.55 months, SD = 1.21 months) and followed longitudinally to age 29. Left hippocampal volume in adulthood was associated with maternal withdrawal in infancy, but not by other components of disrupted parenting. Other risk factors, including maternal psychosocial risk and severity of maltreatment in childhood, were not significantly related to left hippocampal volume. Left hippocampal volume was further associated with increased BPD features and suicidality/self-injury. In addition, left hippocampal volume partially mediated the association between early maternal withdrawal and later suicidality/self-injury. Results point to the importance of quality of early care for hippocampal development and suggest that the first two years of life may be an early sensitive period during which intervention could have important consequences for long-term psychological functioning into adulthood.

Macroporous polyester-covered stent in an experimental abdominal aortic aneurysm model.

PURPOSE: To validate a recently described animal model of abdominal aortic aneurysm (AAA) and to assess a new macroporous polyester-covered stent for endovascular AAA exclusion. METHODS: Twenty adult sheep had AAAs surgically created by replacing a segment of the infrarenal aorta with an autologous jugular venous graft. Three months later, surviving animals underwent percutaneous implantation of macroporous polyester-covered nitinol stents; 3 animals with untreated AAAs served as controls. Follow-up surveillance included spiral computed tomography at 1 month and digital subtraction angiography at 3 and 6 months. Endografted animals were sacrificed at 1, 3, and 6 months after implantation; specimens from all animals were examined grossly and microscopically. RESULTS: Seven (35%) animals died within 24 hours of causes related to the technique; 1 animal developed paraplegia and was sacrificed on day 1. Three (25%) animals died of spontaneous aneurysm rupture at <10 days, and 6 received the stent-graft at 3 months. The macroporous cover did not prevent continued perfusion of the sac early after stent-graft deployment, but all aneurysms were excluded on the 1-month CT. CONCLUSIONS: Spontaneous AAA rupture occurred earlier and was not as frequent as previously described for this model. Implantation of the covered stent was feasible, but aneurysm exclusion was not immediate.