Childhood abuse (CA) is a prevalent global health concern, increasing the risk of negative mental health outcomes later in life. In the literature, CA is commonly defined as physical, sexual, and emotional abuse, as well as neglect. Several mental disorders have been associated with CA, including depression, bipolar disorder, schizophrenia, and post-traumatic stress disorder, along with an increased risk of suicide. It is thought that traumatic life events occurring during childhood and adolescence may have a significant impact on essential brain functions, which may persist throughout adulthood. The interaction between the brain and the external environment can be mediated by epigenetic alterations in gene expression, and there is a growing body of evidence to show that such changes occur as a function of CA. Disruptions in the HPA axis, myelination, plasticity, and signaling have been identified in individuals with a history of CA. Understanding the molecular impact of CA on the brain is essential for the development of treatment and prevention measures. In this review, we will summarize studies that highlight the molecular changes associated with CA in the human brain, along with supporting evidence from peripheral studies and animal models. We will also discuss some of the limitations surrounding the study of CA and propose extracellular vesicles as a promising future approach in the field.

儿童虐待（CA）是一个普遍存在的全球健康问题，增加了晚年出现负面心理健康结果的风险。在文献中，CA 通常被定义为身体、性和情感虐待以及忽视。多种精神障碍与 CA 相关，包括抑郁症、双相情感障碍、精神分裂症和创伤后应激障碍，以及自杀风险增加。人们认为，童年和青少年时期发生的创伤性生活事件可能会对基本的大脑功能产生重大影响，这种影响可能会持续整个成年期。大脑和外部环境之间的相互作用可以通过基因表达的表观遗传改变来介导，并且越来越多的证据表明这种变化是作为 CA 的功能而发生的。在有 CA 病史的个体中已发现 HPA 轴、髓鞘形成、可塑性和信号传导的破坏。了解 CA 对大脑的分子影响对于制定治疗和预防措施至关重要。在这篇综述中，我们将总结强调人脑 CA 相关分子变化的研究，以及来自外围研究和动物模型的支持证据。我们还将讨论 CA 研究的一些局限性，并提出细胞外囊泡作为该领域未来有前途的方法。