Brain activation during anticipation of interoceptive threat
Brain activation during anticipation of interoceptive threat
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DOI：
10.1016/j.neuroimage.2012.03.019
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发表时间：
2012-07-16
期刊：
影响因子：
5.7
通讯作者：
Hamm, Alfons O.
中科院分区：
文献类型：
--
作者：
Holtz, Katharina;Pane-Farre, Christiane A.;Hamm, Alfons O.
目前的研究调查了在一组报告对无法解释的躯体感觉有高或低恐惧的参与者中，在引导过度通气任务引起的潜在威胁性身体症状的预期中激活的神经网络。15名报告身体症状高恐惧的受试者和14名报告身体症状低恐惧的受试者首先了解到，两种线索中的一种可以可靠地预测过度通气任务的发生，从而在所有参与者中产生高恐惧组中被评为更强烈和不愉快的身体症状。在预期不愉快的症状时，高度恐惧的参与者报告了更强烈的身体症状，并表现出增强的惊吓反射。在这个学习过程之后，参与者被带入fMRI，在那里同样的线索要么预测过度通气的发生，要么预测正常通气，尽管这项任务从未在扫描仪中执行。在预期过度通气期间，所有参与者都表现出增加的岛叶前部/眼窝额叶皮层和背前扣带皮层/背内侧前额叶皮层（dACC/dmPFC）吻侧部分的激活。与低恐惧参与者相比，高恐惧参与者的大脑激活在两个方面有所不同。首先，高度恐惧的参与者在威胁和安全条件下表现出更强的网络激活，在整个环境中表现出更强的焦虑忧虑。第二，虽然低恐惧的参与者在经历过度通气挑战没有遵循这一线索后，不再对威胁线索有更强的激活反应，但高恐惧的参与者继续对这一线索表现出更强的网络激活。吻侧dACC/dmPFC的激活与报告的躯体症状恐惧显著相关。这些数据表明，内感受性威胁的预期激活了与外感受性威胁提示预期激活的相同网络。因此，目前的范式可能为研究惊恐障碍患者的焦虑忧虑和治疗效果提供一种创新的方法。(C) 2012爱思唯尔公司版权所有。
The current study investigated the neural networks activated during the anticipation of potentially threatening body symptoms evoked by a guided hyperventilation task in a group of participants reporting either high or low fear of unexplained somatic sensations. 15 subjects reporting high and 14 subjects reporting low fear of somatic symptoms first learned that one of two cues predicted the occurrence of a hyperventilation task reliably producing body symptoms in all participants that were rated as more intense and unpleasant in the high fear group. During anticipation of unpleasant symptoms, high fear participants reported more intense body symptoms and showed potentiation of the startle reflex. After this learning session, participants were taken into the fMRI where the same cues either predicted the occurrence of hyperventilation or normoventilation, although the task was never performed in the scanner. During anticipation of hyperventilation all participants showed an increased activation of anterior insula/orbitofrontal cortex and rostral parts of the dorsal anterior cingulate cortex/dorsomedial prefrontal cortex (dACC/dmPFC). Brain activation of high compared to low fear participants differed in two ways. First, high fear participants showed an overall stronger activation of this network during threat and safe conditions indexing stronger anxious apprehension during the entire context. Second, while low fear participants no longer responded with stronger activation to the threat cue after experiencing that the hyperventilation challenge did not follow this cue, high fear participants continued to show stronger activation of the network to this cue. Activation of the rostral dACC/dmPFC was significantly correlated with reported fear of somatic symptoms. These data demonstrate that anticipation of interoceptive threat activates the same network that has been found to be active during anticipation of exteroceptive threat cues. Thus, the current paradigm might provide an innovative method to study anxious apprehension and treatment effects in patients with panic disorder. (C) 2012 Elsevier Inc. All rights reserved.