Ventrolateral prefrontal cortex activation and attentional bias in response to angry faces in adolescents with generalized anxiety disorder.
Ventrolateral prefrontal cortex activation and attentional bias in response to angry faces in adolescents with generalized anxiety disorder.
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DOI：
10.1176/ajp.2006.163.6.1091
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发表时间：
2006-06
期刊：
影响因子：
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通讯作者：
Christopher S. Monk;E. Nelson;E. McClure;K. Mogg;B. Bradley;E. Leibenluft;R. Blair;Gang Chen;D. Charney;M. Ernst;D. Pine
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文献类型：
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作者：
Christopher S. Monk;E. Nelson;E. McClure;K. Mogg;B. Bradley;E. Leibenluft;R. Blair;Gang Chen;D. Charney;M. Ernst;D. Pine
目的虽然青春期焦虑症是一种普遍的、使人衰弱的疾病，但很少有研究探讨其脑生理学。使用事件相关功能磁共振成像(FMRI)和对愤怒面孔的注意行为测量，作者评估了健康青少年和患有广泛性焦虑症的青少年之间反应的差异。方法在感兴趣的初步试验中，18名广泛性焦虑症青少年和15名年龄/性别/智商相同的对照受试者在fMRI获取过程中观看愤怒/中性面孔对。在呈现每一对面孔后，受试者按下一个按钮，以指示随后的星号是出现在与愤怒的面孔相同(一致)或相反(不一致)的一侧。一致和不一致面孔试验之间的反应时差异提供了对愤怒面孔的注意力偏向的一种衡量标准。结果与对照组相比，广泛性焦虑症患者在包含愤怒面孔的实验中表现出更大的右侧前额叶腹外侧皮层激活。广泛性焦虑症患者也表现出更大的注意力偏向，远离愤怒的面孔。当注意偏向的差异是不同的时，腹外侧额叶皮质激活的差异仍然明显。最后，在对患者进行的焦虑程度和大脑激活之间的关联的检查中，作者发现，随着腹外侧额叶皮质激活的增加，焦虑症状的严重程度减轻。结论广泛性焦虑症青少年较健康青少年表现出更大的右侧前额叶腹外侧区激活和注意偏向，远离愤怒面孔。在患者中，腹外侧额叶皮质的激活与不那么严重的焦虑有关，这表明这种激活可能是一种代偿反应。
OBJECTIVE While adolescent anxiety disorders represent prevalent, debilitating conditions, few studies have explored their brain physiology. Using event-related functional magnetic resonance imaging (fMRI) and a behavioral measure of attention to angry faces, the authors evaluated differences in response between healthy adolescents and adolescents with generalized anxiety disorder. METHOD In the primary trials of interest, 18 adolescents with generalized anxiety disorder and 15 comparison subjects of equivalent age/gender/IQ viewed angry/neutral face pairs during fMRI acquisition. Following the presentation of each face pair, subjects pressed a button to indicate whether a subsequent asterisk appeared on the same (congruent) or opposite (incongruent) side as the angry face. Reaction time differences between congruent and incongruent face trials provided a measure of attention bias to angry faces. RESULTS Relative to the comparison subjects, patients with generalized anxiety disorder manifested greater right ventrolateral prefrontal cortex activation to trials containing angry faces. Patients with generalized anxiety disorder also showed greater attention bias away from angry faces. Ventrolateral prefrontal cortex activation differences remained evident when differences in attention bias were covaried. Finally, in an examination among patients of the association between degree of anxiety and brain activation, the authors found that as ventrolateral prefrontal cortex activation increased, severity of anxiety symptoms diminished. CONCLUSIONS Adolescents with generalized anxiety disorder show greater right ventrolateral prefrontal cortex activation and attentional bias away from angry faces than healthy adolescents. Among patients, increased ventrolateral prefrontal cortex activation is associated with less severe anxiety, suggesting that this activation may serve as a compensatory response.