Aberrant Spontaneous and Task-Dependent Functional Connections in the Anxious Brain.
Aberrant Spontaneous and Task-Dependent Functional Connections in the Anxious Brain.
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DOI：
10.1016/j.bpsc.2015.12.004
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发表时间：
2016-05
期刊：
影响因子：
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通讯作者：
Phan KL
中科院分区：
文献类型：
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作者：
MacNamara A;DiGangi J;Phan KL
许多脑区都与焦虑症有关，但这些区域中没有一个孤立地被区分为负责焦虑症病理的唯一或离散部位。因此，在过去的十年中，越来越多地追求在焦虑症的几个脑区的血氧水平依赖（BOLD）信号的时间相关性的改变所代表的功能失调的神经网络的识别。在这里，我们回顾任务无关（例如，静息状态）和任务诱导的功能连接性磁共振成像（fcMRI）研究在成人焦虑症（包括创伤和压力相关和强迫症）。这篇综述的结果表明，焦虑症的病理生理学涉及异常杏仁核额叶和额叶纹状体区域之间的连接，以及内部和之间的典型的“内在”的大脑网络-默认模式和显着性网络，这些畸变的证据可能有助于通知区域激活异常的结果中观察到的焦虑症。尽管如此，仍然存在重大挑战，包括需要更好地理解使用不同方法观察到的混合结果（例如，休息状态和任务为基础的方法）;需要更多的发展工作;需要划定焦虑症的疾病特异性和transdiagnosis fcMRI畸变;需要更好地了解fcMRI异常的临床意义。在应对这些挑战时，未来的工作有可能阐明异常神经网络作为中间的、基于大脑的表型，以预测疾病的发生和进展，完善诊断疾病分类学，并确定治疗机制和治疗反应的预测因子，包括焦虑、创伤相关和强迫症。
A number of brain regions have been implicated in the anxiety disorders, yet none of these regions in isolation has been distinguished as the sole or discrete site responsible for anxiety disorder pathology. Therefore, the identification of dysfunctional neural networks as represented by alterations in the temporal correlation of blood-oxygen level dependent (BOLD) signal across several brain regions in anxiety disorders has been increasingly pursued in the past decade. Here, we review task-independent (e.g., resting state) and task-induced functional connectivity magnetic resonance imaging (fcMRI) studies in the adult anxiety disorders (including trauma- and stressor-related and obsessive compulsive disorders). The results of this review suggest that anxiety disorder pathophysiology involves aberrant connectivity between amygdala-frontal and frontal-striatal regions, as well as within and between canonical “intrinsic” brain networks - the default mode and salience networks, and that evidence of these aberrations may help inform findings of regional activation abnormalities observed in the anxiety disorders. Nonetheless, significant challenges remain, including the need to better understand mixed findings observed using different methods (e.g., resting state and task-based approaches); the need for more developmental work; the need to delineate disorder-specific and transdiagnostic fcMRI aberrations in the anxiety disorders; and the need to better understand the clinical significance of fcMRI abnormalities. In meeting these challenges, future work has the potential to elucidate aberrant neural networks as intermediate, brain-based phenotypes to predict disease onset and progression, refine diagnostic nosology, and ascertain treatment mechanisms and predictors of treatment response across anxiety, trauma-related and obsessive compulsive disorders.