Neurovisceral phenotypes in the expression of psychiatric symptoms.
Neurovisceral phenotypes in the expression of psychiatric symptoms.
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DOI：
10.3389/fnins.2015.00004
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发表时间：
2015
影响因子：
4.3
通讯作者：
Critchley HD
中科院分区：
文献类型：
--
作者：
Eccles JA;Owens AP;Mathias CJ;Umeda S;Critchley HD
这篇综述探讨了心理症状的脆弱性，特别是焦虑，起源于身体状态控制方面的体质差异，例如一系列条件，包括关节过度活动、体位性心动过速综合征和血管迷走性晕厥。研究揭示了大脑-身体机制是如何导致心理生理反应的个体差异的，这对于预测、分层和治疗患有焦虑症及相关疾病的个人可能很重要。一个常见的体质差异是关节过度活动，其中有一个变化的胶原蛋白导致关节运动范围增加。患有焦虑、情绪和神经发育障碍的人关节活动过度。它还与应激敏感的医疗条件有关，如肠易激综合征、慢性疲劳综合征和纤维肌痛。据报道，过度活动的个体在“情绪”脑区存在结构性差异，许多关节过度活动的人表现出自主神经异常，典型的体位性心动过速综合征。体位性心动过速综合征的特征是体位性心动过速综合征的特征是体位性心动过速综合征，在体位改变时心率反应性增强，以及最近发现的导致血管扩张的因素(如餐后、运动后和伴有高温)，与焦虑症有现象学上的重叠，这可能部分是由于腹内侧额叶皮质神经反应过度所致。经历血管迷走性晕厥的人也更容易患焦虑症。血管迷走性晕厥是一种由情绪挑战(和针/血恐惧症)引起的遗传性晕厥倾向。神经成像表明，脑干对晕厥的易感性存在差异，但尾状核的结构完整性似乎对控制与副交感神经紧张和焦虑有关的晕厥频率很重要。临床和神经解剖学证据一起表明，影响自主神经反应的常见体质差异与精神症状有关，尤其是焦虑。
This review explores the proposal that vulnerability to psychological symptoms, particularly anxiety, originates in constitutional differences in the control of bodily state, exemplified by a set of conditions that include Joint Hypermobility, Postural Tachycardia Syndrome and Vasovagal Syncope. Research is revealing how brain-body mechanisms underlie individual differences in psychophysiological reactivity that can be important for predicting, stratifying and treating individuals with anxiety disorders and related conditions. One common constitutional difference is Joint Hypermobility, in which there is an increased range of joint movement as a result of a variant of collagen. Joint hypermobility is over-represented in people with anxiety, mood and neurodevelopmental disorders. It is also linked to stress-sensitive medical conditions such as irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia. Structural differences in “emotional” brain regions are reported in hypermobile individuals, and many people with joint hypermobility manifest autonomic abnormalities, typically Postural Tachycardia Syndrome. Enhanced heart rate reactivity during postural change and as recently recognized factors causing vasodilatation (as noted post-prandially, post-exertion and with heat) is characteristic of Postural Tachycardia Syndrome, and there is a phenomenological overlap with anxiety disorders, which may be partially accounted for by exaggerated neural reactivity within ventromedial prefrontal cortex. People who experience Vasovagal Syncope, a heritable tendency to fainting induced by emotional challenges (and needle/blood phobia), are also more vulnerable to anxiety disorders. Neuroimaging implicates brainstem differences in vulnerability to faints, yet the structural integrity of the caudate nucleus appears important for the control of fainting frequency in relation to parasympathetic tone and anxiety. Together there is clinical and neuroanatomical evidence to show that common constitutional differences affecting autonomic responsivity are linked to psychiatric symptoms, notably anxiety.
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影响因子：
5.7
作者：
Beacher, Felix D. C. C.;Gray, Marcus A.;Mathias, Christopher J.;Critchley, Hugo D.
通讯作者：
Critchley, Hugo D.
影响因子：
3
作者：
Critchley, Hugo D.
通讯作者：
Critchley, Hugo D.
影响因子：
7
作者：
Bulbena, Antoni;Gago, Jordi;Vilarroya, Oscar
通讯作者：
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影响因子：
4
作者：
Anderson, Jake W.;Lambert, Elisabeth A.;Lambert, Gavin W.
通讯作者：
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影响因子：
3.4
作者：
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通讯作者：
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