Identification of Common Neural Circuit Disruptions in Emotional Processing Across Psychiatric Disorders
Identification of Common Neural Circuit Disruptions in Emotional Processing Across Psychiatric Disorders
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DOI：
10.1176/appi.ajp.2019.18111271
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发表时间：
2020-05-01
影响因子：
17.7
通讯作者：
Etkin, Amit
中科院分区：
文献类型：
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作者：
McTeague, Lisa M.;Rosenberg, Benjamin M.;Etkin, Amit
目的：情绪处理障碍是许多精神疾病的共同特征。作者通过对已发表的神经影像数据进行跨诊断定量荟萃分析，研究了一系列任务和精神疾病中情绪处理背后的神经回路的功能中断。方法：对 2018 年 5 月发表的全脑功能神经影像结果进行了 PubMed 搜索，将精神疾病（包括精神分裂症、双相或单向抑郁症、焦虑和物质使用）患者情绪处理任务期间的激活与匹配的健康对照进行比较参与者。对峰值体素坐标进行激活似然估计 (ALE) 荟萃分析，以确定空间收敛。结果：提交进行荟萃分析的 298 个实验包括 5,427 名患者和 5,491 名对照参与者。 ALE 在患者高反应性和低反应性的诊断和模式中表现出杏仁核、海马/海马旁回、丘脑背内侧/枕核、梭状回以及内侧和外侧背侧和腹侧前额叶区域的异常激活。跨疾病但考虑方向性的 ALE 表明患者杏仁核和海马/海马旁回过度活跃。内侧和外侧前额叶区域的激活不足，在处理不愉快的刺激时最为明显。更精细的针对特定疾病的分析表明，这些总体模式在不同程度上是相同的，过度激活和低激活模式存在显着差异。结论：这些发现表明，在主要精神疾病中，在适应性情绪反应和调节的关键区域和网络中存在神经回路破坏模式。更具体地说，破坏主要对应于“显着”网络、腹侧纹状体/腹内侧前额叶“奖励”网络和外侧眶额“非奖励”网络。与研究领域标准倡议一致，这些发现表明精神疾病可以有效地表述为跨诊断神经行为表型（例如神经回路激活）的功能障碍。
Objective: Disrupted emotional processing is a common feature of many psychiatric disorders. The authors investigated functional disruptions in neural circuitry underlying emotional processing across a range of tasks and across psychiatric disorders through a transdiagnostic quantitative meta-analysis of published neuroimaging data.Methods: A PubMed search was conducted for whole-brain functional neuroimaging findings published through May 2018 that compared activation during emotional processing tasks in patients with psychiatric disorders (including schizophrenia, bipolar or unipotar depression, anxiety, and substance use) to matched healthy control participants. Activation likelihood estimation (ALE) meta-analyses were conducted on peak voxel coordinates to identify spatial convergence.Results: The 298 experiments submitted to meta-analysis included 5,427 patients and 5,491 control participants. ALE across diagnoses and patterns of patient hyper- and hyporeactivity demonstrated abnormal activation in the amygdala, the hippocampal/parahippocampal gyri, the dorsomedial/pulvinar nuclei of the thalamus, and the fusiform gyri, as well as the medial and lateral dorsal and ventral prefrontal regions. ALE across disorders but considering directionality demonstrated patient hyperactivation in the amygdala and the hippocampal/parahippocampal gyri. Hypoactivation was found in the medial and lateral prefrontal regions, most pronounced during processing of unpleasant stimuli. More refined disorder-specific analyses suggested that these overall patterns were shared to varying degrees, with notable differences in patterns of hyper- and hypoactivation.Conclusions: These findings demonstrate a pattern of neurocircuit disruption across major psychiatric disorders in regions and networks key to adaptive emotional reactivity and regulation. More specifically, disruption corresponded prominently to the "salience" network, the ventral striatal/ventromedial prefrontal "reward" network, and the lateral orbitofrontal "nonreward" network. Consistent with the Research Domain Criteria initiative, these findings suggest that psychiatric illness may be productively formulated as dysfunction in transdiagnostic neurobehavioral phenotypes such as neurocircuit activation.