Emotional reactivity in chronic schizophrenia: structural and functional brain correlates and the influence of adverse childhood experiences
Emotional reactivity in chronic schizophrenia: structural and functional brain correlates and the influence of adverse childhood experiences
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DOI：
10.1017/s0033291710001108
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发表时间：
2011-03-01
影响因子：
6.9
通讯作者：
Smeraldi, E.
中科院分区：
文献类型：
--
作者：
Benedetti, F.;Radaelli, D.;Smeraldi, E.
背景。尽管精神分裂症患者的行为表现为情绪扁平化，但他们对负面刺激的敏感性却有所增强。目前关于情绪神经回路的文献支持皮质边缘网络失调，但给出了相反的结果。不良童年经历（ace）可以持续影响健康人的情绪调节和对情绪刺激反应的神经相关。本研究评估了ace和慢性未分化精神分裂症对情绪刺激（负面面部表情）神经反应的影响。研究了3.0 T时杏仁核、海马、前扣带皮层（ACC）和前额叶皮层（PFC）的脑血氧水平依赖功能磁共振成像对人脸匹配范式的神经反应和区域灰质（GM）体积。评估ace的严重程度。参与者包括20名连续入院的慢性未分化性精神分裂症患者，以及20名来自普通人群的无关健康志愿者。患者报告的ace高于对照组。在所有参与者中，较差的ace导致杏仁核和海马体的反应下降，PFC和ACC的反应增加。患者表现出杏仁核和海马体的高激活，PFC和ACC的低激活。较高的ace与PFC和ACC中较高的GM体积相关，精神分裂症与所有研究区域的GM减少相关。情绪反应的结构和功能脑相关因素受到当前慢性未分化精神分裂症和过去ace严重程度的影响。
Background. Despite behavioural signs of flattened affect, patients affected by schizophrenia show enhanced sensitivity to negative stimuli. The current literature concerning neural circuitry for emotions supports dysregulations of cortico-limbic networks, but gives contrasting results. Adverse childhood experiences (ACEs) could persistently influence emotional regulation and neural correlates of response to emotional stimuli in healthy humans. This study evaluated the effect of ACEs and chronic undifferentiated schizophrenia on neural responses to emotional stimuli (negative facial expression).Method. Brain blood-oxygen-level-dependent functional magnetic resonance imaging neural responses to a face-matching paradigm, and regional grey matter (GM) volumes were studied at 3.0 T in the amygdala, hippocampus, anterior cingulated cortex (ACC) and prefrontal cortex (PFC). The severity of ACEs was assessed. Participants included 20 consecutively admitted in-patients affected by chronic undifferentiated schizophrenia, and 20 unrelated healthy volunteers from the general population.Results. Patients reported higher ACEs than controls. Worse ACEs proportionally led to decreasing responses in the amygdala and hippocampus, and to increasing responses in the PFC and ACC in all participants. Patients showed higher activations in the amygdala and hippocampus, and lower activations in the PFC and ACC. Higher ACEs were associated with higher GM volumes in the PFC and ACC, and schizophrenia was associated with GM reduction in all studied regions.Conclusions. Structural and functional brain correlates of emotional reactivity are influenced by both current chronic undifferentiated schizophrenia and the severity of past ACEs.