Failure of anterior cingulate activation and connectivity with the amygdala during implicit regulation of emotional processing in generalized anxiety disorder.
Failure of anterior cingulate activation and connectivity with the amygdala during implicit regulation of emotional processing in generalized anxiety disorder.
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DOI：
10.1176/appi.ajp.2009.09070931
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发表时间：
2010-05
期刊：
影响因子：
--
通讯作者：
Schatzberg AF
中科院分区：
文献类型：
--
作者：
Etkin A;Prater KE;Hoeft F;Menon V;Schatzberg AF
临床数据表明，情绪处理调节的异常有助于广泛性焦虑障碍的病理生理学，但这些异常在神经生物学水平上仍然知之甚少。我们最近在健康的志愿者中报道，出前扣带通过抑制杏仁核的活动来调节情绪冲突。我们还表明，与非情绪冲突相比，这一过程对情绪冲突的调节是特定的。在这里，我们研究了这种形式的非指示情绪调节是否在广泛性焦虑障碍中受到干扰。17名患者和24名健康对照者在执行情绪冲突任务时使用功能性磁共振成像进行研究，该任务涉及在忽略重叠的情绪标签词的情况下对面部情绪进行分类。我们比较了使用行为和神经测量的冲突调节的逐个试验变化。健康的受试者在试验中有效地控制了情绪冲突，即使他们没有意识到自己已经这样做了。相比之下，广泛性焦虑症患者完全无法调节情绪冲突，也无法以抑制杏仁核活动的方式激活前扣带。此外，表现和大脑激活与症状相关，可以用来准确地划分两组。我们的数据表明，广泛性焦虑障碍患者在情绪处理的非指示和自发调节方面表现出明显的缺陷。将焦虑概念化为涉及情绪调节异常的重要因素，特别是发生在意识之外的类型，可能会为新的治疗方法开辟道路，例如针对内侧前额叶皮层。
Clinical data suggest that abnormalities in the regulation of emotional processing contribute to the pathophysiology of generalized anxiety disorder, yet these abnormalities remain poorly understood at the neurobiological level. We recently reported in healthy volunteers that the pregenual anterior cingulate regulates emotional conflict on a trial-by-trial basis by dampening activity in the amygdala. We also showed that this process is specific to the regulation of emotional, compared to non-emotional, conflict. Here we examined whether this form of non-instructed emotion regulation is perturbed in generalized anxiety disorder. 17 patients and 24 healthy comparison subjects, were studied using functional magnetic resonance imaging while they performed an emotional conflict task, which involved categorizing facial affect while ignoring overlaid affect label words. We compared trial-by-trial changes in conflict regulation using behavioral and neural measures. Healthy subjects effectively regulated emotional conflict from trial-to-trial, even though they were unaware of having done so. By contrast, generalized anxiety disorder patients were completely unable to regulate emotional conflict and failed to engage the pregenual anterior cingulate in ways that would dampen amygdalar activity. Moreover, performance and brain activation correlated with symptoms and could be used to accurately classify the two groups. Our data demonstrate that patients with generalized anxiety disorder show significant deficits in the non-instructed and spontaneous regulation of emotional processing. Conceptualization of anxiety as importantly involving abnormalities in emotion regulation, particularly a type occurring outside of awareness, may open up avenues for novel treatments, such as by targeting the medial prefrontal cortex.
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影响因子：
4.1
作者：
GRATTON, G;COLES, MGH;DONCHIN, E
通讯作者：
DONCHIN, E
影响因子：
8.2
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Cunningham, William A.;Van Bavel, Jay J.;Johnsen, Ingrid R.
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影响因子：
16.2
作者：
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通讯作者：
Phelps EA
影响因子：
2.6
作者：
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通讯作者：
Moser, Ewald
影响因子：
3.7
作者：
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