Neural correlates of worry in generalized anxiety disorder and in normal controls: a functional MRI study
Neural correlates of worry in generalized anxiety disorder and in normal controls: a functional MRI study
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DOI：
10.1017/s0033291709005649
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发表时间：
2010-01-01
影响因子：
6.9
通讯作者：
Sassaroli, S.
中科院分区：
文献类型：
--
作者：
Paulesu, E.;Sambugaro, E.;Sassaroli, S.
背景资料。焦虑被认为是广泛性焦虑症(GAD)的一个关键特征，其神经关联鲜为人知。目前尚不清楚参与病理性担忧的大脑区域是否与正常受试者中参与类似担忧的精神活动的大脑区域相似，或者与担忧相关的大脑区域对于不同的触发因素是否相同，如语言刺激或面部。本研究旨在澄清这些问题。8名广泛性焦虑症患者和12名正常对照接受了基于口语句子或面孔的功能磁共振成像(FMRI)情绪诱导范式。句子要么是中性的，要么是旨在引发担忧的。面部表情表现出悲伤或中性的情绪，受试者被要求与这些情绪产生共鸣。我们发现GAD患者和正常对照组的前扣带回和背内侧前额叶皮质[Brodmann Area(BA)32/23和BA 10/11]与句子引发的焦虑有关。然而，GAD受试者即使在担忧阶段之后的休息状态扫描中也显示出这些区域的持续激活，激活与宾夕法尼亚州立大学担忧问卷(PSWQ)的分数相关。这一区域在悲伤面孔的共情实验中被激活。结果表明，正常受试者和广泛性焦虑症受试者的焦虑是基于内侧前额叶和前扣带回区域的激活，这两个区域被认为参与了心灵化和内省思维。这一区域及其回路活动的失调可能是广泛性AD患者无法停止担忧的原因。
Background. Worry is considered a key feature of generalized anxiety disorder (GAD), whose neural correlates are poorly understood. It is not known whether the brain regions involved in pathological worry are similar to those involved in worry-like mental activity in normal subjects or whether brain areas associated with worry are the same for different triggers such as verbal stimuli or faces. This study was designed to clarify these issues.Method. Eight subjects with GAD and 12 normal controls Underwent functional magnetic resonance imaging (fMRI) mood induction paradigms based on spoken sentences or faces. Sentences were either neutral or designed to induce worry. Faces conveyed a sad or a neutral mood and Subjects were instructed to empathize with those moods.Results. We found that the anterior cingulate and dorsal medial prefrontal cortex [Brodmann area (BA) 32/23 and BA 10/11] were associated with worry triggered by sentences in both subjects with GAD and normal controls. However, GAD subjects showed a persistent activation of these areas even during resting state scans that followed the worrying phase, activation that correlated with scores on the Penn State Worry Questionnaire (PSWQ). This region was activated during the empathy experiment for sad faces.Conclusions. The results show that worry in normal subjects and in subjects with GAD is based on activation of the medial prefrontal and anterior cingulate regions, known to be involved in mentalization and introspective thinking. A dysregulation of the activity of this region and its circuitry may underpin the inability of GAD patients to stop worrying.