The Overlapping Neurobiology of Induced and Pathological Anxiety: A Meta-Analysis of Functional Neural Activation
The Overlapping Neurobiology of Induced and Pathological Anxiety: A Meta-Analysis of Functional Neural Activation
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DOI：
10.1176/appi.ajp.2020.19111153
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发表时间：
2021-02-01
影响因子：
17.7
通讯作者：
Robinson, Oliver J.
中科院分区：
文献类型：
--
作者：
Chavanne, Alice, V;Robinson, Oliver J.
目的：虽然焦虑可能是对不可预测的威胁的适应性反应，但当症状对日常生活产生不利影响时，就会发生病理性焦虑症。适应性焦虑和病理性焦虑是否共享机制仍然未知，但如果它们共享，则诱导（适应性）焦虑可以用作病理性焦虑的中间转化模型，以改善药物开发管道。因此，作者比较了诱导性和病理性anxiety.Methods的功能性神经影像学研究的荟萃分析：于2019年6月对PubMed数据库进行了全脑功能性MRI文章的系统检索。符合条件的文章对比焦虑患者与对照受试者或健康受试者的不可预测威胁状况与安全状况。包括五种焦虑症：创伤后应激障碍、社交焦虑障碍、广泛性焦虑障碍、惊恐障碍和特定恐惧症。共识别出3，433条记录，181篇文章符合选择标准，最大的任务类型子集为情感（N=138）。所有分析均使用基于种子的d-映射软件。（N=693名参与者）和病理性焦虑（N= 2，554例患者和2，348例对照受试者）均显示左和右丘脑的激活增加。（坐标，44，14，-14和-38，20，-8; k= 2，102和k= 1，305）和扣带皮层/内侧前额叶皮层（12，8，68; k= 2，217）。当分析分裂的障碍，具体的恐惧症出现最多，和广泛性焦虑症最少，类似于诱导anxiety.Conclusions：此荟萃分析表明一个一致的模式，激活诱导和病理性焦虑，支持的命题，一些神经生物学机制重叠，前者可用作模型，后者。然而，对于某些焦虑症，诱发性焦虑可能是一个比其他焦虑症更好的模型。
Objective: Although anxiety can be an adaptive response to unpredictable threats, pathological anxiety disorders occur when symptoms adversely affect daily life. Whether or not adaptive and pathological anxiety share mechanisms remains unknown, but if they do, induced (adaptive) anxiety could be used as an intermediate translational model of pathological anxiety to improve drug development pipelines. The authors therefore compared meta-analyses of functional neuroimaging studies of induced and pathological anxiety.Methods: A systematic search of the PubMed database was conducted in June 2019 for whole-brain functional MRI articles. Eligible articles contrasted either anxious patients to control subjects or an unpredictable-threat condition to a safe condition in healthy participants. Five anxiety disorders were included: posttraumatic stress disorder, social anxiety disorder, generalized anxiety disorder, panic disorder, and specific phobia. A total of 3,433 records were identified, 181 articles met selection criteria, and the largest subset of task type was emotional (N=138). Seed-based d-mapping software was used for all analyses.Results: Induced anxiety (N=693 participants) and pathological anxiety (N=2,554 patients and 2,348 control subjects) both showed increased activation in the left and right insula (coordinates, 44, 14, -14 and -38, 20, -8; k=2,102 and k=1,305, respectively) and cingulate cortex/medial prefrontal cortex ( 12, 8, 68; k=2,217). When the analyses were split by disorder, specific phobia appeared the most, and generalized anxiety disorder the least, similar to induced anxiety.Conclusions: This meta-analysis indicates a consistent pattern of activation across induced and pathological anxiety, supporting the proposition that some neurobiological mechanisms overlap and that the former may be used as a model for the latter. Induced anxiety might nevertheless be a better model for some anxiety disorders than others.