Fronto-insula network activity explains emotional dysfunctions in juvenile myoclonic epilepsy: Combined evidence from pupillometry and fMRI
Fronto-insula network activity explains emotional dysfunctions in juvenile myoclonic epilepsy: Combined evidence from pupillometry and fMRI
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DOI：
10.1016/j.cortex.2015.01.018
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发表时间：
2015-04
期刊：
影响因子：
3.6
通讯作者：
F. Paulus;S. Krach;Marius Blanke;Christine Roth;M. Belke;J. Sommer;Laura Müller-Pinzler;K. Menzler;A. Jansen;F. Rosenow;F. Bremmer;W. Einhäuser;S. Knake
中科院分区：
文献类型：
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作者：
F. Paulus;S. Krach;Marius Blanke;Christine Roth;M. Belke;J. Sommer;Laura Müller-Pinzler;K. Menzler;A. Jansen;F. Rosenow;F. Bremmer;W. Einhäuser;S. Knake
情绪不稳定、社会适应困难和行为失调是青少年肌阵挛性癫痫（JME）精神合并症最常见的症状。这种精神病理与中脑-额叶脑回路功能障碍有关。目前的工作是对这种联系的第一次直接测试，并采用了一种范式来探测疼痛共情过程中的额叶回路。采用功能磁共振成像（fMRI）和同步瞳孔测量相结合的方法，对15例JME患者和15例匹配的健康对照者进行疼痛共情的神经和心理生理参数评估。在JME患者中，我们观察到前扣带皮层（ACC）、前岛叶（AI）和腹外侧前额叶皮层（VLPFC）的神经激活减少。这种调节与患者在对疼痛感同身受时瞳孔扩张减小相平行。同时，瞳孔扩张与ACC、AI和VLPFC的神经活动呈正相关。在JME患者中，ACC还显示出与初级和次级体感皮层的功能连接减少，而初级和次级体感皮层是处理他人疼痛的躯体原因的基本区域。我们的结果提供了第一个证据，证明内侧额叶回路的改变直接影响JME患者的社会心理功能，并在情绪处理过程中绘制了瞳孔动态与大脑活动的联系。研究发现，与疼痛共情相关的前扣带和人工智能激活减少，前扣带与体感皮层区域的功能整合异常，为该网络在社会行为中的作用提供了进一步的证据，并有助于解释JME的精神病理和患者的社会适应困难。
Emotional instability, difficulties in social adjustment, and disinhibited behavior are the most common symptoms of the psychiatric comorbidities in juvenile myoclonic epilepsy (JME). This psychopathology has been associated with dysfunctions of mesial-frontal brain circuits. The present work is a first direct test of this link and adapted a paradigm for probing frontal circuits during empathy for pain. Neural and psychophysiological parameters of pain empathy were assessed by combining functional magnetic resonance imaging (fMRI) with simultaneous pupillometry in 15 JME patients and 15 matched healthy controls. In JME patients, we observed reduced neural activation of the anterior cingulate cortex (ACC), the anterior insula (AI), and the ventrolateral prefrontal cortex (VLPFC). This modulation was paralleled by reduced pupil dilation during empathy for pain in patients. At the same time, pupil dilation was positively related to neural activity of the ACC, AI, and VLPFC. In JME patients, the ACC additionally showed reduced functional connectivity with the primary and secondary somatosensory cortex, areas fundamentally implicated in processing the somatic cause of another's pain. Our results provide first evidence that alterations of mesial-frontal circuits directly affect psychosocial functioning in JME patients and draw a link of pupil dynamics with brain activity during emotional processing. The findings of reduced pain empathy related activation of the ACC and AI and aberrant functional integration of the ACC with somatosensory cortex areas provide further evidence for this network's role in social behavior and helps explaining the JME psychopathology and patients' difficulties in social adjustment.