In the grip of worry: cerebral blood flow changes during worry induction and reappraisal in late-life generalized anxiety disorder.
In the grip of worry: cerebral blood flow changes during worry induction and reappraisal in late-life generalized anxiety disorder.
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忧虑之中：晚年广泛性焦虑症忧虑诱导和重新评估期间脑血流量的变化。
DOI：
10.1038/tp.2017.180
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发表时间：
2017-08-15
影响因子：
6.8
通讯作者：
Andreescu C
中科院分区：
文献类型：
--
作者：
Karim HT;Tudorascu DL;Butters MA;Walker S;Aizenstein HJ;Andreescu C
严重的忧虑包括适应不良的情感和认知过程的复杂混合。与其他形式的焦虑相反，在这个领域，关于焦虑的神经基础还没有达成共识。到目前为止，还没有研究专门研究与扫描诱发和重新评估忧虑相关的神经模式。在这项研究中，我们试图通过使用个性化的扫描式焦虑脚本来描述焦虑的“神经现象学”的不同组成部分：诱导、维持、严重程度和重新评估。包括20名年龄较大的非焦虑参与者和20名晚期广泛性焦虑障碍（GAD）参与者。采集全脑轴向伪连续动脉自旋标记扫描。我们使用体素双向方差分析来测试分组间的相互作用。与其他受试者相比，焦虑诱导与视觉皮层、丘脑、尾状和内侧额叶皮层的脑血流量（CBF）增加有关。在类似区域，重新评估与更大的CBF相关，而相对于休息，眶额回显示出更低的CBF。与非焦虑参与者相比，GAD在焦虑诱导过程中多个区域（视觉和顶叶皮层、额叶中部和上叶）的CBF更高，而在补充运动区、扣带回中部、脑岛和壳核的重新评估过程中CBF更低。除了丘脑外，在焦虑诱导和重新评估的五个区块中，CBF没有变化。严重的忧虑与几个新皮质调节区域的脑血流增加明显相关。我们提出的新数据支持担忧是一个复杂过程的观点，涉及多个区域在担忧的产生，维持和重新评估。
Severe worry includes a complex blend of maladaptive affective and cognitive processes. Contrary to other forms of anxiety, there is no consensus in the field regarding the neural basis of worry. To date, no study has looked at neural patterns associated specifically with in-scanner induction and reappraisal of worry. In this study, we attempt to describe distinct components of the ‘neural phenomenology’ of worry: induction, maintenance, severity and reappraisal, by using a personalized, in-scanner worry script. Twenty older, non-anxious participants and twenty late-life generalized anxiety disorder (GAD) participants were included. Whole-brain axial pseudo-continuous arterial spin-labeling scans were collected. We used a voxel-wise two-way ANOVA to test the group-by-block interaction. Worry induction was associated with greater cerebral blood flow (CBF) in the visual cortex, thalamus, caudate and medial frontal cortex compared with the rest. Reappraisal was associated with greater CBF in similar regions, whereas the orbital frontal gyrus showed lower CBF relative to rest. Relative to non-anxious participants, GAD had greater CBF in multiple regions during worry induction (visual and parietal cortex, middle and superior frontal) and lower CBF during reappraisal in the supplemental motor area, middle cingulate gyrus, insula and putamen. Except for the thalamus, there was no change in CBF throughout the five blocks of worry induction and reappraisal. Severe worry is distinctly associated with increased CBF in several neocortical regulatory regions. We present new data supporting the view of worry as a complex process, engaging multiple regions in the initiation, maintenance and reappraisal of worry.
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影响因子：
11.3
作者：
Andreescu C;Mennin D;Tudorascu D;Sheu LK;Walker S;Banihashemi L;Aizenstein H
通讯作者：
Aizenstein H
影响因子：
3.4
作者：
Golden, Jeannette;Conroy, Ronan M.;Lawlor, Brian A.
通讯作者：
Lawlor, Brian A.
前瞻性研究焦虑和事件中风。
影响因子：
8.3
作者：
Lambiase MJ;Kubzansky LD;Thurston RC
通讯作者：
Thurston RC
DOI：
10.1192/bjp.bp.110.090217
发表时间：
2011-09
期刊：
The British journal of psychiatry : the journal of mental science
影响因子：
--
作者：
Butters MA;Bhalla RK;Andreescu C;Wetherell JL;Mantella R;Begley AE;Lenze EJ
通讯作者：
Lenze EJ
影响因子：
7.2
作者：
Denollet, Johan;Maas, Kristel;Pop, Victor J.
通讯作者：
Pop, Victor J.