A functional magnetic resonance imaging investigation of uncertainty in adolescents with anxiety disorders
A functional magnetic resonance imaging investigation of uncertainty in adolescents with anxiety disorders
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DOI：
10.1016/j.biopsych.2007.06.011
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发表时间：
2008-03-15
影响因子：
10.6
通讯作者：
Milham, Michael P.
中科院分区：
文献类型：
--
作者：
Krain, Amy L.;Gotimer, Kristin;Milham, Michael P.
背景：儿童焦虑症虽然非常普遍，但研究不足，对其病理生理知之甚少。不确定性不耐受(Iu)是与担忧相关的特征，而担忧是这些障碍的关键特征。健康受试者对不确定性的神经反应涉及与儿童焦虑症中高反应相同的额叶-边缘环路。方法：16名被诊断为广泛性焦虑症和/或社交恐惧症(ANX)的青少年和13名非焦虑对照组受试者在接受功能磁共振扫描的同时完成了一项决策任务。结果：ANX组在任务后问卷上比对照组被试支持更多的任务相关焦虑和更低的确定性。与对照组相比，ANX组并没有表现出假设的脑区高反应性。在不同组别中，Iu与几个额叶和边缘区域的活动呈正相关。进一步的分析确定了ANX组中的亚组：高IU组激活额叶/边缘区域，而那些在任务期间低IU和较少焦虑的人激活相同的区域以应对不确定性。结论：结果证实了在一些患有焦虑症的青少年中IU和神经对不确定性的反应之间的假设联系。我们的发现，如果重复，表明特质测量，如IU，可以显著提高我们对儿童焦虑症的神经生物学基础的理解。
Background: Pediatric anxiety disorders, although highly prevalent, are understudied with little known about their pathophysiology. intolerance of uncertainty (IU) is a trait associated with worry, a key characteristic of these disorders. Neural responses to uncertainty in healthy subjects involve the same frontal-limbic circuits that are hyper-responsive in pediatric anxiety. As such,the present study examines the relationship between IU and neural responses to uncertainty in anxious adolescents.Methods: Sixteen adolescents (ages 13-17) diagnosed with generalized anxiety disorder and/or social phobia (ANX) and 13 non-anxious control subjects completed a decision-making task while functional magnetic resonance imaging scans were acquired.Results: The ANX group endorsed greater task-related anxiety and less certainty than control subjects on a post-task questionnaire. Compared with control subjects, the ANX group did not demonstrate hyper-responsivity of brain regions as hypothesized. Across groups, IU was positively correlated with activity in several frontal and limbic regions. Further analyses identified subgroups within the ANX group: those with high IU activated frontal/limbic regions, whereas those with low IU and less anxiety during the task deactivated the same regions in response to uncertainty.Conclusions: Results substantiate the hypothesized link between IU and neural responses to uncertainty in some adolescents with anxiety disorders. Our findings, if replicated, suggest that trait measures, such as IU, can significantly improve our understanding of the neurobiological basis of pediatric anxiety disorders.