Area-dependent time courses of brain activation during video-induced symptom provocation in social anxiety disorder
Area-dependent time courses of brain activation during video-induced symptom provocation in social anxiety disorder
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DOI：
10.1186/2045-5380-4-6
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发表时间：
2014-12-01
期刊：
影响因子：
--
通讯作者：
Straube, Thomas
中科院分区：
文献类型：
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作者：
Boehme, Stephanie;Mohr, Alexander;Straube, Thomas
背景：以前在社交焦虑症(SAD)患者中使用症状激发的功能成像研究报道了不一致的结果，这可能至少部分与不同脑区不同的时间依赖性激活谱有关。在本次功能磁共振成像研究中，我们使用了一种新的基于视频的症状激发设计，以研究20名SAD患者和20名健康对照组不同脑区激活的幅度和时间过程。结果：与健康对照组相比，与障碍相关的视频导致SAD患者焦虑增加。对与紊乱相关的视频片段和中性视频片段的大脑激活分析显示，与对照组相比，患者在视频片段的前半部分激活了杏仁核，但在后半部分没有激活。相反，脑岛的激活表现出相反的模式，在视频片段的后半部分，激活增加，但在前半部分不增加。此外，在整个视频过程中，前背侧前扣带回皮质中的一个簇显示出持续的反应。结论：在视频诱导的症状激发过程中，恐惧网络的不同区域表现出不同的时间反应模式。虽然杏仁核在最初的威胁处理过程中参与其中，但在随后的焦虑反应中，脑岛似乎更多地参与其中。根据SAD的认知模型，参与情绪-认知交互作用的内侧前额叶区域通常处于过度激活状态。
Background: Previous functional imaging studies using symptom provocation in patients with social anxiety disorder (SAD) reported inconsistent findings, which might be at least partially related to different time-dependent activation profiles in different brain areas. In the present functional magnetic resonance imaging study, we used a novel video-based symptom provocation design in order to investigate the magnitude and time course of activation in different brain areas in 20 SAD patients and 20 healthy controls.Results: The disorder-related videos induced increased anxiety in patients with SAD as compared to healthy controls. Analyses of brain activation to disorder-related versus neutral video clips revealed amygdala activation during the first but not during the second half of the clips in patients as compared to controls. In contrast, the activation in the insula showed a reversed pattern with increased activation during the second but not during the first half of the video clips. Furthermore, a cluster in the anterior dorsal anterior cingulate cortex showed a sustained response for the entire duration of the videos.Conclusions: The present findings suggest that different regions of the fear network show differential temporal response patterns during video-induced symptom provocation in SAD. While the amygdala is involved during initial threat processing, the insula seems to be more involved during subsequent anxiety responses. In accordance with cognitive models of SAD, a medial prefrontal region engaged in emotional-cognitive interactions is generally hyperactivated.