Neural correlates of altered general emotion processing in social anxiety disorder
Neural correlates of altered general emotion processing in social anxiety disorder
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DOI：
10.1016/j.brainres.2010.12.084
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发表时间：
2011-03-10
期刊：
影响因子：
2.9
通讯作者：
Herwig, Uwe
中科院分区：
文献类型：
--
作者：
Bruehl, Annette B.;Rufer, Michael;Herwig, Uwe
特定的焦虑障碍在神经生物学层面的特征是对恐惧症特定刺激的情绪处理发生改变。近期的研究工作集中在特定的引发焦虑的刺激上，重点关注与唤醒或恐惧相关的大脑区域，比如杏仁核。我们分析了在对不愉快或不确定的情绪刺激进行线索性预期时的大脑激活情况，以此作为对一种非特定的充满焦虑的情境进行建模的一种手段。16名社交焦虑障碍（SAD）患者和18名健康对照受试者在功能性磁共振成像过程中完成了一项任务，该任务涉及对具有事先已知的情绪效价（积极、消极和中性）或事先未知/模糊的情绪内容的线索性视觉刺激进行预期。预期的刺激没有社交恐惧症特定的内容。在对事先已知为消极和事先具有模糊情绪效价的情绪刺激进行预期时，与对照受试者相比，社交焦虑障碍患者在上中脑/背侧丘脑、杏仁核以及颞枕叶和顶叶区域的大脑活动增加。社交焦虑障碍患者左侧眶额皮质的活动减少。杏仁核和枕叶区域的激活与特质焦虑和社交焦虑的测量指标相关。总之，社交焦虑障碍与在对非特定的、一般性的情绪刺激进行预期时，参与情绪唤醒以及注意力和感知处理的大脑区域的激活增强有关。因此，我们的研究结果表明，社交焦虑障碍患者不仅对特定的恐惧刺激的处理发生了改变，而且在基本的神经通路中的情绪处理也受到了更普遍的干扰。这些发现对社交焦虑障碍的诊断模型和治疗具有启示意义。（C）2011爱思唯尔有限公司。保留所有权利。
Specific anxiety disorders are characterized by altered emotion processing of phobia-specific stimuli at the neurobiological level. Recent work has concentrated on specific anxiety-provoking stimuli; focusing on arousal- or fear-related brain areas such as the amygdala. We analyzed brain activation during the cued anticipation of unpleasant or uncertain emotional stimuli as a means of modeling an unspecific anxiety-laden situation. Sixteen patients with social anxiety disorder (SAD) and eighteen healthy control subjects completed a task during functional magnetic resonance imaging involving the anticipation of cued visual stimuli with prior known emotional valence (positive, negative, and neutral) or prior unknown/ambiguous emotional content. The anticipated stimuli had no social phobia specific content. During the anticipation of emotional stimuli of prior known negative and prior ambiguous emotional valence, brain activity in patients with SAD was increased in the upper midbrain/dorsal thalamus, the amygdala, and in temporo-occipital and parietal regions as compared to control subjects. Activity was decreased in SAD in left orbitofrontal cortex. Activations in the amygdala and in occipital regions correlated with trait anxiety and social anxiety measures. In conclusion, SAD was associated with enhanced activation in brain regions involved in emotional arousal as well as in attention and perception processing during the anticipation of non-specific, general emotional stimuli. Hence, our results suggest that patients with SAD not only have an altered processing of specific feared stimuli, but also a more generally disturbed emotion processing in basic neural pathways. These findings have implications for diagnostic models and the treatment of SAD. (C) 2011 Elsevier B.V. All rights reserved.