Altered cerebral blood flow patterns associated with pathologic worry in the elderly.
Altered cerebral blood flow patterns associated with pathologic worry in the elderly.
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DOI：
10.1002/da.20799
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发表时间：
2011-03
影响因子：
7.4
通讯作者：
Aizenstein, Howard
中科院分区：
文献类型：
--
作者：
Andreescu, Carmen;Gross, James J.;Lenze, Eric;Edelman, Kathryn Dunfee;Snyder, Sara;Tanase, Costin;Aizenstein, Howard
广泛性焦虑障碍（GAD）是老年人中最常见的焦虑障碍，具有较高的功能和认知发病率。然而，晚年广泛性焦虑症的研究相对不足，其功能性神经解剖学是未知的。一些影像学研究表明，在年轻人的焦虑症情绪调节的认知控制系统的异常。本研究的目的是探讨晚年广泛性焦虑症患者情绪调节的神经相关性。我们比较了7名老年GAD受试者和10名老年非焦虑对照受试者使用功能MRI。局部脑血流量（rCBF）的测量使用脉冲动脉自旋标记（ASL）灌注MRI在休息和情绪调节范式。相对于休息状态，老年非焦虑对照组在右侧杏仁核、双侧杏仁核和相关颞枕区的焦虑诱导过程中rCBF增加。老年GAD受试者在焦虑诱导过程中颞枕联合区的rCBF增加，但在杏仁核或杏仁核中没有。在焦虑抑制期间，老年非焦虑对照组的前额叶皮层（PFC）和背侧ACC的rCBF增加。老年GAD受试者在前额叶皮层的焦虑抑制期间的rCBF没有变化。当试图调节他们的情绪反应时，老年焦虑受试者未能激活参与负性情绪下调的前额叶区域。这些结果表明，老年焦虑受试者没有有效地参与PFC抑制担心，可能是临床相关的发展个性化的治疗策略，治疗晚年广泛性焦虑症。
Generalized Anxiety Disorder (GAD) is the most prevalent anxiety disorder among the elderly and has high functional and cognitive morbidity. However, late-life GAD is relatively understudied, and its functional neuroanatomy is uncharted. Several imaging studies have suggested abnormalities in the cognitive control systems of emotion regulation in anxiety disorders in young adults. The aim of this study was to examine the neural correlates of emotion regulation in late-life GAD. We compared seven elderly GAD subjects and ten elderly non-anxious comparison subjects using functional MRI. Regional cerebral blood flow (rCBF) was measured using Pulsed Arterial Spin Labeling (ASL) perfusion MRI at rest and during an emotion regulation paradigm. Relative to the rest condition, elderly non-anxious comparison subjects had increased rCBF during worry induction in the right insula, bilateral amygdala, and associative temporo-occipital areas. Elderly GAD subjects had increased rCBF during worry induction in the associative temporo-occipital areas, but not in the insula or the amygdala. During worry suppression, elderly non-anxious comparison subjects had increased rCBF in the prefrontal cortex (PFC) and dorsal ACC. Elderly GAD subjects had no changes in rCBF during worry suppression in the prefrontal cortex. When attempting to regulate their emotional responses, elderly anxious subjects failed to activate prefrontal regions involved in the down-regulation of negative emotions. These results, showing that elderly anxious subjects are not effectively engaging the PFC in suppressing worry, may be clinically relevant for developing personalized therapeutic strategies for the treatment of late-life GAD.
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影响因子：
2.3
作者：
Hoehn-Saric, R;Schlund, MW;Wong, SHY
通讯作者：
Wong, SHY
影响因子：
7.2
作者：
Andreescu, Carmen;Belnap, Bea Herbeck;Lenze, Eric J.
通讯作者：
Lenze, Eric J.
DOI：
10.1176/appi.ajp.2009.09070931
发表时间：
2010-05
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Etkin A;Prater KE;Hoeft F;Menon V;Schatzberg AF
通讯作者：
Schatzberg AF
影响因子：
5.7
作者：
Campbell-Sills, Laura;Simmons, Alan N.;Lovero, Kathryn L.;Rochlin, Alexis A.;Paulus, Martin P.;Stein, Murray B.
通讯作者：
Stein, Murray B.
影响因子：
6.9
作者：
de Beurs, E;Beekman, ATF;van Tilburg, W
通讯作者：
van Tilburg, W