Neuroanatomical circuits modulating fear and anxiety behaviors
Neuroanatomical circuits modulating fear and anxiety behaviors
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DOI：
10.1034/j.1600-0447.108.s417.3.x
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发表时间：
2003-01-01
影响因子：
6.7
通讯作者：
Charney, DS
中科院分区：
文献类型：
--
作者：
Charney, DS
目的：我们对焦虑症的神经生物学的理解，虽然还不完全，但随着遗传学、神经影像学和神经化学方法的发展和应用，焦虑症的神经解剖学基础已经得到了显著的发展。焦虑症，如恐慌症，特定的恐惧症和创伤后应激障碍的功能解剖学相关性也discussed.Results：功能性神经影像学研究焦虑症患者的症状激发试验期间显示神经生理异常，涉及边缘，边缘和感觉关联区域。神经递质如5-羟色胺和去甲肾上腺素与抑郁症的关系已得到证实。影响这些神经递质系统的抗抑郁药也被证明在治疗和管理焦虑症患者中是有用的。5-羟色胺和去甲肾上腺素在焦虑症的病理生理中的作用进行了审查。此外，参与应激激素促肾上腺皮质激素释放激素，肽胆囊收缩素和氨基酸递质γ-氨基丁酸在焦虑disorders.Conclusion：焦虑症的生物学调查结果的不一致突出了解决内在的神经生物学异质性的重要性，基于标准的精神病诊断。遗传学、神经影像学和神经化学方法的不断发展和应用将有助于理解这种异质性。新的焦虑症表型和阐明与这些疾病相关的基因型。这些实验方法的应用也将促进旨在阐明抗焦虑治疗机制的研究。
Objective: Our understanding of the neurobiology of anxiety disorders, although not complete, has advanced significantly with the development and application of genetic, neuroimaging and neurochemical approaches.Method: The neuroanatomical basis of anxiety disorders is reviewed with particular focus on the amygdala and the temporal and prefrontal cortex. The functional anatomical correlates of anxiety disorders such as panic disorder, specific phobias and post-traumatic stress disorder are also discussed.Results: Functional neuroimaging studies in patients with anxiety disorders have shown neurophysiological abnormalities during symptom provocation tests, implicating the limbic, paralimbic and sensory association regions. The involvement of neurotransmitters such as serotonin and norepinephrine in depressive disorders is well established. Antidepressants that affect these neurotransmitter systems have also been shown to be useful in the treatment and management of patients with anxiety disorders. The role of serotonin and norepinephrine in the pathophysiology of anxiety disorders is reviewed. In addition, the involvement of the stress hormone corticotropin-releasing hormone, the peptide cholecystokinin and the amino acid transmitter gamma-amino butyric acid in anxiety disorders is reviewed.Conclusion: The inconsistency in the results of biologic investigations of anxiety disorders highlights the importance of addressing the neurobiologic heterogeneity inherent within criteria-based, psychiatric diagnoses. Understanding of this heterogeneity will be facilitated by the continued development and application of genetic, neuroimaging and neurochemical approaches that can re. ne anxiety disorder phenotypes and elucidate the genotypes associated with these disorders. Application of these experimental approaches will also facilitate research aimed at clarifying the mechanisms of anti-anxiety therapies.