Human fear neurobiology reimagined: Can brain-derived biotypes predict fear-based disorders after trauma?
Human fear neurobiology reimagined: Can brain-derived biotypes predict fear-based disorders after trauma?
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DOI：
10.1016/j.neubiorev.2022.104988
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发表时间：
2022-12-13
影响因子：
8.2
通讯作者：
Jovanovic, Tanja
中科院分区：
文献类型：
--
作者：
McClellan, John;Jovanovic, Tanja
对恐惧神经生物学的人类研究已经建立了对威胁刺激被激活的神经回路，无论是在巴甫洛夫恐惧条件反射期间还是在对自然发生的威胁做出反应时。该回路涉及中央和基底外侧杏仁核，以及终纹、岛叶、海马的床核，以及前扣带皮层和腹内侧前额叶皮层等调节区域。虽然研究发现基于恐惧的疾病，例如焦虑和创伤后应激障碍，与这些回路的功能障碍有关，但症状的临床表现存在很大的个体异质性。最近的工作使用数据驱动的方法来导出大脑生物型，该生物型利用恐惧回路的活动及其与大脑其他区域的相互作用。这些生物型在描述精神病理学的个体差异和识别在环境压力源（例如创伤事件）后面临更大风险的基于恐惧的疾病的个体方面具有很大的实用性。该评论讨论了最近的例子，说明如何利用恐惧神经生物学研究来得出生物型，最终可能改善治疗。
Human studies of fear neurobiology have established neural circuits that are activated to threatening stimuli, whether it be during Pavlovian fear conditioning or in response to naturally occurring threats. This circuitry involves the central and basolateral amygdala, as well as the bed nucleus of the stria terminalis, insula, hip-pocampus, and regulatory regions such as the anterior cingulate cortex and ventromedial prefrontal cortex. While research has found that fear-based disorders, such as anxiety and post-traumatic stress disorder, as associated with dysfunction in these circuits, there is substantial individual heterogeneity in the clinical pre-sentation of symptoms. Recent work has used data-driven methods to derive brain biotypes that capitalize on the activity of the fear circuit and its interaction with other regions of the brain. These biotypes have great utility in both describing individual variation in psychopathology and in identifying individuals at greater risk for fear -based disorders after an environmental stressor, such as a traumatic event. The review discusses recent exam-ples of how fear neurobiology studies can be leveraged to derive biotypes that may ultimately lead to improved treatment.