Neurophysiological Markers That Predict and Track Treatment Outcomes in Childhood Anxiety
Neurophysiological Markers That Predict and Track Treatment Outcomes in Childhood Anxiety
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DOI：
10.1007/s10802-013-9755-7
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发表时间：
2013-11-01
影响因子：
3.6
通讯作者：
Lewis, Marc D.
中科院分区：
文献类型：
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作者：
Hum, Kathryn M.;Manassis, Katharina;Lewis, Marc D.
本研究探讨了大脑皮层的过程，调解认知调节情绪引发的刺激，焦虑的儿童参与认知行为治疗计划之前和之后。在治疗前后记录焦虑儿童（n = 24，8名男性）和对照儿童（n = 16，7名男性）的脑电图活动。焦虑T评分从治疗前到治疗后的变化用于表示焦虑儿童的临床改善（改善者：n = 11 vs.非改善者：n = 13）。事件相关电位的组成部分，而儿童进行了一个去/不去任务，使用情绪面部表情。对于P1成分，被认为反映了注意力和/或唤醒过程，在两次会议上，非改进者相对于改进者和对照组具有更高的激活水平。治疗前P1振幅越大，治疗后无改善。对于被认为反映认知控制处理的额叶N2成分，改善者从治疗前到治疗后招募了更大的激活，这种激活变化可以预测治疗结果。非改善者在P1的时间窗内显示皮质激活增加，无论是在治疗前还是治疗后。这些数据表明，提高知觉警觉可能导致更差的结果。从治疗前到治疗后，改善者在N2的时间窗内表现出前额叶激活增加。这些数据表明，认知控制的增加可能导致治疗结果的改善。总之，P1激活可作为治疗结果的预测因子，而N2激活可作为治疗反应的指标。
The present study examined the cortical processes that mediate cognitive regulation in response to emotion-eliciting stimuli, before and after anxious children participated in a cognitive behavioral therapy program. Electroencephalographic activity was recorded from anxious children (n = 24, 8 males) and comparison children (n = 16, 7 males) at pre-and post-treatment sessions. The change in anxiety T-scores from pre- to post-treatment was used to signify clinical improvement among anxious children (Improvers: n = 11 vs. Non-improvers: n = 13). Event-related potential components were recorded while children performed a Go/No-go task using emotional facial expressions. For the P1 component, believed to reflect attention and/or arousal processes, Non-improvers had greater activation levels relative to Improver and comparison groups at both sessions. Greater P1 amplitudes at pre-treatment predicted non-improvement following treatment. For the frontal N2 component, thought to reflect cognitive control processing, Improvers recruited greater activation from pre- to post-treatment, a change in activation that was predictive of treatment outcome. Non-improvers showed increased cortical activation within the time window of the P1, whether at pre- or post-treatment. These data suggest that heightened perceptual vigilance may have led to poorer outcomes. Improvers showed increased prefrontal activation within the time window of the N2 from pre- to post-treatment. These data suggest that increased cognitive control may have led to improved treatment outcomes. In sum, P1 activation may serve as a predictor of treatment outcome, while N2 activation may serve as an indicator of treatment response.