Effects of Escitalopram Administration on Face Processing in Intermittent Explosive Disorder: An fMRI Study
Effects of Escitalopram Administration on Face Processing in Intermittent Explosive Disorder: An fMRI Study
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DOI：
10.1038/npp.2015.187
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发表时间：
2016-01-01
影响因子：
7.6
通讯作者：
Coccaro, Emil
中科院分区：
文献类型：
--
作者：
Cremers, Henk;Lee, Royce;Coccaro, Emil
间歇性爆炸障碍（IED）的神经生物学基础传统上与血清素能系统的缺陷有关。在这项研究中，我们研究了选择性血清素再摄取抑制剂艾司西酞普兰（escitalopram）对面部加工过程中大脑激活的影响。我们预期艾司西酞普兰会降低IED患者的杏仁核活动，此外，我们还探索了艾司西酞普兰对其他与社会情绪相关的大脑区域的影响。共有17名患有IED的受试者和14名健康对照者参加了一项随机、双盲、安慰剂对照、平衡fMRI面部处理研究。分析的重点是与注视基线对比的面部，并测试了以组为受试者之间因素和药物为受试者内因素的析因模型。在杏仁核（小体积校正）和左侧颞顶叶交界（TPJ，全脑校正）发现药物相互作用效应。艾司西酞普兰增加了对照组的杏仁核激活，但令人惊讶的是，在IED中没有。然而，与安慰剂相比，艾司西酞普兰组的TPJ在IED中的活性增加。TPJ与社会认知过程有关，如观点接受和同理心。TPJ的研究结果表明，服用SSRI可以通过增强这些社会认知过程来减少对他人的攻击倾向。未来的研究应进一步阐明ssri类药物对IED患者各种社会情绪任务的长期影响。
The neurobiological underpinnings of intermittent explosive disorder (IED) are traditionally linked to deficiencies in the serotonergic system. In this study, we investigated the effects of escitalopram, a selective serotonin reuptake inhibitor (SSRI), on brain activation during face processing. We expected that escitalopram would reduce amygdala activity in IED and in addition, we explored the effect in other social-emotional-related brain regions. A total of 17 subjects with current IED and 14 healthy controls participated in a randomized, double-blind, placebo-controlled, counterbalanced fMRI face processing study. The analysis focused on the faces compared to a fixation baseline contrast, and a factorial model with Group as between-subject and Drug as within-subject factor was tested. Group x Drug interaction effects were found in the amygdala (small volume corrected) and the left temporal parietal junction (TPJ; whole-brain corrected). Escitalopram increased amygdala activation in controls, but surprisingly not in IED. However, the TPJ showed increased activity in IED on escitalopram compared with placebo. The TPJ is associated with social-cognitive processes, such as perspective taking and empathy. The TPJ findings suggest that SSRI administration may reduce aggressive tendencies towards other people by enhancing these social-cognitive processes. Future research should further elucidate the long-term effects of SSRIs on various social-emotional tasks in IED.