Cortico-limbic responses to masked affective faces across ptsd, panic disorder, and specific phobia.
Cortico-limbic responses to masked affective faces across ptsd, panic disorder, and specific phobia.
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DOI：
10.1002/da.22156
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发表时间：
2014-02
影响因子：
7.4
通讯作者：
Rauch SL
中科院分区：
文献类型：
--
作者：
Killgore WD;Britton JC;Schwab ZJ;Price LM;Weiner MR;Gold AL;Rosso IM;Simon NM;Pollack MH;Rauch SL
在对个体焦虑症的研究中，有报告称在情绪处理过程中杏仁核过度活跃以及腹内侧前额叶皮质（vmPFC）反应性降低。然而，需要在同一研究中对多种焦虑症的杏仁核 - 皮质回路激活情况进行直接比较的研究。在此，我们使用一种经过充分验证的情绪探测任务，对三种不同焦虑症的皮质 - 边缘神经回路进行了比较。
65名成年志愿者，包括22名健康对照者（HC）以及符合《精神疾病诊断与统计手册》第四版（DSM - IV）中创伤后应激障碍（14名PTSD患者）、惊恐障碍（14名PD患者）、特定动物恐惧症（15名SP患者）诊断标准的参与者，在3T磁场下接受功能性磁共振成像（fMRI）检查，同时被动观看呈现恐惧、快乐和中性情绪的面部图像（这些图像经过了反向掩蔽处理）。
在掩蔽的恐惧与中性条件对比中，由三种焦虑症组成的一组与健康对照组相比，左侧杏仁核激活程度更高，vmPFC激活程度更低。成对组比较显示，杏仁核激活仅在PTSD组与健康对照组之间具有显著差异，而vmPFC激活降低仅在SP组和PD组与健康对照组相比时明显。此外，当焦虑症组之间直接相互对比时，激活情况没有差异。对于掩蔽的快乐与中性面部图像，也观察到了类似的模式。
不考虑具体的诊断类别，焦虑症通常与杏仁核激活增加以及vmPFC激活降低有关。类别差异通常较弱或未被观察到，这表明功能差异可能反映的是不同疾病中常见神经回路内反应的程度，而非不同系统的激活。
Exaggerated amygdala and reduced ventromedial prefrontal cortex (vmPFC) responsiveness during emotional processing have been reported in studies examining individual anxiety disorders. Studies are needed, however, that directly compare activation of amygdalo-cortical circuitry across multiple anxiety disorders within the same study. Here we compared cortico-limbic neurocircuitry across three different anxiety disorders using a well-validated emotional probe task. Sixty-five adult volunteers, including 22 healthy controls (HC) and participants meeting DSM-IV criteria for either post-traumatic stress disorder (14 PTSD), panic disorder (14 PD), specific animal phobia (15 SP) underwent functional magnetic resonance imaging (fMRI) at 3T while passively viewing backward-masked images of faces expressing fear, happy, and neutral emotions. A group comprising all three anxiety disorders showed greater activation within the left amygdala and reduced activation within the vmPFC compared to the HC group during the masked fear versus neutral condition. Pairwise group comparisons showed that amygdala activation only reached significance for the PTSD versus HCs, while decreased vmPFC was only evident for SP and PD groups versus the HC group. Furthermore, activation did not differ among the anxiety groups when contrasted directly with one another. A similar pattern was observed for masked happy versus neutral faces. Exclusive of specific diagnostic category, anxiety disorders were generally associated with increased activation of the amygdala and reduced activation within vmPFC. Categorical distinctions were generally weak or not observed and suggest that functional differences may reflect the magnitude of responses within a common neurocircuitry across disorders rather than activation of distinct systems.