The role of the orbitofrontal cortex in anxiety disorders
The role of the orbitofrontal cortex in anxiety disorders
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DOI：
10.1196/annals.1401.006
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发表时间：
2007-01-01
期刊：
影响因子：
--
通讯作者：
Rauch, Scott L.
中科院分区：
文献类型：
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作者：
Milad, Mohammed R.;Rauch, Scott L.
过去二十年来，神经成像技术的进步使科学家能够研究焦虑症的神经回路。这些研究涉及眶额皮质（OFC）。然而，表征OFC在焦虑症中的作用，主要是复杂的两个因素的差异，在潜在的病理生理学的焦虑症和异质性的功能在不同的OFC子领土。现代焦虑症的神经回路模型主要集中在杏仁皮质的相互作用。杏仁核与产生恐惧反应有关，而皮层区域，特别是内侧前额叶皮层（mOFC）和腹内侧前额叶皮层（vmPFC）与恐惧消退有关。与mOFC相反，前外侧OFC（IOFC）与负面情绪和强迫症相关，因此功能障碍的IOFC可能是某些焦虑症的不同方面的基础。在此，我们的目的是回顾上述理论，并提供一个启发式模型概念化的mOFC和IOFC在焦虑症的病理生理和治疗中的各自作用。我们还将回顾眶额皮层在恐惧消退中的作用，以及这种作用对焦虑症病理生理学的影响。
Advances in neuroimaging techniques over the past two decades have allowed scientists to investigate the neurocircuitry of anxiety disorders. Such research has implicated the orbitofrontal cortex (OFC). Characterizing the role of OFC in anxiety disorders, however, is principally complicated by two factors-differences in underlying pathophysiology across the anxiety disorders and heterogeneity in function across different OFC sub-territories. Contemporary neurocircuitry models of anxiety disorders have primarily focused on amygdalocortical interactions. The amygdala is implicated in generating fear responses, whereas cortical regions, specifically the medial OFC (mOFC) and the ventromedial prefrontal cortex (vmPFC), are implicated in fear extinction. In contrast to mOFC, anterolateral OFC (lOFC) has been associated with negative affects and obsessions and thus dysfunctional lOFC may underlie different aspects of certain anxiety disorders. Herein, we aim to review the above-mentioned theories and provide a heuristic model for conceptualizing the respective roles of mOFC and lOFC in the pathophysiology and treatment of anxiety disorders. We will also review the role of the OFC in fear extinction and the implications of this role to the pathophysiology of anxiety disorders.