惊恐障碍患者负性情绪加工异常的任务态功能磁共振研究
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摘要
目的:通过功能磁共振(f MRI)扫描,探讨惊恐障碍(PD)患者认知监控网络(cognitive control network,CCN)及情绪调节网络(mood regulating circuit,MRC)的功能异常。方法:对19例PD患者(PD组)和18名健康志愿者(健康对照组)在负性情绪图片刺激下进行f MRI扫描,并收集其基本资料,使用两样本t检验比较两组被试CCN及MRC脑区的差异,采用独立样本t检验对其一般资料和临床量表进行分析。结果:与健康对照组相比,以中性情绪图片为基线,PD患者在观察负性情绪图片时,左侧背外侧前额叶(MNI:-21,3,60;t=-3.15;P<0.05)、右侧背外侧前额叶(MNI:21,0,66;t=-2.70;P<0.05)、左侧背外侧前扣带回(MNI:-6,15,24;t=-1.82;P<0.05)、右侧背外侧前扣带回(MNI:6,-12,30;t=-3.04;P<0.05)、右侧丘脑(MNI:18,-9,0;t=-2.56;P<0.05)、左侧楔前叶(MNI:-12,-66,51;t=-2.86;P<0.05)、左侧背外侧海马(MNI:-18,-36,6;t=-1.80;P<0.05)脑区激活减弱;左侧腹内侧海马(MNI:-18,-15,-18;t=2.06;P<0.05)、左侧腹内侧前额叶(MNI:-6,45,-9;t=2.48;P<0.05)脑区激活增强。结论:PD的发病机制可能与患者CCN认知监控能力减弱和MRC负性情绪反应增强有关。
Objective: To investigate the functional abnormalities of cognitive control network( CCN)and mood regulating circuit( MRC) in panic disorder( PD) by functional magnetic resonance imaging( f MRI). Method: We recruited 19 PD patients and 18 healthy controls to task-state f MRI scans and collected their demographics and clinical characteristics. Then we used two sample t-test to analyze the difference between the two groups. Results: In task-related condition,while the neutral mood pictures were used as a baseline contrast,the negative pictures decreased the activation of left dorsolateral prefrontal cortex( MNI:-21,3,60;t =-3. 15; P < 0. 05),right dorsolateral prefrontal cortex( MNI: 21,0,66; t =-2. 70; P < 0. 05),left dorsal anterior cingulate cortex( MNI:-6,15,24; t =-1. 82; P < 0. 05),right dorsal anterior cingulate cortex( MNI:6,-12,30; t =-3. 04; P < 0. 05),right thalamus( MNI: 18,-9,0; t =-2. 56; P < 0. 05),left precuneus( MNI:-12,-66,51; t =-2. 86; P < 0. 05),left dorsal hippocampus( MNI:-18,-36,6; t =-1. 80; P <0. 05) and activated left ventral hippocampus( MNI:-18,-15,-18; t = 2. 06; P < 0. 05),left ventromedial prefrontal cortex( MNI:-6,45,-9; t = 2. 48; P < 0. 05) in PD patients. Conclusion: Our results suggest that PD patients may have weakened cognitive regulation of the CCN and enhanced negative emotion reaction of the MRC,which may be associated with the disease mechanism of PD.
Objective: To investigate the functional abnormalities of cognitive control network( CCN)and mood regulating circuit( MRC) in panic disorder( PD) by functional magnetic resonance imaging( f MRI). Method: We recruited 19 PD patients and 18 healthy controls to task-state f MRI scans and collected their demographics and clinical characteristics. Then we used two sample t-test to analyze the difference between the two groups. Results: In task-related condition,while the neutral mood pictures were used as a baseline contrast,the negative pictures decreased the activation of left dorsolateral prefrontal cortex( MNI:-21,3,60;t =-3. 15; P < 0. 05),right dorsolateral prefrontal cortex( MNI: 21,0,66; t =-2. 70; P < 0. 05),left dorsal anterior cingulate cortex( MNI:-6,15,24; t =-1. 82; P < 0. 05),right dorsal anterior cingulate cortex( MNI:6,-12,30; t =-3. 04; P < 0. 05),right thalamus( MNI: 18,-9,0; t =-2. 56; P < 0. 05),left precuneus( MNI:-12,-66,51; t =-2. 86; P < 0. 05),left dorsal hippocampus( MNI:-18,-36,6; t =-1. 80; P <0. 05) and activated left ventral hippocampus( MNI:-18,-15,-18; t = 2. 06; P < 0. 05),left ventromedial prefrontal cortex( MNI:-6,45,-9; t = 2. 48; P < 0. 05) in PD patients. Conclusion: Our results suggest that PD patients may have weakened cognitive regulation of the CCN and enhanced negative emotion reaction of the MRC,which may be associated with the disease mechanism of PD.
引文
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[16]Blair K,Shaywitz J,Smith BW,et al.Response to emotional expressions in generalized social phobia and generalized anxiety disorder:evidence for separate disorders[J].American Journal Psychiatry,2008,165(9):1193-1202.
[17]Davis M,Walker DL,Miles L,et al.Phasic vs sustained fear in rats and humans:role of the extended amygdala in fear vs anxiety[J].Neuropsychopharmacology,2010,35(1):105-135.
[18]Walker DL,Miles LA,Davis M.Selective participation of the bed nucleus of the stria terminalis and CRF in sustained anxiety-like versus phasic fear-like responses[J].Progress Neuropsychopharmacology Biological Psychiatry,2009,33(8):1291-1308.
[19]Cabeza R,Nyberg L.Imaging cognition II:An empirical review of275 PET and f MRI studies[J].Journal Cognitive Neuroscience,2000,12(1):1-47.
[20]Lai CH,Wu YT.The alterations in inter-hemispheric functional coordination of panic with panic disorder:The findings in the posterior sub-network of default mode network[J].Journal Affective Disorders,2014,166:279-284.
[21]Ferri J,Schmidt J,Hajcak G,et al.Emotion regulation and amygdala-precuneus connectivity:Focusing on attentional deployment[J].Cognitive Affective Behavioral Neuroscience,2016,16(6):991-1002.
[2]Feldker K,Heitmann CY,Neumeister P,et al.Cardiorespiratory concerns shape brain responses during automatic panic-related scene processing in patients with panic disorder[J].Journal Psychiatry Neuroscience,2017,42(6):160226
[3]Alexopoulos GS,Hoptman MJ,Kanellopoulos D,et al.Functional connectivity in the cognitive control network and the default mode network in late-life depression[J].Journal Affective Disorders,2012,139(1):56-65.
[4]Pourtois G,Vocat R.N'diaye K,et al.Errors recruit both cognitive and emotional monitoring systems:Simultaneous intracranial recordings in the dorsal anterior cingulate gyrus and amygdala combined with f MRI[J].Neuropsychologia,2010,48(4):1144-1159.
[5]Clark DA,Beck AT.Cognitive theory and therapy of anxiety and depression:convergence with neurobiological findings[J].Trends Cognitive Sciences,2010,14(9):418-424.
[6]Das P,Coulston CM,Bargh DM,et al.Neural antecedents of emotional disorders:a functional magnetic resonance imaging study of subsyndromal emotional symptoms in adolescent girls[J].Biological Psychiatry,2013,74(4):265-272.
[7]李鸿磊,王纯,滕昌军,等.广泛性焦虑障碍患者认知监控网络异常的功能磁共振研究[J].临床精神医学杂志,2016,26(5):299-301.
[8]Koenigs M,Grafman J.The functional neuroanatomy of depression:distinct roles for ventromedial and dorsolateral prefrontal cortex[J].Behavioural Brain Research,2009,201(2):239-243.
[9]Han DH,Renshaw PF,Dager SR,et al.Altered cingulate white matter connectivity in panic disorder patients[J].Journal Psychiatric Research,2008,42(5):399-407.
[10]Pourtois G,Vocat R,N'diaye K,et al.Errors recruit both cognitive and emotional monitoring systems:simultaneous intracranial recordings in the dorsal anterior cingulate gyrus and amygdala combined with f MRI[J].Neuropsychologia,2010,48(4):1144-1159.
[11]Satpute AB,Mumford JA,Naliboff BD,et al.Human anterior and posterior hippocampus respond distinctly to state and trait anxiety[J].Emotion,2012,12(1):58-68.
[12]Nieuwenhuis IL,Takashima A.The role of the ventromedial prefrontal cortex in memory consolidation[J].Behavioural Brain Research,2011,218(2):325-334.
[13]Qin S,Young CB,Duan X,et al.Amygdala subregional structure and intrinsic functional connectivity predicts individual differences in anxiety during early childhood[J].Biological Psychiatry,2014,75(11):892-900.
[14]Machadodesousa JP,Osório FL,Jackowski AP,et al.Increased amygdalar and hippocampal volumes in young adults with social anxiety[J].PLo S One,2014,9(2):e88523.
[15]Boehme S,Ritter V,Tefikow S,et al.Brain activation during anticipatory anxiety in social anxiety disorder[J].Social Cognitive Affective Neuroscience,2014,9(9):1413-1418.
[16]Blair K,Shaywitz J,Smith BW,et al.Response to emotional expressions in generalized social phobia and generalized anxiety disorder:evidence for separate disorders[J].American Journal Psychiatry,2008,165(9):1193-1202.
[17]Davis M,Walker DL,Miles L,et al.Phasic vs sustained fear in rats and humans:role of the extended amygdala in fear vs anxiety[J].Neuropsychopharmacology,2010,35(1):105-135.
[18]Walker DL,Miles LA,Davis M.Selective participation of the bed nucleus of the stria terminalis and CRF in sustained anxiety-like versus phasic fear-like responses[J].Progress Neuropsychopharmacology Biological Psychiatry,2009,33(8):1291-1308.
[19]Cabeza R,Nyberg L.Imaging cognition II:An empirical review of275 PET and f MRI studies[J].Journal Cognitive Neuroscience,2000,12(1):1-47.
[20]Lai CH,Wu YT.The alterations in inter-hemispheric functional coordination of panic with panic disorder:The findings in the posterior sub-network of default mode network[J].Journal Affective Disorders,2014,166:279-284.
[21]Ferri J,Schmidt J,Hajcak G,et al.Emotion regulation and amygdala-precuneus connectivity:Focusing on attentional deployment[J].Cognitive Affective Behavioral Neuroscience,2016,16(6):991-1002.
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