Stein Murray B, Goldin Philippe R, Sareen Jitender, Zorrilla Lisa T Eyler, Brown Gregory G
Department of Psychiatry, University of California-San Diego, CA 92093-0985, USA.
Arch Gen Psychiatry. 2002 Nov;59(11):1027-34. doi: 10.1001/archpsyc.59.11.1027.
Generalized social phobia (GSP) is characterized by fear of social interactions and sensitivity to disapproval by others. Given the established role of the amygdala as part of a distributed neural system for the processing of emotional cues, we hypothesized that subjects with GSP would exhibit greater amygdala activation in response to harsh (angry, fearful, and contemptous) vs accepting (happy) facial emotional expressions compared with healthy control subjects (HCs).
Fifteen subjects with DSM-IV GSP and 15 age-, sex-, handedness-, and education-matched HCs, free of psychotropic medication for at least 12 weeks, viewed 60 color photographs from a standardized set of human facial stimuli, during which the task was to identify the sex of the person in the photograph. Data were collected across 3 functional (echo-planar) runs using a Siemens 1.5-T magnet, and analyzed using Analysis of Functional Neuroimaging software (Medical College of Wisconsin, Milwaukee).
In the left allocortex (including the amygdala, uncus, and parahippocampal gyrus), subjects with GSP produced a significantly greater percent blood oxygen level-dependent signal change than did HCs for contemptous compared with happy faces (GSP: 0.72% vs HC: -0.01%; F(1,29) = 9.56, P =.004, Cohen d = 1.15) and for angry compared with happy faces (GSP: 0.45% vs HC: -0.09%; F(1,29) = 6.78, P =.02, Cohen d = 1.00). Subjects with GSP and HCs did not produce a statistically different percent signal change for fearful or nonexpressive faces compared with the happy faces in this region.
These findings are consistent with a role for differential amygdala (and associated limbic) functioning in GSP. The pronounced response to contemptuous and angry facial expressions suggests that the amygdala in GSP may be particularly active in the processing of disorder-salient stimuli.
广泛性社交恐惧症（GSP）的特征是害怕社交互动以及对他人的不认可敏感。鉴于杏仁核作为处理情绪线索的分布式神经系统的一部分已确定的作用，我们假设与健康对照受试者（HCs）相比，GSP受试者在面对严厉（愤怒、恐惧和轻蔑）与接受（开心）面部情绪表情时会表现出更大的杏仁核激活。
15名符合《精神疾病诊断与统计手册》第四版（DSM-IV）的GSP受试者和15名年龄、性别、利手和教育程度相匹配的HCs，至少12周未服用精神药物，观看一组标准化的人类面部刺激的60张彩色照片，在此期间的任务是识别照片中人物的性别。使用西门子1.5-T磁体在3次功能性（回波平面）扫描中收集数据，并使用功能神经成像分析软件（威斯康星医学院，密尔沃基）进行分析。
在左侧异皮质（包括杏仁核、钩回和海马旁回）中, 与开心面孔相比，GSP受试者在面对轻蔑面孔时产生的血氧水平依赖信号变化百分比显著高于HCs（GSP：0.72% vs HC：-0.01%；F(1,29) = 9.56，P = 0.004，Cohen d = 1.15），在面对愤怒面孔与开心面孔时也是如此（GSP：0.45% vs HC：-0.09%；F(1,29) = 6.78，P = 0.02，Cohen d = 1.00）。在该区域，与开心面孔相比，GSP受试者和HCs在面对恐惧或无表情面孔时产生的信号变化百分比没有统计学差异。
这些发现与杏仁核（及相关边缘系统）在GSP中功能存在差异的作用一致。对轻蔑和愤怒面部表情的明显反应表明，GSP中的杏仁核在处理与疾病相关的显著刺激时可能特别活跃。
