Sareen Jitender, Campbell Darren W, Leslie William D, Malisza Krisztina L, Stein Murray B, Paulus Martin P, Kravetsky Laura B, Kjernisted Kevin D, Walker John R, Reiss Jeffrey P
Department of Psychiatry, University of Manitoba, Winnipeg, Canada.
Biol Psychiatry. 2007 Feb 1;61(3):396-404. doi: 10.1016/j.biopsych.2006.05.043. Epub 2006 Nov 9.
Although evidence suggests the involvement of the amygdala in generalized social phobia (GSP), few studies have examined other neural regions. Clinical, preclinical, and dopamine receptor imaging studies demonstrating altered dopaminergic functioning in GSP suggest an association with striatal dysfunction. This is the first functional magnetic resonance imaging (fMRI) study to use a cognitive task known to involve the striatum to examine the neural correlates of GSP. We examined whether subjects with GSP had differential activation in striatal regions compared with healthy control subjects while engaged in a cognitive task that has been shown to activate striatal regions reliably.
Ten adult, unmedicated subjects with a primary DSM-IV diagnosis of GSP and 10 age-, gender-, and education-matched healthy comparison subjects underwent fMRI while performing the implicit sequence learning task.
The GSP and healthy comparison subjects did not differ significantly on the behavioral performance of the task. Subjects with GSP, however, had significantly reduced neural activation related to implicit learning compared with healthy comparison subjects in the left caudate head, left inferior parietal lobe, and bilateral insula.
These findings support the hypothesis that GSP is associated with striatal dysfunction and further the neurobiological understanding of this complex anxiety disorder.
尽管有证据表明杏仁核参与了广泛性社交恐惧症（GSP），但很少有研究考察其他神经区域。临床、临床前及多巴胺受体成像研究表明GSP中多巴胺能功能发生改变，提示其与纹状体功能障碍有关。这是第一项使用已知涉及纹状体的认知任务来研究GSP神经关联的功能磁共振成像（fMRI）研究。我们考察了在进行一项已被证明能可靠激活纹状体区域的认知任务时，与健康对照受试者相比，GSP受试者在纹状体区域是否有不同的激活情况。
10名成年、未接受药物治疗且主要诊断为DSM-IV标准下GSP的受试者以及10名年龄、性别和教育程度相匹配的健康对照受试者在执行内隐序列学习任务时接受了fMRI检查。
GSP受试者和健康对照受试者在任务的行为表现上没有显著差异。然而，与健康对照受试者相比，GSP受试者在左侧尾状核头部、左侧顶下叶和双侧脑岛中与内隐学习相关的神经激活显著减少。
这些发现支持了GSP与纹状体功能障碍有关的假说，并进一步加深了对这种复杂焦虑症的神经生物学理解。
