Asami Takeshi, Hayano Fumi, Nakamura Motoaki, Yamasue Hidenori, Uehara Kumi, Otsuka Tatsui, Roppongi Tomohide, Nihashi Namiko, Inoue Tomio, Hirayasu Yoshio
Department of Psychiatry, Yokohama City University School of Medicine, Yokohama, Japan.
Psychiatry Clin Neurosci. 2008 Jun;62(3):322-30. doi: 10.1111/j.1440-1819.2008.01800.x.
Recent neuroimaging studies have suggested that the anterior cingulate cortex (ACC) has an important role in the pathology of panic disorder. Despite numerous functional neuroimaging studies that have elucidated the strong relationship between functional abnormalities of the ACC and panic disorder and its symptoms and response to emotional tasks associated with panic disorder, there has been no study showing volumetric changes of the ACC or its subregions.
To clarify the structural abnormalities of ACC and its subregions, the combination of region of interest (ROI) and optimized voxel-based morphometry (VBM) methods were performed on 26 patients with panic disorder, and 26 age and sex-matched healthy subjects. In the ROI study, ACC was divided into four subregions: dorsal, rostral, subcallosal and subgenual ACC.
The results of the manually traced ROI volume comparison showed significant volume reduction in the right dorsal ACC. VBM also showed a volume reduction in the right dorsal as well as a part of the rostral ACC as a compound mass.
Both manual ROI tracing and optimized VBM suggest a subregion-specific pattern of ACC volume deficit in panic disorder. In addition to functional abnormalities, these results suggest that structural abnormalities of the ACC contribute to the pathophysiology of panic disorder.
近期的神经影像学研究表明，前扣带回皮质（ACC）在惊恐障碍的病理过程中起重要作用。尽管众多功能神经影像学研究已阐明ACC功能异常与惊恐障碍及其症状以及与惊恐障碍相关的情感任务反应之间的紧密关系，但尚无研究显示ACC及其亚区的体积变化。
为明确ACC及其亚区的结构异常，对26例惊恐障碍患者以及26名年龄和性别匹配的健康受试者采用感兴趣区（ROI）与优化的基于体素的形态学测量（VBM）方法相结合进行研究。在ROI研究中，ACC被分为四个亚区：背侧、喙侧、胼胝体下和膝下ACC。
手动追踪的ROI体积比较结果显示，右侧背侧ACC体积显著减小。VBM也显示右侧背侧以及喙侧ACC的一部分作为复合团块体积减小。
手动ROI追踪和优化的VBM均提示惊恐障碍中ACC体积缺失存在亚区特异性模式。除功能异常外，这些结果表明ACC的结构异常也参与了惊恐障碍的病理生理过程。
