Zhao Xiao-Hu, Wang Pei-Jun, Li Chun-Bo, Xi Qian, Shao Zhi-Hong, Hu Zheng-Hui
Imaging Department, Tongji Hospital, Tongji University, Shanghai 200065, China.
Zhonghua Yi Xue Za Zhi. 2008 Jun 17;88(23):1603-6.
Neuronal circuits involved in the pathophysiology of anxiety are not yet fully understood. We used functional connectivity MRI to explore the characteristic of functional connectivity in anxiety disorders patient and the neural mechanism of this disease. This work was selected as an oral presentation in 2006 ISMRM.
Twenty right-handed subjects were included in this study, and were divided into two groups. The anxiety (P) group (n = 10; 7 male, mean age 42 years) consisted of patients meeting DSM-IV criteria for a principal diagnosis of anxiety disorder. The control (C) group consisted of volunteers free of psychiatric symptoms, and was matched on age and gender (n = 10; 7 male) with the panic patients. The subjects underwent noninvasive functional magnetic resonance imaging while listening actively to (1): emotionally neutral word alternating with no word as the control condition (CN, PN), and (2): threat-related words alternating with emotionally neutral word as the experimental condition (CT, PT). Each word was presented in pseudorandom order in each 16 s block of 12 words of the same type. Eight alternating blocks of neutral words were presented for about 256 s. The subject was only asked to passively listen to each word. All MRI data were obtained on a 1.5-Tesla scanner Data analysis was performed with SPM99 to find significant activations in two tasks for two groups. Based on group t-test, we chose two anatomically defined regions: left superior temporal gyrus (GTs) and right GTs. Then, based on individual t-map, the voxel with the largest t-value within two regions was taken as the subject-specific peak voxel. We define clusters based on faces and edges, but not corners, so each voxel has 18 neighbors. Subject-specific averaged time series were extracted by averaging the time series of 19 voxels. Since healthy control subjects showed no significant activation (corrected, P < 0.05) during processing of anxiety word to neutral word, region of interest during processing of neutral word to no word was used as substitution. The connectivity degree eta(i j) between the node i and the node j is used to identify the change of the functional connectivity associated with differential tasks, which calculated by using the methods that have developed by ourselves. Moreover, we just consider coherence in low-frequency (0-0.15 Hz).
The activation brain regions have been reported in our previous work. Patients were significant different from normal controls on two experiments. The connectivity degree of left Gts and right Gts in two tasks across all subjects was calculated. Comparing during processing neutral word to blank, a significant decrease (P < 0.001) in functional degree was observed during processing of threaten word to neutral word (eta = 0.5636 for CN, eta = 0.555 for CT, eta = 0.5616 for PN, eta = 0.4926 for PT). Especially, the greater decrease connectivity degree was identified for patient group compared with normal control during threat-related words alternating with emotionally neutral word condition. The connectivity degree identifies that functional interactions change with differential task.
This result suggests decreased functional connectivity among left superior temporal gyrus and right GTs during processing of anxiety word to neutral word in anxiety patients. This dysfunction may mediate the neural mechanism of this sort of disease.
参与焦虑症病理生理过程的神经回路尚未完全明确。我们采用功能连接磁共振成像来探究焦虑症患者功能连接的特征以及该疾病的神经机制。这项研究成果在2006年国际磁共振医学学会(ISMRM)上被选为口头报告。
本研究纳入了20名右利手受试者,并将其分为两组。焦虑症(P)组(n = 10;7名男性,平均年龄42岁)由符合DSM-IV标准的焦虑症主要诊断患者组成。对照组(C)由无精神症状的志愿者组成,在年龄和性别上与惊恐障碍患者匹配(n = 10;7名男性)。受试者在积极聆听时接受无创功能磁共振成像检查:(1)情感中性词与无词交替出现作为对照条件(CN,PN),以及(2)威胁相关词与情感中性词交替出现作为实验条件(CT,PT)。每个词在每16秒的12个同类型词块中以伪随机顺序呈现。呈现8个中性词交替块,持续约256秒。受试者只需被动聆听每个词。所有磁共振成像数据均在1.5特斯拉扫描仪上获取。使用SPM99进行数据分析,以找出两组在两项任务中的显著激活区域。基于组间t检验,我们选择了两个解剖学定义区域:左侧颞上回(GTs)和右侧GTs。然后,基于个体t图,将两个区域内t值最大的体素作为受试者特异性峰值体素。我们基于面和边而非角来定义簇,因此每个体素具有18个邻居。通过对19个体素的时间序列进行平均来提取受试者特异性平均时间序列。由于健康对照受试者在从焦虑词处理到中性词的过程中未显示出显著激活(校正后,P < 0.05),因此将从中性词处理到无词的过程中的感兴趣区域用作替代。节点i和节点j之间的连接度eta(i j)用于识别与不同任务相关的功能连接变化,其通过我们自己开发的方法计算得出。此外,我们仅考虑低频(0 - 0.15 Hz)的相干性。
激活的脑区已在我们之前的研究中报道。在两项实验中,患者与正常对照存在显著差异。计算了所有受试者在两项任务中左侧GTs和右侧GTs的连接度。与从中性词处理到空白相比,在从威胁词处理到中性词的过程中观察到功能连接度显著降低(P < 0.001)(CN时eta = 0.5636,CT时eta = 0.555,PN时eta = 0.5616,PT时eta = 0.4926)。特别是,与正常对照相比,在威胁相关词与情感中性词交替出现的条件下,患者组的连接度降低更为明显。连接度表明功能相互作用随不同任务而变化。
该结果表明,在焦虑症患者从焦虑词处理到中性词的过程中,左侧颞上回和右侧GTs之间的功能连接降低。这种功能障碍可能介导了此类疾病的神经机制。