Rosenkranz Melissa A, Davidson Richard J
University of Wisconsin-Madison, Waisman Laboratory for Brain Imaging and Behavior, 1500 Highland Ave., Madison, WI 53705, USA.
Neuroimage. 2009 Sep;47(3):972-80. doi: 10.1016/j.neuroimage.2009.05.042. Epub 2009 May 22.
Individuals with asthma have twice the risk of developing mood and anxiety disorders as individuals without asthma and these psychological factors are associated with worse outcomes and greater need for medical intervention. Similarly, asthma symptom onset and exacerbation often occur during times of increased psychological stress. Remission from depression, on the other hand, is associated with improvement in asthma symptoms and decreased usage of asthma medication. Yet research aimed at understanding the biological underpinnings of asthma has focused almost exclusively on the periphery. An extensive literature documents the relationship between emotion and asthma, but little work has explored the function of affective neural circuitry in asthma symptom expression. Therefore, the following review integrates neuroimaging research related to factors that may impact symptom expression in asthma, such as individual differences in sensitivity to visceral signals, the influence of expectation and emotion on symptom perception, and changes related to disease chronicity, such as conditioning and plasticity. The synthesis of these literatures suggests that the insular and anterior cingulate cortices, in addition to other brain regions previously implicated in the regulation of emotion, may be both responsive to asthma-related bodily changes and important in influencing the appearance and persistence of symptom expression in asthma.
哮喘患者患情绪和焦虑症的风险是无哮喘者的两倍，这些心理因素与更差的预后及更大的医疗干预需求相关。同样，哮喘症状的发作和加重常常发生在心理压力增加之时。另一方面，抑郁症的缓解与哮喘症状改善及哮喘药物使用减少相关。然而，旨在了解哮喘生物学基础的研究几乎完全集中在外周。大量文献记载了情绪与哮喘之间的关系，但很少有研究探讨情感神经回路在哮喘症状表达中的作用。因此，以下综述整合了与可能影响哮喘症状表达的因素相关的神经影像学研究，如对内脏信号敏感性的个体差异、期望和情绪对症状感知的影响，以及与疾病慢性化相关的变化，如条件作用和可塑性。这些文献的综合表明，除了先前涉及情绪调节的其他脑区外，脑岛和前扣带回皮质可能对哮喘相关的身体变化有反应，并且在影响哮喘症状表达的出现和持续方面很重要。
