Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai, China.
Neuropsychiatr Dis Treat. 2011;7:241-9. doi: 10.2147/NDT.S10997. Epub 2011 May 2.
Anxiety disorders are highly prevalent internationally, and constitute a substantial social and economic burden for patients, their families, and society. A number of neuroimaging studies have investigated the etiology of anxiety disorders in China in the last decade. We discuss the findings of these studies, and compare them with the results of neuroimaging studies of anxiety disorders outside China.
A literature search was conducted using the Chinese BioMedical Literature Database, the Chinese Scientific and Technical Periodicals Database, the Chinese Journal Full-text Database, and PubMed, from 1989 to April 2009. We selected neuroimaging studies in which all participants and researchers were Chinese.
Twenty-five studies fit our inclusion criteria. Nine studies examined general anxiety disorder (GAD) and/or panic disorder (PD), eight examined obsessive-compulsive disorder (OCD), and eight examined posttraumatic stress disorder (PTSD). Our literature review revealed several general findings. First, reduced regional cerebral blood flow (rCBF) was found in the frontal lobe and temporal lobe in patients with GAD and PD compared with healthy controls. Second, when viewing images with negative and positive valence, relatively increased or decreased activation was found in several brain areas in patients with GAD and PD, respectively. Third, studies with positron emission tomography (PET) and magnetic resonance spectroscopy (MRS) imaging revealed that OCD patients exhibited hyperperfusion and hypoperfusion in some brain regions compared with healthy controls. Neuroimaging studies of PTSD indicate that the hippocampal volume and the N-acetylaspartic acid (NAA) level and the NAA/creatine ratio in the hippocampus are decreased in patients relative to controls.
Neuroimaging studies within and outside China have provided evidence of specific neurobiological changes associated with anxiety disorders. However, results have not been entirely consistent across different studies of patients with the same diagnoses. International collaborative research using large samples and robust designs should be conducted in future.
焦虑障碍在国际上普遍存在，给患者、其家庭和社会带来了巨大的社会和经济负担。过去十年，许多神经影像学研究已经在中国调查了焦虑障碍的病因。我们讨论了这些研究的结果，并将其与中国以外的焦虑障碍神经影像学研究的结果进行了比较。
我们使用中国生物医学文献数据库、中国科技期刊数据库、中国期刊全文数据库和 PubMed 进行了文献检索，检索时间为 1989 年至 2009 年 4 月。我们选择了所有参与者和研究人员均为中国人的神经影像学研究。
有 25 项研究符合我们的纳入标准。其中 9 项研究检查了广泛性焦虑障碍（GAD）和/或惊恐障碍（PD），8 项研究检查了强迫症（OCD），8 项研究检查了创伤后应激障碍（PTSD）。我们的文献复习揭示了一些普遍的发现。首先，与健康对照组相比，GAD 和 PD 患者的额叶和颞叶区域的局部脑血流（rCBF）减少。其次，在观看具有正性和负性效价的图像时，GAD 和 PD 患者的几个脑区分别表现出相对增加或减少的激活。第三，使用正电子发射断层扫描（PET）和磁共振波谱（MRS）成像的研究表明，与健康对照组相比，OCD 患者的一些脑区存在过度灌注和灌注不足。PTSD 的神经影像学研究表明，与对照组相比，患者的海马体积以及海马内的 N-乙酰天冬氨酸（NAA）水平和 NAA/肌酸比降低。
中国和国外的神经影像学研究提供了与焦虑障碍相关的特定神经生物学变化的证据。然而，不同研究对相同诊断的患者的结果并不完全一致。未来应进行使用大样本和稳健设计的国际合作研究。
