INSERM U610, Paris, France.
Hum Brain Mapp. 2012 Aug;33(8):1973-86. doi: 10.1002/hbm.21340. Epub 2011 Jul 18.
The neural bases of interactions between anxiety and cognitive control are not fully understood. We conducted an fMRI study in healthy participants and in patients with an anxiety disorder (social phobia) to determine the impact of stress on the brain network involved in cognitive control. Participants performed two working memory tasks that differed in their level of performance-induced stress. In both groups, the cognitive tasks activated a frontoparietal network, involved in working memory tasks. A supplementary activation was observed in the right ventrolateral prefrontal cortex (VLPFC) in patients during the more stressful cognitive task. Region of interest analyses showed that activation in the right VLPFC decreased in the more stressful condition as compared to the less stressful one in healthy subjects and remain at a similar level in the two cognitive tasks in patients. This pattern was specific to the right when compared to the left VLPFC activation. Anxiety was positively correlated with right VLPFC activation across groups. Finally, left dorsolateral prefrontal cortex (DLPFC) activation was higher in healthy subjects than in patients in the more stressful task. These findings demonstrate that in healthy subjects, stress induces an increased activation in left DLPFC, a critical region for cognitive control, and a decreased activation in the right VLPFC, an area associated with anxiety. In patients, the differential modulation between these dorsal and ventral PFC regions disappears. This absence of modulation may limit anxious patients' ability to adapt to demanding cognitive control tasks.
焦虑与认知控制相互作用的神经基础尚不完全清楚。我们在健康参与者和焦虑障碍（社交恐惧症）患者中进行了 fMRI 研究，以确定应激对认知控制相关脑网络的影响。参与者完成了两项工作记忆任务，它们在产生压力的程度上有所不同。在两组中，认知任务都激活了额顶叶网络，参与工作记忆任务。在患者中，在更具压力的认知任务中，右侧腹外侧前额叶皮层（VLPFC）观察到补充激活。感兴趣区分析显示，与健康受试者在较不紧张的条件下相比，在更紧张的条件下，右侧 VLPFC 的激活减少，而在患者中，两个认知任务的激活水平相似。与左侧 VLPFC 激活相比，这种模式是特定于右侧的。焦虑与右 VLPFC 的激活在各组之间呈正相关。最后，在更紧张的任务中，健康受试者的左背外侧前额叶皮层（DLPFC）激活高于患者。这些发现表明，在健康受试者中，应激会引起左 DLPFC 的激活增加，而左 DLPFC 是认知控制的关键区域，同时右侧 VLPFC 的激活减少，右侧 VLPFC 与焦虑有关。在患者中，这些背侧和腹侧 PFC 区域之间的调节差异消失。这种调节的缺失可能限制了焦虑患者适应高要求认知控制任务的能力。
