National Institute of Mental Health, Bethesda, MD, USA.
Am J Psychiatry. 2012 Jul;169(7):750-8. doi: 10.1176/appi.ajp.2012.11081270.
Amygdala dysfunction has been reported to exist in youths and adults with psychopathic traits. However, there has been disagreement as to whether this dysfunction reflects a primary emotional deficit or is secondary to atypical attentional control. The authors examined the validity of the contrasting predictions.
Participants were 15 children and adolescents (ages 10–17 years) with both disruptive behavior disorders and psychopathic traits and 17 healthy comparison youths. Functional MRI was used to assess the response of the amygdala and regions implicated in top-down attentional control (the dorsomedial and lateral frontal cortices) to emotional expression under conditions of high and low attentional load.
Relative to youths with disruptive behavior disorders and psychopathic traits, healthy comparison subjects showed a significantly greater increase in the typical amygdala response to fearful expressions under low relative to high attentional load conditions. There was also a selective inverse relationship between the response to fearful expressions under low attentional load and the callous-unemotional component (but not the narcissism or impulsivity component) of psychopathic traits. In contrast, the two groups did not differ in the significant recruitment of the dorsomedial and lateral frontal cortices as a function of attentional load.
Youths with disruptive behavior disorders and psychopathic traits showed reduced amygdala responses to fearful expressions under low attentional load but no indications of increased recruitment of regions implicated in top-down attentional control. These findings suggest that the emotional deficit observed in youths with disruptive behavior disorders and psychopathic traits is primary and not secondary to increased top-down attention to nonemotional stimulus features.
已有研究报道，具有精神病态特征的青少年和成年人的杏仁核功能存在障碍。然而，对于这种功能障碍是反映了原发性情绪缺陷，还是继发于非典型的注意力控制，目前仍存在分歧。作者对这两种相互矛盾的预测结果进行了验证。
研究参与者为 15 名患有破坏性行为障碍和精神病态特征的儿童和青少年（年龄 10-17 岁），以及 17 名健康的对照青少年。使用功能磁共振成像（fMRI）技术，在高、低注意力负荷条件下，评估杏仁核及与自上而下注意力控制相关的区域（背内侧和外侧额皮质）对情绪表达的反应。
与患有破坏性行为障碍和精神病态特征的青少年相比，健康对照组在低注意力负荷条件下对恐惧表情的典型杏仁核反应明显增强。在低注意力负荷条件下对恐惧表情的反应与精神病态特征中的冷酷无情成分（但不是自恋或冲动成分）呈显著负相关，而两组之间在注意力负荷条件下背内侧和外侧额皮质的招募情况则没有差异。
患有破坏性行为障碍和精神病态特征的青少年在低注意力负荷条件下对恐惧表情的杏仁核反应减弱，但并未表现出与自上而下注意力对非情绪刺激特征的增加相关的区域的招募增加。这些发现表明，患有破坏性行为障碍和精神病态特征的青少年所观察到的情绪缺陷是原发性的，而不是由于对非情绪刺激特征的过度注意而继发的。
