Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30322, USA.
Curr Opin Neurobiol. 2013 Jun;23(3):346-52. doi: 10.1016/j.conb.2013.01.013. Epub 2013 Feb 9.
Fear and anxiety are debilitating conditions that affect a significant number of individuals in their lifetimes. Understanding underlying mechanisms of these disorders affords us the possibility of therapeutic intervention. Such clarity in terms of mechanism and intervention can only come from an amalgamation of research from human to animal studies that attempt to mimic the human condition, both of which are discussed in this review. We begin by presenting an outline of our current understanding of the neurobiological basis of fear and anxiety. This outline spans various levels of organization that include the circuitry, molecular pathways, genetic and epigenetic components of fear and anxiety. Using these organizational levels as a scaffold, we then discuss strategies that are currently used to ameliorate these disorders, and forecast future interventions that hold therapeutic promise. Among these newer promising treatments, we include, optogenetic, pharmacological, and extinction-based approaches, as well as lifestyle modifications, with combinatorial treatment regimens of these holding the most promise.
恐惧和焦虑是使人衰弱的状况，会在一生中影响大量的人。了解这些疾病的潜在机制使我们有可能进行治疗干预。只有将人类研究和试图模拟人类状况的动物研究的研究成果融合在一起，才能在机制和干预方面有如此清晰的认识，这在本文综述中进行了讨论。我们首先介绍了我们目前对恐惧和焦虑的神经生物学基础的理解概述。该概述涵盖了包括恐惧和焦虑的电路、分子途径、遗传和表观遗传成分在内的各种组织层次。然后，我们使用这些组织层次作为支架，讨论目前用于改善这些疾病的策略，并预测具有治疗前景的未来干预措施。在这些较新的有前途的治疗方法中，我们包括光遗传学、药理学和基于消退的方法，以及生活方式的改变，这些方法的联合治疗方案最有希望。
