Price Rebecca B, Paul Ben, Schneider Walt, Siegle Greg J
Department of Psychiatry University of Pittsburgh School of Medicine Pittsburgh, PA.
Cognit Ther Res. 2013 Aug 1;37(4):657-672. doi: 10.1007/s10608-012-9508-x.
Brain-based behavioral interventions targeting specific neurocognitive mechanisms show initial promise in the treatment of emotional disorders, but personalization of such approaches will be facilitated if brain targets are empirically established. As a preliminary step, we conducted a proof-of-concept study to test whether particular emotion regulatory neural circuitry can be differentially targeted by specific neurocognitive tasks, and whether these tasks effectively inhibit amygdala activity. Eleven healthy individuals underwent an idiographic sadness and guilt induction. Brain response was measured via fMRI during 4 subsequent emotion regulation conditions: fixation, cognitive reappraisal (selected to target the ventrolateral prefrontal cortex), working memory practice (selected to target the dorsolateral prefrontal cortex), and visual distraction (Tetris; selected to target occipital cortex). In whole-brain comparisons to fixation, hypotheses were upheld. Reappraisal uniquely activated left ventrolateral prefrontal cortex, working memory practice uniquely activated left dorsolateral prefrontal cortex, and Tetris uniquely activated bilateral occipitoparietal cortex, activations that were largely robust at the single-subject level. All tasks inhibited amygdala activity relative to fixation. Data support examining whether repeated exposure to these tasks in psychiatric patients affects neural abnormalities implicated in emotional disorders. Ideally, psychiatric treatment will be accelerated by matching specific treatments to patients with specific neural profiles.
针对特定神经认知机制的基于脑的行为干预在情绪障碍治疗中显示出初步前景,但如果能通过实证确定脑靶点,将有助于此类方法的个性化。作为初步步骤,我们进行了一项概念验证研究,以测试特定的情绪调节神经回路是否能被特定的神经认知任务差异性靶向,以及这些任务是否能有效抑制杏仁核活动。11名健康个体接受了个性化的悲伤和内疚诱导。在随后的4种情绪调节条件下,通过功能磁共振成像测量脑反应:注视、认知重评(选择靶向腹外侧前额叶皮层)、工作记忆练习(选择靶向背外侧前额叶皮层)和视觉分心(俄罗斯方块;选择靶向枕叶皮层)。在与注视的全脑比较中,假设得到了支持。重评独特地激活了左侧腹外侧前额叶皮层,工作记忆练习独特地激活了左侧背外侧前额叶皮层,俄罗斯方块独特地激活了双侧枕顶叶皮层,这些激活在单个体水平上大多很显著。相对于注视,所有任务均抑制了杏仁核活动。数据支持研究在精神疾病患者中重复进行这些任务是否会影响与情绪障碍相关的神经异常。理想情况下,通过将特定治疗与具有特定神经特征的患者相匹配,精神疾病治疗将得到加速。