Dodhia Sonam, Hosanagar Avinash, Fitzgerald Daniel A, Labuschagne Izelle, Wood Amanda G, Nathan Pradeep J, Phan K Luan
Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
1] Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA [2] Mental Health Service, VA Ann Arbor Healthcare System, Ann Arbor, MI, USA.
Neuropsychopharmacology. 2014 Aug;39(9):2061-9. doi: 10.1038/npp.2014.53. Epub 2014 Mar 5.
Generalized social anxiety disorder (GSAD) is characterized by aberrant patterns of amygdala-frontal connectivity to social signals of threat and at rest. The neuropeptide oxytocin (OXT) modulates anxiety, stress, and social behaviors. Recent functional neuroimaging studies suggest that these effects are mediated through OXT's effects on amygdala reactivity and/or amygdala-frontal connectivity. The aim of the current study was to examine OXT's effects on amygdala-frontal resting-state functional connectivity (rsFC) in GSAD patients and healthy controls (HCs). In a randomized, double-blind, cross-over design, 18 GSAD and 18 HC participants received intranasal OXT (24 IU or 40.32 μg) or placebo (PBO) before resting-state functional magnetic resonance imaging. In individuals with GSAD, OXT enhanced rsFC of the left and right amygdala with rostral anterior cingulate cortex (ACC)/medial prefrontal cortex (mPFC), and in doing so, reversed (ie, 'normalized') the reduced amygdala-frontal connectivity observed relative to HCs evident on PBO. Higher social anxiety severity in GSAD subjects correlated with lower amygdala-ACC/mPFC connectivity on PBO and higher social anxiety also correlated with greater enhancement in amygdala-frontal connectivity induced by OXT. These findings show that OXT modulates a neural circuit known for social threat processing and emotion regulation, suggesting a neural mechanism by which OXT may have a role in the pathophysiology and treatment of social anxiety disorder.
广泛性社交焦虑障碍（GSAD）的特征是杏仁核与额叶之间在面对威胁性社交信号以及静息状态时的连接模式异常。神经肽催产素（OXT）可调节焦虑、压力和社交行为。最近的功能性神经影像学研究表明，这些作用是通过OXT对杏仁核反应性和/或杏仁核-额叶连接性的影响来介导的。本研究的目的是检验OXT对GSAD患者和健康对照者（HCs）杏仁核-额叶静息态功能连接（rsFC）的影响。在一项随机、双盲、交叉设计中，18名GSAD患者和18名HC参与者在进行静息态功能磁共振成像前接受了鼻内催产素（24国际单位或40.32微克）或安慰剂（PBO）。在GSAD患者中，催产素增强了左右杏仁核与喙部前扣带回皮质（ACC）/内侧前额叶皮质（mPFC）之间的rsFC，并且通过这样做，逆转了（即“正常化”）相对于接受安慰剂时在HCs中明显观察到的杏仁核-额叶连接性降低。GSAD受试者中较高的社交焦虑严重程度与接受安慰剂时较低的杏仁核-ACC/mPFC连接性相关，较高的社交焦虑也与催产素诱导的杏仁核-额叶连接性更大增强相关。这些发现表明，催产素调节一个以社交威胁处理和情绪调节而闻名的神经回路，提示了一种神经机制，通过该机制催产素可能在社交焦虑障碍的病理生理学和治疗中发挥作用。
