Donzuso Giulia, Cerasa Antonio, Gioia Maria C, Caracciolo Manuela, Quattrone Aldo
IBFM, National Research Council Catanzaro, Italy ; Department "G.F. Ingrassia", Section of Neuroscience, University of Catania Catania, Italy.
IBFM, National Research Council Catanzaro, Italy.
Brain Behav. 2014 Jul;4(4):504-14. doi: 10.1002/brb3.232. Epub 2014 Jun 18.
The State-Trait Anxiety Inventory (STAI) and the Hamilton scale for anxiety (HARS) are two of the most important scales employed in clinical and psychological realms for the evaluation of anxiety. Although the reliability and sensibility of these scales are widely demonstrated there is an open debate on what exactly their scores reflect. Neuroimaging provides the potential to validate the quality and reliability of clinical scales through the identification of specific biomarkers. For this reason, we evaluated the neural correlates of these two scales in a large cohort of healthy individuals using structural neuroimaging methods.
Neuroimaging analysis included thickness/volume estimation of cortical and subcortical limbic structures, which were regressed on anxiety inventory scores with age and gender used for assessing discriminant validity. A total of 121 healthy subjects were evaluated. Despite the two anxiety scales, at a behavioral level, displaying significant correlations among them (HARS with STAI-state (r = 0.24; P = 0.006) and HARS with STAI-trait (r = 0.42; P < 0.001)), multivariate neuroimaging analyses demonstrated that anatomical variability in the anterior cingulate cortex was the best predictor of the HARS scores (all β's ≥ 0.31 and P's ≤ 0.01), whereas STAI-related measures did not show any significant relationship with regions of limbic circuits, but their scores were predicted by gender (all β's ≥ 0.23 and P's ≤ 0.02).
Although the purpose of HARS and STAI is to quantify the degree and characteristics of anxiety-like behaviors, our neuroimaging data indicated that these scales are neurobiologically different, confirming that their scores might reflect different aspects of anxiety: the HARS is more related to subclinical expression of anxiety disorders, whereas the STAI captures sub-dimensions of personality linked to anxiety.
状态-特质焦虑量表（STAI）和汉密尔顿焦虑量表（HARS）是临床和心理领域用于评估焦虑的两个最重要量表。尽管这些量表的信度和效度已得到广泛证实，但对于其分数究竟反映了什么仍存在公开争论。神经影像学有潜力通过识别特定生物标志物来验证临床量表的质量和可靠性。因此，我们使用结构神经影像学方法在一大群健康个体中评估了这两个量表的神经关联。
神经影像学分析包括对皮质和皮质下边缘结构的厚度/体积估计，将其与焦虑量表分数进行回归分析，并将年龄和性别用于评估判别效度。共评估了121名健康受试者。尽管这两个焦虑量表在行为水平上显示出显著相关性（HARS与STAI状态量表(r = 0.24; P = 0.006)以及HARS与STAI特质量表(r = 0.42; P < 0.001)），但多变量神经影像学分析表明，前扣带回皮质的解剖学变异性是HARS分数的最佳预测指标（所有β值≥0.31且P值≤0.01），而与STAI相关的指标与边缘回路区域未显示出任何显著关系，但其分数由性别预测（所有β值≥0.23且P值≤0.02）。
尽管HARS和STAI的目的是量化焦虑样行为的程度和特征，但我们的神经影像学数据表明这些量表在神经生物学上存在差异，证实它们的分数可能反映了焦虑的不同方面：HARS与焦虑症的亚临床表达更相关，而STAI捕捉到了与焦虑相关的人格亚维度。
