Gorka Stephanie M, Nelson Brady D, Phan K Luan, Shankman Stewart A
Department of Psychology, University of Illinois-Chicago, 1007 West Harrison St. (M/C 285), Chicago, IL 60607, USA.
Department of Psychology, Stony Brook University, Stony Brook, NY 11794, USA.
Biol Mood Anxiety Disord. 2014 Oct 7;4:9. doi: 10.1186/2045-5380-4-9. eCollection 2014.
Prior studies suggest that hyperactive insula responding to unpredictable aversiveness is a core feature of anxiety disorders. However, no study to date has investigated the neural correlates of unpredictable aversiveness in those with panic disorder (PD) with comorbid major depressive disorder (MDD). The aim of the current study was to examine group differences in neural responses to unpredictable and predictable aversiveness in 41 adults with either 1) current PD with comorbid MDD (PD-MDD), 2) current MDD with no lifetime diagnosis of an anxiety disorder (MDD-only), or 3) no lifetime diagnosis of psychopathology. All participants completed a functional magnetic resonance imaging (fMRI) scan while viewing temporally predictable or unpredictable negative or neutral images.
The results indicated that individuals with PD-MDD exhibited greater bilateral insula activation to unpredictable aversiveness compared with controls and individuals with MDD-only (who did not differ). There were no group differences in insula activation to predictable aversiveness.
These findings add to a growing literature highlighting the role of the insula in the pathophysiology of anxiety disorders.
先前的研究表明，对不可预测的厌恶刺激产生过度活跃的脑岛反应是焦虑症的一个核心特征。然而，迄今为止，尚无研究调查合并重度抑郁症（MDD）的惊恐障碍（PD）患者对不可预测的厌恶刺激的神经相关性。本研究的目的是检验41名成年人在面对不可预测和可预测的厌恶刺激时神经反应的组间差异，这些成年人分为以下三组：1）目前患有合并MDD的PD（PD-MDD）；2）目前患有MDD但无焦虑症终生诊断史（仅MDD）；3）无精神病理学终生诊断史。所有参与者在观看时间上可预测或不可预测的负面或中性图像时完成了功能磁共振成像（fMRI）扫描。
结果表明，与对照组和仅患有MDD的个体（二者无差异）相比，PD-MDD个体对不可预测的厌恶刺激表现出更大的双侧脑岛激活。在对可预测的厌恶刺激的脑岛激活方面，各组之间没有差异。
这些发现进一步丰富了越来越多的文献，强调了脑岛在焦虑症病理生理学中的作用。
