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强迫症中消极情绪干扰对从背外侧前额叶皮层到眶额叶皮层的有效连接的破坏。

Disruption of effective connectivity from the dorsolateral prefrontal cortex to the orbitofrontal cortex by negative emotional distraction in obsessive-compulsive disorder.

作者信息

Han H J, Jung W H, Yun J-Y, Park J W, Cho K K, Hur J-W, Shin N Y, Lee T Y, Kwon J S

机构信息

Department of Brain and Cognitive Sciences,College of Natural Sciences,Seoul National University,Seoul,South Korea.

Medical Research Center,Seoul National University Hospital,Seoul,South Korea.

出版信息

Psychol Med. 2016 Apr;46(5):921-32. doi: 10.1017/S0033291715002391. Epub 2015 Dec 1.

Abstract

BACKGROUND

Obsessive-compulsive disorder (OCD) has been associated with abnormal cognitive and emotional functions and these dysfunctions may be dependent on the disruption of dynamic interactions within neuronal circuits associated with emotion regulation. Although several studies have shown the aberrant cognitive-affective processing in OCD patients, little is known about how to characterize effective connectivity of the disrupted neural interactions. In the present study, we applied effective connectivity analysis using dynamic causal modeling to explore the disturbed neural interactions in OCD patients.

METHOD

A total of 20 patients and 21 matched healthy controls performed a delayed-response working memory task under emotional or non-emotional distraction while undergoing functional magnetic resonance imaging.

RESULTS

During the delay interval under negative emotional distraction, both groups showed similar patterns of activations in the amygdala. However, under negative emotional distraction, the dorsolateral prefrontal cortex (DLPFC) and the orbitofrontal cortex (OFC) exhibited significant differences between groups. Bayesian model averaging indicated that the connection from the DLPFC to the OFC was negatively modulated by negative emotional distraction in patients, when compared with healthy controls (p < 0.05, Bonferroni-corrected).

CONCLUSIONS

Exaggerated recruitment of the DLPFC may induce the reduction of top-down prefrontal control input over the OFC, leading to abnormal cortico-cortical interaction. This disrupted cortico-cortical interaction under negative emotional distraction may be responsible for dysfunctions of cognitive and emotional processing in OCD patients and may be a component of the pathophysiology associated with OCD.

摘要

背景

强迫症(OCD)与认知和情感功能异常有关,这些功能障碍可能取决于与情绪调节相关的神经回路内动态相互作用的破坏。尽管多项研究表明强迫症患者存在认知-情感加工异常,但对于如何表征被破坏的神经相互作用的有效连接知之甚少。在本研究中,我们应用动态因果模型进行有效连接分析,以探索强迫症患者中被扰乱的神经相互作用。

方法

20名患者和21名匹配的健康对照在功能性磁共振成像过程中,于情绪或非情绪干扰下执行延迟反应工作记忆任务。

结果

在负性情绪干扰下的延迟间隔期间,两组杏仁核的激活模式相似。然而,在负性情绪干扰下,背外侧前额叶皮质(DLPFC)和眶额皮质(OFC)在两组间表现出显著差异。贝叶斯模型平均法表明,与健康对照相比,在患者中,从DLPFC到OFC的连接受到负性情绪干扰的负向调节(p < 0.05,经Bonferroni校正)。

结论

DLPFC过度激活可能导致前额叶对OFC自上而下的控制输入减少,从而导致皮质-皮质相互作用异常。这种在负性情绪干扰下被破坏的皮质-皮质相互作用可能是强迫症患者认知和情感加工功能障碍的原因,并且可能是与强迫症相关病理生理学的一个组成部分。

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