创伤后应激障碍中的先天警报回路：对恐惧和创伤相关线索的意识和潜意识加工。
The innate alarm circuit in post-traumatic stress disorder: Conscious and subconscious processing of fear- and trauma-related cues.
机构信息
Department of Psychiatry, University of Western Ontario, University Hospital (Room C3-103), 339 Windermere Road, London, ON, Canada N6A 5A5.
Department of Psychiatry, University of Western Ontario, University Hospital (Room C3-103), 339 Windermere Road, London, ON, Canada N6A 5A5; Department of Psychology, University of Western Ontario, London, ON, Canada; Department of Neuroscience, University of Western Ontario, London, ON, Canada.
出版信息
Psychiatry Res Neuroimaging. 2016 Feb 28;248:142-50. doi: 10.1016/j.pscychresns.2015.12.005. Epub 2015 Dec 23.
Fast defensive responses to salient threatening stimuli are an important clinical feature of post-traumatic stress disorder (PTSD). We investigated the neural correlates of subliminal and supraliminal processing of fearful faces and individualized trauma-related words in individuals with PTSD (n=26) compared with healthy controls (n=20) using functional magnetic resonance imaging. Increased activity in the right cerebellum and the posterior cingulum was observed in individuals with PTSD during subliminal processing of trauma-related words, whereas increased activity of the basal forebrain was found within the PTSD group when processing supraliminal trauma-related words. Moreover, significant positive correlations were found between re-experiencing symptoms and response within the amygdala, and between hyper-arousal symptoms and response within the periaqueductal gray matter, during subliminal processing of trauma-related words and during supraliminal processing of fearful faces, respectively. These findings further our understanding of rapid threat processing and defensive responses, highlighting the role of the cerebellum and periaqueductal gray matter as part of an 'innate alarm system' in PTSD.
快速防御性反应对明显的威胁性刺激是创伤后应激障碍（PTSD）的一个重要临床特征。我们使用功能磁共振成像，比较了 PTSD 患者（n=26）和健康对照组（n=20）对恐惧面孔和个体化创伤相关词汇的潜意识和显意识处理的神经相关性。在潜意识处理创伤相关词汇时，PTSD 患者的右侧小脑和后扣带活动增加，而在处理显意识创伤相关词汇时，基底前脑的活动增加。此外，在潜意识处理创伤相关词汇和显意识处理恐惧面孔时，分别发现再体验症状与杏仁核内的反应以及过度警觉症状与导水管周围灰质内的反应之间存在显著正相关。这些发现进一步加深了我们对快速威胁处理和防御反应的理解，强调了小脑和导水管周围灰质作为 PTSD 中“先天警报系统”的一部分的作用。
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