Andrew W Goddard, Department of Psychiatry, UCSF Fresno Medical Education and Research Program, Fresno, CA 93701, United States.
World J Psychiatry. 2016 Mar 22;6(1):43-53. doi: 10.5498/wjp.v6.i1.43.
Anxiety and stress disorders are a major public health issue. However, their pathophysiology is still unclear. The gamma amino acid butyric acid (GABA) neurochemical system has been strongly implicated in their pathogenesis and treatment by numerous preclinical and clinical studies, the most recent of which have been highlighted and critical review in this paper. Changes in cortical GABA appear related to normal personality styles and responses to stress. While there is accumulating animal and human neuroimaging evidence of cortical and subcortical GABA deficits across a number of anxiety conditions, a clear pattern of findings in specific brain regions for a given disorder is yet to emerge. Neuropsychiatric conditions with anxiety as a clinical feature may have GABA deficits as an underlying feature. Different classes of anxiolytic therapies support GABA function, and this may be an area in which newer GABA neuroimaging techniques could soon offer more personalized therapy. Novel GABAergic pharmacotherapies in development offer potential improvements over current therapies in reducing sedative and physiologic dependency effects, while offering rapid anxiolysis.
焦虑和压力障碍是一个主要的公共卫生问题。然而，它们的病理生理学仍然不清楚。γ-氨基丁酸（GABA）神经化学系统已被大量的临床前和临床研究强烈暗示与其发病机制和治疗有关，其中最新的研究已在本文中得到了强调和批判性的回顾。皮质 GABA 的变化似乎与正常的人格类型和对压力的反应有关。虽然越来越多的动物和人类神经影像学证据表明，在许多焦虑症中存在皮质和皮质下 GABA 缺陷，但特定疾病在特定脑区的发现模式尚未出现。以焦虑为临床特征的神经精神疾病可能存在 GABA 缺陷作为潜在特征。不同类别的抗焦虑治疗支持 GABA 功能，这可能是一个新的 GABA 神经影像学技术很快就能提供更个性化治疗的领域。正在开发中的新型 GABA 能药物治疗方法提供了在减少镇静和生理依赖性作用的同时快速缓解焦虑的潜在改善，优于目前的治疗方法。
