van den Bulk Bianca G, Somerville Leah H, van Hoof Marie-José, van Lang Natasja D J, van der Wee Nic J A, Crone Eveline A, Vermeiren Robert R J M
Curium-LUMC, Department of Child Psychiatry, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands; Leiden Consortium on Individual Development, Department of Child and Family Studies, Leiden University, P.O. box 9555, 2300 RB Leiden, the Netherlands; Institute of Psychology, Brain and Development Lab, Leiden University, P.O. box 9555, 2300 RB Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands.
Department of Psychology, Affective Neuroscience and Development Lab, Harvard University, 52 Oxford Street, Cambridge, MA 02138, USA.
Dev Cogn Neurosci. 2016 Oct;21:15-25. doi: 10.1016/j.dcn.2016.08.002. Epub 2016 Aug 25.
Adolescents with internalizing disorders and adolescents with childhood sexual abuse related post-traumatic stress disorder (CSA-related PTSD) show a large overlap in symptomatology. In addition, brain research indicated hyper-responsiveness and sustained activation instead of habituation of amygdala activation to emotional faces in both groups. Little is known, however, about whether the same patterns of amygdala habituation are present in these two groups. The current study examined habituation patterns of amygdala activity to emotional faces (fearful, happy and neutral) in adolescents with a DSM-IV depressive and/or anxiety disorder (N=25), adolescents with CSA-related PTSD (N=19) and healthy controls (N=26). Behaviourally, the adolescents from the internalizing and CSA-related PTSD group reported more anxiety to fearful and neutral faces than adolescents from the control group and adolescents from the CSA-related PTSD group reacted slower compared to the internalizing group. At the whole brain level, there was a significant interaction between time and group within the left amygdala. Follow-up ROI analysis showed elevated initial activity in the amygdala and rapid habituation in the CSA-related PTSD group compared to the internalizing group. These findings suggest that habituation patterns of amygdala activation provide additional information on problems with emotional face processing. Furthermore, the results suggest there are differences in the underlying neurobiological mechanisms related to emotional face processing for adolescents with internalizing disorders and adolescents with CSA-related PTSD. Possibly CSA-related PTSD is characterized by a stronger primary emotional response driven by the amygdala.
患有内化性障碍的青少年与患有童年性虐待相关创伤后应激障碍（CSA相关PTSD）的青少年在症状学上有很大重叠。此外，脑部研究表明，两组对情绪面孔的杏仁核激活均表现出反应过度和持续激活，而非习惯化。然而，对于这两组是否存在相同的杏仁核习惯化模式，人们知之甚少。本研究考察了患有DSM-IV抑郁和/或焦虑症的青少年（N = 25）、患有CSA相关PTSD的青少年（N = 19）和健康对照组（N = 26）对情绪面孔（恐惧、快乐和中性）的杏仁核活动习惯化模式。行为学上，内化性障碍组和CSA相关PTSD组的青少年对恐惧和中性面孔报告的焦虑比对照组青少年更多，且CSA相关PTSD组青少年与内化性障碍组相比反应更慢。在全脑水平上，左侧杏仁核内时间和组间存在显著交互作用。后续的感兴趣区分析显示，与内化性障碍组相比，CSA相关PTSD组杏仁核的初始活动增强且习惯化迅速。这些发现表明，杏仁核激活的习惯化模式为情绪面孔加工问题提供了额外信息。此外，结果表明，患有内化性障碍的青少年和患有CSA相关PTSD的青少年在与情绪面孔加工相关的潜在神经生物学机制上存在差异。可能与CSA相关的PTSD的特征是由杏仁核驱动的更强的初级情绪反应。
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