Fonzo Gregory A, Etkin Amit
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA; Stanford Neurosciences Institute, Stanford University, Stanford, California, USA; Veterans Affairs Palo Alto Healthcare System and the Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), Palo Alto, California, USA.
Dialogues Clin Neurosci. 2017 Jun;19(2):169-179. doi: 10.31887/DCNS.2017.19.2/gfonzo.
Affective neuroimaging has contributed to our knowledge of generalized anxiety disorder (GAD) through measurement of blood oxygenation level-dependent (BOLD) responses, which facilitate inference on neural responses to emotional stimuli during task-based functional magnetic resonance imaging (fMRI). In this article, the authors provide an integrated review of the task-based affective fMRI literature in GAD. Studies provide evidence for variable presence and directionality of BOLD abnormalities in limbic and prefrontal regions during reactivity to, regulation of, and learning from emotional cues. We conclude that understanding the sources of this variability is key to accelerating progress in this area. We propose that the cardinal symptom of GAD-worry-predominantly reflects stimulus-independent mental processes that impose abnormal, inflexible functional brain configurations, ie, the overall pattern of information transfer among behaviorally relevant neural circuits at a given point in time. These configurations that are inflexible to change from the incoming flux of environmental stimuli may underlie inconsistent task-based findings.
情感神经成像通过测量血氧水平依赖（BOLD）反应，增进了我们对广泛性焦虑障碍（GAD）的了解，这种反应有助于在基于任务的功能磁共振成像（fMRI）期间推断对情绪刺激的神经反应。在本文中，作者对GAD中基于任务的情感fMRI文献进行了综合综述。研究为在对情绪线索的反应、调节和学习过程中，边缘和前额叶区域BOLD异常的不同存在和方向性提供了证据。我们得出结论，理解这种变异性的来源是加速该领域进展的关键。我们提出，GAD的主要症状——担忧——主要反映了与刺激无关的心理过程，这些过程导致了异常、僵化的功能性脑结构，即在给定时间点行为相关神经回路之间信息传递的整体模式。这些结构对于来自环境刺激输入流的变化缺乏灵活性，可能是基于任务的研究结果不一致的原因。
