Department of Pharmacology and Toxicology, University of Innsbruck, Innsbruck, Austria.
Prog Neuropsychopharmacol Biol Psychiatry. 2018 Jul 13;85:23-32. doi: 10.1016/j.pnpbp.2018.04.002. Epub 2018 Apr 6.
Fear and anxiety-related disorders are highly prevalent psychiatric conditions characterized by avoidant and fearful reactions towards specific stimuli or situations, which are disproportionate given the real threat such stimuli entail. These conditions comprise the most common mental disorder group. There are a high proportion of patients who fail to achieve remission and the presence of high relapse rates indicate the therapeutic options available are far from being fully efficient. Despite an increased understanding the neural circuits underlying fear and anxiety-related behaviors in the last decades, a factor that could be partially contributing to the lack of adequate therapies may be an insufficient understanding of the core features of the disorders and their associated neurobiology. Interestingly, the cerebellum shows connections with fear and anxiety-related brain areas and functional involvement in such processes, but explanations for its role in anxiety disorders are lacking. Therefore, the aims of this review are to provide an overview of the neural circuitry of fear and anxiety and its connections to the cerebellum, and of the animal studies that directly assess an involvement of the cerebellum in these processes. Then, the studies performed in patients suffering from anxiety disorders that explore the cerebellum will be discussed. Finally, we'll propose a function for the cerebellum in these disorders, which could guide future experimental approaches to the topic and lead to a better understanding of the neurobiology of anxiety-related disorders, ultimately helping to develop more effective treatments for these conditions.
恐惧和焦虑相关障碍是高度流行的精神疾病,其特征是对特定刺激或情况产生回避和恐惧反应,而这些反应与这些刺激所带来的实际威胁不成比例。这些疾病构成了最常见的精神障碍群体。有很大比例的患者无法达到缓解,高复发率表明现有的治疗选择远未完全有效。尽管在过去几十年中对恐惧和焦虑相关行为的神经回路有了更多的了解,但导致缺乏足够治疗方法的一个因素可能是对这些疾病的核心特征及其相关神经生物学的理解不足。有趣的是,小脑与恐惧和焦虑相关的大脑区域有联系,并在这些过程中发挥功能作用,但对其在焦虑障碍中的作用的解释还很缺乏。因此,本综述的目的是概述恐惧和焦虑的神经回路及其与小脑的联系,以及直接评估小脑在这些过程中参与的动物研究。然后,将讨论患有焦虑障碍的患者的小脑研究。最后,我们将为小脑在这些疾病中的功能提出一个假设,这可能指导未来对该主题的实验方法,并有助于更好地理解焦虑相关障碍的神经生物学,最终有助于为这些疾病开发更有效的治疗方法。