创伤相关的前扣带皮层在奖励学习过程中的连接，可预测青年成年人的情感和焦虑状态。
Trauma-associated anterior cingulate connectivity during reward learning predicts affective and anxiety states in young adults.
机构信息
Department of Psychiatry,University of Pittsburgh,Pittsburgh, PA,USA.
出版信息
Psychol Med. 2019 Aug;49(11):1831-1840. doi: 10.1017/S0033291718002520. Epub 2018 Sep 19.
BACKGROUND
Trauma exposure is associated with development of depression and anxiety; yet, some individuals are resilient to these trauma-associated effects. Differentiating mechanisms underlying development of negative affect and resilience following trauma is critical for developing effective interventions. One pathway through which trauma could exert its effects on negative affect is reward-learning networks. In this study, we examined relationships among lifetime trauma, reward-learning network function, and emotional states in young adults.
METHODS
One hundred eleven young adults self-reported trauma and emotional states and underwent functional magnetic resonance imaging during a monetary reward task. Trauma-associated neural activation and functional connectivity were analyzed during reward prediction error (RPE). Relationships between trauma-associated neural functioning and affective and anxiety symptoms were examined.
RESULTS
Number of traumatic events was associated with greater ventral anterior cingulate cortex (vACC) activation, and lower vACC connectivity with the right insula, frontopolar, inferior parietal, and temporoparietal regions, during RPE. Lower trauma-associated vACC connectivity with frontoparietal regions implicated in regulatory and decision-making processes was associated with heightened affective and anxiety symptoms; lower vACC connectivity with insular regions implicated in interoception was associated with lower affective and anxiety symptoms.
CONCLUSIONS
In a young adult sample, two pathways linked the impact of trauma on reward-learning networks with higher v. lower negative affective and anxiety symptoms. The disconnection between vACC and regions implicated in decision-making and self-referential processes may reflect aberrant regulatory but appropriate self-focused mechanisms, respectively, conferring risk for v. resilience against negative affective and anxiety symptoms.
背景
创伤暴露与抑郁和焦虑的发展有关；然而，有些人对这些与创伤相关的影响具有弹性。区分创伤后产生负面情绪和韧性的机制对于开发有效的干预措施至关重要。创伤影响负面情绪的途径之一是奖励学习网络。在这项研究中，我们研究了一生中创伤、奖励学习网络功能与年轻人情绪状态之间的关系。
方法
111 名年轻成年人报告了创伤和情绪状态，并在进行货币奖励任务时接受了功能磁共振成像。在奖励预测误差（RPE）期间分析了与创伤相关的神经激活和功能连接。检查了与创伤相关的神经功能与情感和焦虑症状之间的关系。
结果
创伤事件的数量与腹侧前扣带皮层（vACC）在 RPE 期间的激活增加有关，与右侧岛叶、额极、下顶叶和颞顶叶区域的 vACC 连接降低有关。与涉及调节和决策过程的额顶叶区域的创伤相关 vACC 连接降低与较高的情感和焦虑症状有关；与涉及内脏感知的岛叶区域的 vACC 连接降低与较低的情感和焦虑症状有关。
结论
在年轻成年人样本中，有两种途径将创伤对奖励学习网络的影响与较高的 v. 较低的负面情绪和焦虑症状联系起来。vACC 与涉及决策和自我参照过程的区域之间的脱节可能分别反映了异常的调节但适当的自我关注机制，分别为 v. 对负面情绪和焦虑症状的弹性提供了风险。
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