Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149, Muenster, Germany.
Sci Rep. 2019 Feb 20;9(1):2415. doi: 10.1038/s41598-019-38990-0.
Despite considerable effort, the neural correlates of altered threat-related processing in panic disorder (PD) remain inconclusive. Mental imagery of disorder-specific situations proved to be a powerful tool to investigate dysfunctional threat processing in anxiety disorders. The current functional magnetic resonance imaging (fMRI) study aimed at investigating brain activation in PD patients during disorder-related script-driven imagery. Seventeen PD patients and seventeen healthy controls (HC) were exposed to newly developed disorder-related and neutral narrative scripts while brain activation was measured with fMRI. Participants were encouraged to imagine the narrative scripts as vividly as possible and they rated their script-induced emotional states after the scanning session. PD patients rated disorder-related scripts as more arousing, unpleasant and anxiety-inducing as compared to HC. Patients relative to HC showed elevated activity in the right amygdala and the brainstem as well as decreased activity in the rostral anterior cingulate cortex, and the medial and lateral prefrontal cortex to disorder-related vs. neutral scripts. The results suggest altered amygdala/ brainstem and prefrontal cortex engagement and point towards the recruitment of brain networks with opposed activation patterns in PD patients during script-driven imagery.
尽管付出了相当大的努力，但恐慌障碍 (PD) 中与改变的威胁相关的处理的神经相关性仍然没有定论。对特定于疾病的情况的心理意象被证明是研究焦虑障碍中功能失调的威胁处理的有力工具。目前的功能磁共振成像 (fMRI) 研究旨在研究 PD 患者在与疾病相关的脚本驱动意象期间的大脑激活。17 名 PD 患者和 17 名健康对照者 (HC) 暴露于新开发的与疾病相关和中性叙事脚本中，同时使用 fMRI 测量大脑激活。鼓励参与者尽可能生动地想象叙事脚本，并在扫描后评估他们的脚本引起的情绪状态。与 HC 相比，PD 患者认为与疾病相关的脚本更令人兴奋、不愉快和引起焦虑。与 HC 相比，患者在右侧杏仁核和脑干以及额前回、内侧和外侧前额叶皮质中显示出与疾病相关的脚本比中性脚本更高的活动。结果表明，在脚本驱动的意象中，PD 患者的杏仁核/脑干和前额叶皮质参与度发生改变，并指向大脑网络的募集，其激活模式相反。
