Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China; 71282 Hospital, Baoding 071052, China.
Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China; Department of Radilogy, The 960th Hospital of the PLA Joint Logistice Support Force, Jinan, Shandong Province 250031, China.
J Affect Disord. 2019 May 15;251:280-286. doi: 10.1016/j.jad.2019.03.082. Epub 2019 Mar 30.
Aberrant functional and structural connectivity are considered to be involved in the underlying neural mechanism of generalized anxiety disorder (GAD). However, alterations in functional and structural interactions between the bilateral hemispheres are rarely examined. The current study aimed to characterized interhemispheric resting-state functional connectivity and white matter microstructural integrity of the corpus callosum in patients with GAD.
Resting-state Blood oxygen level-dependent and diffusion tensor image were acquired for patients with GAD and healthy subjects. The two groups were matched in age, gender, education years. The voxel-mirrored homotopic connectivity (VMHC) of whole brain and white matter integrity of the corpus callosum (CC) were compared between the two groups. Their correlations with clinical measures were further performed.
Compare to controls, decreased resting-state VMHC were found in the precentral gyrus, middle cingulate gyrus and insula/putamen in patients with GAD. No regions of increased VMHC were detected in GAD. Compared to controls, GAD patients showed decreased fractional anisotropy (FA) values in CC2. In GAD group, further Pearson's correlation analyses showed that VMHC of the midcingulate gyrus positively correlated with FA of CC2, FA of CC2 negatively correlated with anxiety severity. Further mediation analyses demonstrated that attenuated VMHC in bilateral midcingulate gyrus partly mediated the association between white matter integrity of CC2 sub-region and anxiety severity.
Our findings suggested impairment of interhemispheric coordination in GAD. Moreover, disrupted interhemispheric connectivity correlated with anxiety severity in GAD. Our findings provided a novel clue about the neural mechanism of GAD, and may contribute to further deep exploration and treatment of GAD.
The study was lack of comparison with non-GAD anxiety disorders.
异常的功能和结构连接被认为是广泛性焦虑障碍(GAD)的潜在神经机制。然而,双侧半球之间的功能和结构相互作用的改变很少被研究。本研究旨在描述 GAD 患者的大脑半球间静息状态功能连接和胼胝体的白质微观结构完整性。
对 GAD 患者和健康受试者进行静息状态血氧水平依赖和弥散张量成像。两组在年龄、性别、教育年限上相匹配。比较两组之间的全脑体素镜像同伦连接(VMHC)和胼胝体(CC)的白质完整性。并进一步对其与临床指标的相关性进行了分析。
与对照组相比,GAD 患者的中央前回、中扣带回和岛叶/壳核的静息状态 VMHC 降低。在 GAD 中没有发现 VMHC 增加的区域。与对照组相比,GAD 患者的 CC2 区的各向异性分数(FA)值降低。在 GAD 组中,进一步的 Pearson 相关分析显示,中扣带回的 VMHC 与 CC2 的 FA 值呈正相关,CC2 的 FA 值与焦虑严重程度呈负相关。进一步的中介分析表明,双侧中扣带回 VMHC 的减弱部分介导了 CC2 亚区白质完整性与焦虑严重程度之间的关联。
我们的研究结果表明,GAD 患者大脑半球间的协调能力受损。此外,GAD 患者的半球间连接中断与焦虑严重程度相关。我们的研究结果为 GAD 的神经机制提供了新的线索,并可能有助于进一步深入探索和治疗 GAD。
本研究缺乏与非 GAD 焦虑障碍的比较。