Clauss Jacqueline
Child and Adolescent Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA.
Child and Adolescent Psychiatry, McLean Hospital, Belmont, Massachusetts, USA.
Gen Psychiatr. 2019 Dec 18;32(6):e100137. doi: 10.1136/gpsych-2019-100137. eCollection 2019.
Behavioural inhibition is a biologically based risk factor for anxiety disorders. Children with behavioural inhibition are shy, cautious and avoidant of new situations. Much research on behavioural inhibition has focused on the amygdala as an underlying neural substrate and has identified differences in amygdala function and volume; however, amygdala findings have yet to lead to meaningful interventions for prevention or treatment of anxiety disorders. The bed nucleus of the stria terminalis (BNST) is a prime candidate to be a neural substrate of behavioural inhibition, given current evidence of BNST function and development in human research and animal models. Children with behavioural inhibition have an increased startle response to safety cues and an increased cortisol response to social evaluative situations, both of which are mediated by the BNST. In rodents, activation of the BNST underlies contextual fear responses and responses to uncertain and sustained threat. Non-human primates with anxious temperament (the macaque equivalent of behavioural inhibition) have increased BNST activity to ambiguous social situations, and activity of the BNST in anxious temperament is significantly heritable. Importantly, the BNST is sexually dimorphic and continues to develop into adulthood, paralleling the development of anxiety disorders in humans. Together, these findings suggest that further investigation of the BNST in behavioural inhibition is necessary and may lead to new avenues for the prevention and treatment of anxiety disorders.
行为抑制是焦虑症基于生物学的一个风险因素。有行为抑制的儿童害羞、谨慎且回避新情况。许多关于行为抑制的研究都聚焦于杏仁核作为潜在的神经基质，并已确定杏仁核功能和体积的差异；然而，杏仁核的研究结果尚未带来针对焦虑症预防或治疗的有意义的干预措施。鉴于目前人类研究和动物模型中关于终纹床核（BNST）功能和发育的证据，终纹床核是行为抑制的神经基质的主要候选者。有行为抑制的儿童对安全线索的惊跳反应增强，对社会评价情境的皮质醇反应增强，这两者均由终纹床核介导。在啮齿动物中，终纹床核的激活是情境恐惧反应以及对不确定和持续威胁的反应的基础。具有焦虑气质（相当于猕猴的行为抑制）的非人灵长类动物对模糊社会情境的终纹床核活动增加，且焦虑气质的终纹床核活动具有显著遗传性。重要的是，终纹床核具有性别二态性，并持续发育至成年期，这与人类焦虑症的发展平行。总之，这些发现表明有必要对行为抑制中的终纹床核进行进一步研究，这可能会为焦虑症的预防和治疗带来新途径。
