Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Population Health, University of Oxford, United Kingdom; Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.
Translational Research Center, University Hospital of Psychiatry, University of Bern, Bern, Switzerland.
Psychiatry Res Neuroimaging. 2020 Jun 30;300:111066. doi: 10.1016/j.pscychresns.2020.111066. Epub 2020 Mar 31.
Glucocorticoids reduce phobic fear in anxiety disorders and enhance psychotherapy, possibly by reducing the retrieval of fear memories and enhancing the consolidation of new corrective memories. Glucocorticoid signaling in the basolateral amygdala can influence connected fear and memory-related cortical regions, but this is not fully understood. Previous studies investigated specific pathways moderated by glucocorticoids, for example, visual-temporal pathways; however, these analyses were limited to a-priori selected regions. Here, we performed whole-brain pattern analysis to localize phobic stimulus decoding related to the fear-reducing effect of glucocorticoids. We reanalyzed functional magnetic resonance imaging (fMRI) data from a previously published study with spider-phobic patients and healthy controls. The patients received glucocorticoids or a placebo before the exposure to spider images. There was moderate evidence that patients with phobia had higher decoding of phobic content in the anterior cingulate cortex (ACC) and the left and right anterior insula compared to controls. Decoding in the ACC and the right insula showed strong evidence for correlation with experienced fear. Patients with cortisol reported a reduction of fear by 10-13%; however, there was only weak evidence for changes in neural decoding compared to placebo which was found in the precuneus, the opercular cortex, and the left cerebellum.
糖皮质激素可减轻焦虑障碍中的恐惧症，并增强心理治疗效果，这可能是通过减少恐惧记忆的提取和增强新的纠正性记忆的巩固来实现的。外侧杏仁核中的糖皮质激素信号可以影响相关的恐惧和与记忆相关的皮质区域，但这一点尚未得到充分理解。先前的研究调查了糖皮质激素调节的特定途径，例如视觉-时间途径；然而，这些分析仅限于预先选择的区域。在这里，我们进行了全脑模式分析，以定位与糖皮质激素降低恐惧相关的恐惧症刺激解码。我们重新分析了先前发表的一项研究的功能磁共振成像 (fMRI) 数据，该研究涉及蜘蛛恐惧症患者和健康对照者。患者在暴露于蜘蛛图像之前接受糖皮质激素或安慰剂治疗。有中等证据表明，与对照组相比，恐惧症患者在前扣带皮层 (ACC) 和左右前岛叶中对恐惧症内容的解码能力更高。在 ACC 和右岛叶中的解码与所经历的恐惧具有很强的相关性。皮质醇报告的恐惧减少了 10-13%；然而，与安慰剂相比，只有微弱的证据表明神经解码发生了变化，而在楔前叶、脑岛盖和左小脑中发现了这种变化。
