Department of Psychology, Humboldt-Universität zu Berlin, Berlin 10117, Germany.
Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, Berlin 10117, Germany.
Soc Cogn Affect Neurosci. 2020 Oct 8;15(8):849-859. doi: 10.1093/scan/nsaa103.
Cigarette smoking increases the likelihood of developing anxiety disorders, among them panic disorder (PD). While brain structures altered by smoking partly overlap with morphological changes identified in PD, the modulating impact of smoking as a potential confounder on structural alterations in PD has not yet been addressed. In total, 143 PD patients (71 smokers) and 178 healthy controls (62 smokers) participated in a multicenter magnetic resonance imaging (MRI) study. T1-weighted images were used to examine brain structural alterations using voxel-based morphometry in a priori defined regions of the defensive system network. PD was associated with gray matter volume reductions in the amygdala and hippocampus. This difference was driven by non-smokers and absent in smoking subjects. Bilateral amygdala volumes were reduced with increasing health burden (neither PD nor smoking > either PD or smoking > both PD and smoking). As smoking can narrow or diminish commonly observed structural abnormalities in PD, the effect of smoking should be considered in MRI studies focusing on patients with pathological forms of fear and anxiety. Future studies are needed to determine if smoking may increase the risk for subsequent psychopathology via brain functional or structural alterations.
吸烟会增加焦虑障碍的发病风险，其中包括惊恐障碍（PD）。虽然吸烟引起的大脑结构改变与 PD 中确定的形态学改变部分重叠，但吸烟作为一个潜在混杂因素对 PD 结构改变的调节作用尚未得到解决。共有 143 名 PD 患者（71 名吸烟者）和 178 名健康对照者（62 名吸烟者）参加了一项多中心磁共振成像（MRI）研究。使用基于体素的形态测量学，在防御系统网络的预先定义区域中，使用 T1 加权图像检查大脑结构改变。PD 与杏仁核和海马体的灰质体积减少有关。这种差异是由不吸烟者驱动的，而在吸烟者中则不存在。随着健康负担的增加（既不是 PD 也不是吸烟>要么 PD 要么吸烟>两者 PD 和吸烟），双侧杏仁核体积减少。由于吸烟可能会缩小或减轻 PD 中常见的结构异常，因此在关注病理性恐惧和焦虑患者的 MRI 研究中，应考虑吸烟的影响。需要进一步的研究来确定吸烟是否会通过大脑功能或结构改变增加随后发生精神病理学的风险。
