He Wenjing, Xiong Hang, Fang Jiangshan, Gu Hao
Xinjiang Medical University, Urumqi, China.
Department of Medical Neurology, Tongzhou District of Dongzhimen Hospital, Beijing University of TCM, Beijing, China.
Ann Palliat Med. 2021 Feb;10(2):1313-1324. doi: 10.21037/apm-20-300. Epub 2020 Oct 27.
Generalized anxiety disorder (GAD) is a persistent chronic excessive anxiety that is hard to control. Our previous study indicated that self-designed Ningxin Anshen Formula (NXAS) was effective to treat mild to moderate GAD patients. This study is a randomized controlled clinical trial and aimed to investigate the imapct of self-designed NXAS on the resting-state functional connectivity (rsFC) in patients with mild to moderate GAD and explore the potential mechanisms.
A total of 61 patients diagnosed with mild to moderate GAD were recruited and divided into two groups randomly: NXAS group (n=31) and placebo group (n=30). Before and after treatment, the rsFC was examined by resting-state functional MRI (rs-fMRI), the anxiety was assessed with HAMA, and the independent component analysis (ICA) was used to analyze the resting-state functional connectivity (rsFC). The correlation between HAMA score and abnormal rsFC was further evaluated.
The default mode network (DMN) showed evident rsFC interaction in the PCUN in both groups before and after therapy. The salience network (SN) showed obvious rsFC interaction in the bilateral gyrus frontalis inferiors and bilateral gyri temporalis superiors before and after therapy. In the NXAS group, the rsFC interction reduced significantly in the left gyrus frontalis inferior, but remained unchanged in the right gyrus frontalis inferior and bilateral gyri temporalis superiors after therapy. In the control group, the rsFC interaction increased dramatically after treatment. In addition, the abnormal rsFC had no relationship with HAMA score.
The self-designed NXAS can increase the rsFC in the PUCN on DMN and reduce rsFC in the orbIFG.L on SN to exert anti-anxiety effect.
广泛性焦虑障碍（GAD）是一种持续存在且难以控制的慢性过度焦虑症。我们之前的研究表明，自行设计的宁心安神方（NXAS）对治疗轻至中度GAD患者有效。本研究是一项随机对照临床试验，旨在探讨自行设计的NXAS对轻至中度GAD患者静息态功能连接（rsFC）的影响，并探索其潜在机制。
共招募61例诊断为轻至中度GAD的患者，随机分为两组：NXAS组（n = 31）和安慰剂组（n = 30）。治疗前后，通过静息态功能磁共振成像（rs - fMRI）检查rsFC，用汉密尔顿焦虑量表（HAMA）评估焦虑程度，并采用独立成分分析（ICA）分析静息态功能连接（rsFC）。进一步评估HAMA评分与异常rsFC之间的相关性。
治疗前后两组的默认模式网络（DMN）在楔前叶均显示出明显的rsFC相互作用。突显网络（SN）在治疗前后双侧额下回和双侧颞上回均显示出明显的rsFC相互作用。在NXAS组中，治疗后左侧额下回的rsFC相互作用显著降低，但右侧额下回和双侧颞上回保持不变。在对照组中，治疗后rsFC相互作用显著增加。此外，异常rsFC与HAMA评分无关。
自行设计的NXAS可增加DMN上楔前叶的rsFC，并降低SN上左侧额下回眶部的rsFC，从而发挥抗焦虑作用。
