Du Yang, Li Hailong, Xiao Hongqi, Wang Mei, Zhang Wei, Gong Qiyong, Qiu Changjian, Huang Xiaoqi
Mental Health Center and Psychiatric Laboratory, The State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China.
Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, Huaxi MR Research Center, West China Hospital, Sichuan University, Chengdu, China.
Front Behav Neurosci. 2021 Mar 18;15:637426. doi: 10.3389/fnbeh.2021.637426. eCollection 2021.
Trait anxiety is considered a vulnerability factor for the development of generalized anxiety disorder (GAD). The amygdala is related to both trait anxiety and GAD. Thus, we investigated amygdala-based functional connectivity (FC) in drug-naive non-comorbid GAD patients and explored its associations with personality, symptoms, and illness severity. FC analyses using the bilateral amygdala as seeds were performed with resting-state functional MRI data from 38 GAD patients and 20 matched healthy controls (HCs). Clinical characteristics were correlated with FC -scores from regions showing significant group differences. Furthermore, moderation analyses were used to explore the conditional effect of illness severity measured by the Clinical Global Impression-Severity (CGI-S) scale on the relationship between FC and trait anxiety. Relative to HCs, GAD patients showed hypoconnectivity between the amygdala and the rostral anterior cingulate cortex (rACC), inferior frontal gyrus (IFG), parahippocampal gyrus, and cerebellum and hyperconnectivity between the amygdala and the superior temporal gyrus (STG), insula, and postcentral gyrus. In GAD patients, amygdala-rACC connectivity was negatively associated with symptom severity and trait anxiety, and amygdala-IFG connectivity was positively associated with symptom severity. Moreover, CGI-S scores moderated the negative correlation between trait anxiety and amygdala-rACC FC. We demonstrate that there is extensive amygdala-based network dysfunction in patients with GAD. More importantly, amygdala-rACC connectivity plays a key role in the neural pathology of trait anxiety. Finally, the more severe the illness, the stronger the negative association between trait anxiety and amygdala-rACC FC. Our results emphasize the importance of personalized intervention in GAD.
特质焦虑被认为是广泛性焦虑症（GAD）发展的一个易感性因素。杏仁核与特质焦虑和广泛性焦虑症都有关联。因此，我们研究了未服用过药物的非共病广泛性焦虑症患者基于杏仁核的功能连接（FC），并探讨了其与人格、症状和疾病严重程度的关联。使用双侧杏仁核作为种子进行功能连接分析，分析对象为38名广泛性焦虑症患者和20名匹配的健康对照者（HCs）的静息态功能磁共振成像数据。临床特征与显示出显著组间差异区域的功能连接分数相关。此外，采用调节分析来探讨由临床总体印象严重程度（CGI-S）量表测量的疾病严重程度对功能连接与特质焦虑之间关系的条件效应。相对于健康对照者，广泛性焦虑症患者在杏仁核与喙前扣带回皮质（rACC）、额下回（IFG）、海马旁回和小脑之间表现出低连接性，而在杏仁核与颞上回（STG）、岛叶和中央后回之间表现出高连接性。在广泛性焦虑症患者中，杏仁核-rACC连接性与症状严重程度和特质焦虑呈负相关，杏仁核-IFG连接性与症状严重程度呈正相关。此外，CGI-S分数调节了特质焦虑与杏仁核-rACC功能连接之间的负相关。我们证明广泛性焦虑症患者存在广泛的基于杏仁核的网络功能障碍。更重要的是，杏仁核-rACC连接性在特质焦虑的神经病理学中起关键作用。最后，疾病越严重，特质焦虑与杏仁核-rACC功能连接之间的负相关越强。我们的结果强调了广泛性焦虑症个性化干预的重要性。
