Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States; Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, United States.
Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States.
Behav Brain Res. 2021 Aug 27;412:113428. doi: 10.1016/j.bbr.2021.113428. Epub 2021 Jun 26.
In schizophrenia, impairments in affect are prominent and anxiety disorders are prevalent. Neuroimaging studies of fear and anxiety in schizophrenia have focused on the amygdala and show alterations in connectivity. Emerging evidence suggests that the bed nucleus of the stria terminalis (BNST) also plays a critical role in anxiety, especially during anticipation of an unpredictable threat; however, previous studies have not examined the BNST in schizophrenia. In the present study, we examined BNST function and connectivity in people with schizophrenia (n = 31; n = 15 with comorbid anxiety) and controls (n = 15) during anticipation of unpredictable and predictable threat. A secondary analysis tested for differences in activation and connectivity of the central nucleus of the amygdala (CeA), which has also been implicated in threat anticipation. Analyses tested for group differences in both activation and connectivity during anticipation of unpredictable threat and predictable threat (p < .05). Relative to controls, individuals with schizophrenia showed stronger BNST-middle temporal gyrus (MTG) connectivity during unpredictable threat anticipation and stronger BNST-MTG and BNST-dorsolateral prefrontal connectivity during predictable threat anticipation. Comparing subgroups of individuals with schizophrenia and a comorbid anxiety disorder (SZ+ANX) to those without an anxiety disorder (SZ-ANX) revealed broader patterns of altered connectivity. During unpredictable threat anticipation, the SZ+ANX group had stronger BNST connectivity with regions of the salience network (insula, dorsal anterior cingulate cortex). During predictable threat anticipation, the SZ+ANX group had stronger BNST connectivity with regions associated with fear processing (insula, extended amygdala, prefrontal cortex). A secondary CeA analysis revealed a different pattern; the SZ+ANX group had weaker CeA connectivity across multiple brain regions during threat anticipation compared to the SZ-ANX group. These findings provide novel evidence for altered functional connectivity during threat anticipation in schizophrenia, especially in individuals with comorbid anxiety.
在精神分裂症中，情感障碍较为突出，焦虑障碍也较为普遍。精神分裂症的恐惧和焦虑神经影像学研究集中在杏仁核上，并显示出连接的改变。新出现的证据表明，终纹床核（BNST）在焦虑中也起着关键作用，特别是在预测不可预测的威胁时；然而，以前的研究并未研究精神分裂症中的 BNST。在本研究中，我们在不可预测和可预测的威胁预期中，研究了精神分裂症患者（n = 31；n = 15 人合并焦虑）和对照组（n = 15）的 BNST 功能和连接。二次分析测试了在威胁预期中也涉及的杏仁核中央核（CeA）的激活和连接的差异。分析测试了不可预测和可预测威胁预期期间激活和连接的组间差异（p <.05）。与对照组相比，精神分裂症患者在不可预测的威胁预期期间表现出更强的 BNST-颞中回（MTG）连接，在可预测的威胁预期期间表现出更强的 BNST-MTG 和 BNST-背外侧前额叶连接。将具有合并焦虑障碍的精神分裂症个体（SZ+ANX）亚组与没有焦虑障碍的精神分裂症个体（SZ-ANX）进行比较，发现了更广泛的连接改变模式。在不可预测的威胁预期期间，SZ+ANX 组与突显网络（岛叶、背侧前扣带回皮质）的区域有更强的 BNST 连接。在可预测的威胁预期期间，SZ+ANX 组与与恐惧处理相关的区域（岛叶、扩展杏仁核、前额叶皮质）有更强的 BNST 连接。二次 CeA 分析显示出不同的模式；与 SZ-ANX 组相比，SZ+ANX 组在威胁预期期间与多个脑区的 CeA 连接较弱。这些发现为精神分裂症中威胁预期期间的功能连接改变提供了新的证据，尤其是在合并焦虑的个体中。
