Center of Mental Health, Dept. of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany.
Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Germany.
J Psychiatr Res. 2021 Nov;143:268-275. doi: 10.1016/j.jpsychires.2021.09.003. Epub 2021 Sep 3.
Recent studies indicate differential involvement of the centromedial amygdala (CM) and the bed nucleus of the stria terminalis (BNST) during processing (anticipation and confrontation) of threat stimuli. Here, temporal predictability was shown to be a relevant factor. In this study, we want to investigate the relevance of these effects, which were found in healthy subjects, for anxiety disorders. Therefore, we investigated the differential involvement of CM and BNST in the anticipation and confrontation of phobic stimuli under variation of temporal predictability in spider phobia. 21 patients with spider phobia and 21 healthy controls underwent a temporally predictable/unpredictable phobic and neutral anticipation and confrontation paradigm using functional magnetic resonance imaging (fMRI) and ROI analyses. During the anticipation phase, healthy controls showed higher CM and BNST activity during the predictable compared with the unpredictable condition compared with the anxiety patients. During a confrontation phase that followed the anticipation phase, CM was more activated than BNST during the phobic compared with the neutral confrontation. While this effect was independent of threat predictability in patients, healthy controls showed higher activation in the CM compared with the BNST only during the predictable spider confrontation compared with the predictable bird confrontation. The results contribute to a better understanding of the separate roles of the CM and BNST during phobic processes. The CM was found to be more relevant to phobic confrontation in patients with spider phobia compared with the BNST.
最近的研究表明，在处理（预期和面对）威胁刺激时，中隔核（CM）和终纹床核（BNST）的参与存在差异。在这里，时间可预测性被证明是一个相关因素。在这项研究中，我们想研究这些在健康受试者中发现的效应对于焦虑症的相关性。因此，我们研究了在蜘蛛恐惧症中，时间可预测性变化时，CM 和 BNST 在预期和面对恐惧刺激时的差异参与。21 名蜘蛛恐惧症患者和 21 名健康对照组接受了功能磁共振成像（fMRI）和 ROI 分析的时间可预测/不可预测的恐惧和中性预期和面对范式。在预期阶段，与焦虑症患者相比，健康对照组在可预测条件下比不可预测条件下 CM 和 BNST 的活动更高。在紧随预期阶段的面对阶段，与中性面对相比，CM 在恐惧时比 BNST 更活跃。虽然这种效应在患者中与威胁可预测性无关，但与可预测的鸟类面对相比，健康对照组仅在可预测的蜘蛛面对时，CM 的激活程度高于 BNST。这些结果有助于更好地理解 CM 和 BNST 在恐惧过程中的单独作用。与 BNST 相比，CM 被发现与蜘蛛恐惧症患者的恐惧面对更相关。
