Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Sci Adv. 2022 Jun 24;8(25):eabn5803. doi: 10.1126/sciadv.abn5803. Epub 2022 Jun 22.
The amygdala processes valenced stimuli, influences emotion, and exhibits aberrant activity across anxiety disorders, depression, and PTSD. Interventions modulating amygdala activity hold promise as transdiagnostic psychiatric treatments. In 45 healthy participants, we investigated whether transcranial magnetic stimulation (TMS) elicits indirect changes in amygdala activity when applied to ventrolateral prefrontal cortex (vlPFC), a region important for emotion regulation. Harnessing in-scanner interleaved TMS/functional MRI (fMRI), we reveal that vlPFC neurostimulation evoked acute and focal modulations of amygdala fMRI BOLD signal. Larger TMS-evoked changes in the amygdala were associated with higher fiber density in a vlPFC-amygdala white matter pathway when stimulating vlPFC but not an anatomical control, suggesting this pathway facilitated stimulation-induced communication between cortex and subcortex. This work provides evidence of amygdala engagement by TMS, highlighting stimulation of vlPFC-amygdala circuits as a candidate treatment for transdiagnostic psychopathology. More broadly, it indicates that targeting cortical-subcortical structural connections may enhance the impact of TMS on subcortical neural activity and, by extension, subcortex-subserved behaviors.
杏仁核处理有价值的刺激，影响情绪，并在焦虑障碍、抑郁和 PTSD 中表现出异常活动。调节杏仁核活动的干预措施有望成为跨诊断精神治疗。在 45 名健康参与者中，我们研究了经颅磁刺激 (TMS) 是否会在刺激腹外侧前额叶皮层 (vlPFC) 时引起杏仁核活动的间接变化，vlPFC 是情绪调节的重要区域。利用扫描内交错 TMS/fMRI，我们发现 vlPFC 神经刺激引起了杏仁核 fMRI BOLD 信号的急性和局部调制。当刺激 vlPFC 而不是解剖对照时，TMS 诱发的杏仁核变化越大，vlPFC-杏仁核白质通路中的纤维密度越高，这表明该通路促进了皮层和皮层下之间刺激诱导的通讯。这项工作提供了 TMS 引起杏仁核参与的证据，强调刺激 vlPFC-杏仁核回路作为一种治疗跨诊断精神病理学的候选方法。更广泛地说，它表明靶向皮质-皮质下结构连接可能会增强 TMS 对皮质下神经活动的影响，并由此增强皮质下神经活动所支持的行为。
