Wang Hai-Yang, Guan Bei-Yan, Wang Shi-Yao, Ni Ming-Fei, Miao Yan-Wei, Tian Feng, Chen Yumin, Wu Meng-Li, Li Rui, Zhang Bing-Wei
Department of Neurology, Jining No.1 People's Hospital, Shandong First Medical University, Jining, China.
Department of Neurology and Psychiatry, First Affiliated Hospital of Dalian Medical University, Dalian, China.
Ther Adv Psychopharmacol. 2024 Nov 16;14:20451253241298871. doi: 10.1177/20451253241298871. eCollection 2024.
Emotional dysregulation, particularly unconscious catastrophic cognitions, plays a pivotal role in the genesis of panic disorder (PD). However, no studies have yet applied the percentage of amplitude fluctuation (PerAF) metric in resting-state functional magnetic resonance imaging to examine spontaneous neural functioning and its relation to catastrophic cognitions in PD.
To explore the interplay between resting-state neural activity, functional connectivity (FC), and unconscious emotion regulation in individuals with PD.
Cross-sectional study.
The study encompassed 51 participants, including 26 PD patients and 25 healthy individuals. The PerAF algorithm was employed to explore the local spontaneous neural activity in PD. Regions exhibiting aberrant spontaneous neural activity were used as seed points for whole-brain FC analysis. Correlations were utilized to examine associations between local neural activity patterns and neurocognitive assessments in PD.
The study revealed that compared to healthy individuals, PD patients exhibited elevated PerAF values in key emotion-regulation-related brain regions, including the ventromedial prefrontal cortex (vmPFC), striatum, amygdala, dorsomedial prefrontal cortex (dmPFC), and cerebellum. In addition, the resting-state FC between vmPFC and precuneus, as well as between the cerebellum and precuneus, was weakened in PD patients. Furthermore, positive associations were noted between PerAF measurements of vmPFC and amygdala and catastrophizing scores.
PD involves regional and network-level alterations in resting-state brain activity. The fronto-striatal-limbic circuits play a critical role in catastrophic-style emotion regulation in PD patients. Reduced FC within the default mode network and cerebellum-default mode network may signify a coordination anomaly in introspection and cognitive activities in PD. These findings complement the model of implicit emotion regulation in PD and suggest potential intervention targets.
情绪调节障碍，尤其是无意识的灾难性认知，在惊恐障碍（PD）的发病机制中起关键作用。然而，尚无研究应用静息态功能磁共振成像中的振幅波动百分比（PerAF）指标来检查PD患者的自发神经功能及其与灾难性认知的关系。
探讨PD患者静息态神经活动、功能连接（FC）和无意识情绪调节之间的相互作用。
横断面研究。
该研究纳入了51名参与者，包括26名PD患者和25名健康个体。采用PerAF算法探索PD患者的局部自发神经活动。将表现出自发神经活动异常的区域用作全脑FC分析的种子点。利用相关性分析来检查PD患者局部神经活动模式与神经认知评估之间的关联。
研究发现，与健康个体相比，PD患者在关键的情绪调节相关脑区，包括腹内侧前额叶皮质（vmPFC）、纹状体、杏仁核、背内侧前额叶皮质（dmPFC）和小脑中，PerAF值升高。此外，PD患者中vmPFC与楔前叶之间以及小脑与楔前叶之间的静息态FC减弱。此外，vmPFC和杏仁核的PerAF测量值与灾难化评分之间存在正相关。
PD涉及静息态脑活动的区域和网络水平改变。额-纹状体-边缘回路在PD患者的灾难性情绪调节中起关键作用。默认模式网络和小脑-默认模式网络内FC的降低可能表明PD患者在内省和认知活动中存在协调异常。这些发现补充了PD的内隐情绪调节模型，并提示了潜在的干预靶点。
