Rauch S L, van der Kolk B A, Fisler R E, Alpert N M, Orr S P, Savage C R, Fischman A J, Jenike M A, Pitman R K
Harvard Medical School, Boston, Mass., USA.
Arch Gen Psychiatry. 1996 May;53(5):380-7. doi: 10.1001/archpsyc.1996.01830050014003.
Previous studies have used symptom provocation and positron emission tomography to delineate the brain systems that mediate various anxiety states. Using an analogous approach, the goal of this study was to measure regional cerebral blood flow changes associated with posttraumatic stress disorder (PTSD) symptoms.
Eight patients with PTSD, screened as physiologically responsive to a script-driven imagery symptom provocation paradigm, were exposed sequentially to audiotaped traumatic and neutral scripts in conjunction with positron emission tomography. Heart rate and subjective measures of emotional state were obtained for each condition. Statistical mapping techniques were used to determine locations of significant brain activation.
Increases in normalized blood flow were found for the traumatic as compared with control conditions in right-sided limbic, paralimbic, and visual areas; decreases were found in left inferior frontal and middle temporal cortex.
The results suggest that emotions associated with the PTSD symptomatic state are mediated by the limbic and paralimbic systems within the right hemisphere. Activation of visual cortex may correspond to the visual component of PTSD reexperiencing phenomena.
以往的研究利用症状激发和正电子发射断层扫描来描绘介导各种焦虑状态的脑系统。采用类似的方法，本研究的目的是测量与创伤后应激障碍（PTSD）症状相关的局部脑血流变化。
8名经筛选对脚本驱动的意象症状激发范式有生理反应的PTSD患者，在正电子发射断层扫描的同时，依次暴露于录音的创伤性和中性脚本。对每种情况都获取心率和情绪状态的主观测量值。使用统计映射技术来确定大脑显著激活的位置。
与对照条件相比，右侧边缘系统、边缘旁系统和视觉区域在创伤性条件下的标准化血流增加；左侧额下回和颞中回皮质血流减少。
结果表明，与PTSD症状状态相关的情绪由右半球的边缘系统和边缘旁系统介导。视觉皮质的激活可能与PTSD重现现象的视觉成分相对应。
