Wiedemann G, Pauli P, Dengler W, Lutzenberger W, Birbaumer N, Buchkremer G
University Hospital of Psychiatry and Psychotherapy, University of Tuebingen, Germany.
Arch Gen Psychiatry. 1999 Jan;56(1):78-84. doi: 10.1001/archpsyc.56.1.78.
Right frontal hemisphere activation, as indicated by reduced frontal alpha amplitude, seems to represent activation of an avoidance-withdrawal system and seems to be associated with negative emotions. Since patients with panic disorder are characterized by both negative emotions and avoidance-withdrawal behavior, we expected them to show greater right than left frontal hemisphere activation.
Spontaneous electroencephalography was recorded from the left and right frontal and parietal scalp regions of 23 patients with panic disorder patients without a diagnosis of depression and from 25 healthy control participants during the following conditions: rest, confrontation with neutral, panic-relevant, anxiety-relevant but panic-irrelevant, or anxiety-irrelevant but emotionally relevant stimuli, and performance of a motor task. Their emotional state during these conditions was assessed by the Self-Assessment Manikin.
In patients with panic disorders, there were asymmetries in frontal hemisphere activation during resting phases and when confronted with anxiety-relevant stimuli. Their right frontal alpha power was significantly decreased compared with the left, while control participants did not show frontal brain asymmetry during these phases. There was no frontal brain asymmetry when patients observed an emotionally neutral picture or performed a motor task. Under these conditions, left and right frontal hemisphere alpha activation of patients with panic disorder and healthy participants were comparable.
These data support the hypothesis that patients with panic disorder are characterized by greater activation of a right frontal avoidance-withdrawal system in negatively valenced situations. The findings are interpreted as biological evidence for a disturbed cortical processing in patients with panic disorder.
额叶α波幅降低所表明的右额叶半球激活似乎代表了一种回避 - 退缩系统的激活，并且似乎与负面情绪相关。由于惊恐障碍患者的特征是既有负面情绪又有回避 - 退缩行为，我们预期他们右额叶半球的激活程度会高于左额叶半球。
在以下几种情况下，对23名未诊断出抑郁症的惊恐障碍患者以及25名健康对照参与者的左、右额叶和顶叶头皮区域进行自发脑电图记录：休息、面对中性刺激、与惊恐相关的刺激、与焦虑相关但与惊恐无关的刺激、与焦虑无关但与情绪相关的刺激以及执行一项运动任务。通过情绪自评量表评估他们在这些情况下的情绪状态。
在惊恐障碍患者中，休息阶段以及面对与焦虑相关的刺激时，额叶半球激活存在不对称性。与左侧相比，他们的右额叶α波功率显著降低，而对照参与者在这些阶段未表现出额叶脑区不对称。当患者观察情绪中性图片或执行运动任务时，不存在额叶脑区不对称。在这些情况下，惊恐障碍患者和健康参与者的左、右额叶半球α波激活程度相当。
这些数据支持了这样的假设，即惊恐障碍患者在负性情绪情境下，其右额叶回避 - 退缩系统的激活程度更高。这些发现被解释为惊恐障碍患者皮质加工紊乱的生物学证据。
