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Yang Y, Wang F, Andrade-Machado R, De Vito A, Wang J, Zhang T, Liu H. Disrupted functional connectivity patterns of the left inferior frontal gyrus subregions in benign childhood epilepsy with centrotemporal spikes. Transl Pediatr 2022; 11:1552-1561. [PMID: 36247884 PMCID: PMC9561512 DOI: 10.21037/tp-22-270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Benign epilepsy with centrotemporal spikes (BECTS) is one of the most common pediatric epileptic syndromes. Recent studies have shown that BECTS can lead to significant language dysfunction. Although research supports the role of the left inferior frontal gyrus (LIFG) in BECTS, it is unclear whether the subregions of the LIFG show different change patterns in patients with this syndrome. METHODS Using resting-state functional magnetic resonance imaging (fMRI) data in a group of 49 BECTS patients and 49 healthy controls, we investigated whether the BECTS patients show abnormal connectivity patterns of the LIFG subregions. RESULTS Compared with healthy controls, the BECTS patients exhibited higher connectivity between the following: the inferior frontal sulcus (IFS) and the right anterior cingulate cortex (ACC), and the ventral area 44 (A44v) region and the left hippocampus/parahippocampus. Also, a decreased connectivity was found between the IFS and the left inferior temporal gyrus (ITG). No other significant differences in functional connectivity were found in the other 4 functional subregions of the LIFG in the BECTS. CONCLUSIONS These findings provide evidence for BECTS-related functional connectivity patterns of the LIFG subregions and suggest that different subregions may be involved in different neural circuits associated with language function in the BECTS.
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Affiliation(s)
- Yang Yang
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, China.,Department of Radiology, Suining Central Hospital, Suining, China
| | - Fuqin Wang
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, China
| | - René Andrade-Machado
- Epilepsy Fellow at Children Hospital of Michigan, Detroit Medical Center, Detroit, MI, USA
| | - Andrea De Vito
- Department of Neuroradiology, H. S. Gerardo Monza, Monza, Italy
| | - Jiaojian Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Tijiang Zhang
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, China
| | - Heng Liu
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, China
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Busatto G, Rosa PG, Serpa MH, Squarzoni P, Duran FL. Psychiatric neuroimaging research in Brazil: historical overview, current challenges, and future opportunities. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2021; 43:83-101. [PMID: 32520165 PMCID: PMC7861184 DOI: 10.1590/1516-4446-2019-0757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/03/2020] [Indexed: 11/23/2022]
Abstract
The last four decades have witnessed tremendous growth in research studies applying neuroimaging methods to evaluate pathophysiological and treatment aspects of psychiatric disorders around the world. This article provides a brief history of psychiatric neuroimaging research in Brazil, including quantitative information about the growth of this field in the country over the past 20 years. Also described are the various methodologies used, the wealth of scientific questions investigated, and the strength of international collaborations established. Finally, examples of the many methodological advances that have emerged in the field of in vivo neuroimaging are provided, with discussion of the challenges faced by psychiatric research groups in Brazil, a country of limited resources, to continue incorporating such innovations to generate novel scientific data of local and global relevance.
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Affiliation(s)
- Geraldo Busatto
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Pedro G. Rosa
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Mauricio H. Serpa
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Paula Squarzoni
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Fabio L. Duran
- Laboratório de Neuroimagem em Psiquiatria (LIM 21), Departamento e Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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3
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Hinze J, Röder A, Menzie N, Müller U, Domschke K, Riemenschneider M, Noll-Hussong M. Spider Phobia: Neural Networks Informing Diagnosis and (Virtual/Augmented Reality-Based) Cognitive Behavioral Psychotherapy-A Narrative Review. Front Psychiatry 2021; 12:704174. [PMID: 34504447 PMCID: PMC8421596 DOI: 10.3389/fpsyt.2021.704174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/26/2021] [Indexed: 11/30/2022] Open
Abstract
Recent fMRI studies on specific animal phobias, particularly spider phobia (arachnophobia), have identified a large variety of specific brain regions involved in normal and disturbed fear processing. Both functional and structural brain abnormalities have been identified among phobic patients. Current research suggests that both conscious and subconscious fear processing play a crucial role in phobic disorders. Cognitive behavioral therapy has been identified as an effective treatment for specific phobias and has been associated with neuroplastic effects which can be evaluated using current neuroimaging techniques. Recent research suggests that new approaches using virtual (VR) or augmented reality (AR) tend to be similarly effective as traditional "in vivo" therapy methods and could expand treatment options for different medical or individual scenarios. This narrative review elaborates on neural structures and particularities of arachnophobia. Current treatment options are discussed and future research questions are highlighted.
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Affiliation(s)
- Jonas Hinze
- Department of Psychiatry and Psychotherapy, Saarland University Medical Center, Homburg, Germany.,Psychosomatic Medicine and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Anne Röder
- Department of Psychiatry and Psychotherapy, Saarland University Medical Center, Homburg, Germany.,Psychosomatic Medicine and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Nicole Menzie
- Department of Psychiatry and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Ulf Müller
- Department of Psychiatry and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Riemenschneider
- Department of Psychiatry and Psychotherapy, Saarland University Medical Center, Homburg, Germany.,Psychosomatic Medicine and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Michael Noll-Hussong
- Psychosomatic Medicine and Psychotherapy, Saarland University Medical Center, Homburg, Germany
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4
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Jimenez DA, Bond RL, Requena-Komuro MC, Sivasathiaseelan H, Marshall CR, Russell LL, Greaves C, Moore KM, Woollacott IO, Shafei R, Hardy CJ, Rohrer JD, Warren JD. Altered phobic reactions in frontotemporal dementia: A behavioural and neuroanatomical analysis. Cortex 2020; 130:100-110. [PMID: 32650059 PMCID: PMC7447974 DOI: 10.1016/j.cortex.2020.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 05/24/2020] [Accepted: 05/28/2020] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Abnormal behavioural and physiological reactivity to emotional stimuli is a hallmark of frontotemporal dementia (FTD), particularly the behavioural variant (bvFTD). As part of this repertoire, altered phobic responses have been reported in some patients with FTD but are poorly characterised. METHODS We collected data (based on caregiver reports) concerning the prevalence and nature of any behavioural changes related to specific phobias in a cohort of patients representing canonical syndromes of FTD and Alzheimer's disease (AD), relative to healthy older controls. Neuroanatomical correlates of altered phobic reactivity were assessed using voxel-based morphometry. RESULTS 46 patients with bvFTD, 20 with semantic variant primary progressive aphasia, 25 with non-fluent variant primary progressive aphasia, 29 with AD and 55 healthy age-matched individuals participated. Changes in specific phobia were significantly more prevalent in the combined FTD cohort (15.4% of cases) and in the bvFTD group (17.4%) compared both to healthy controls (3.6%) and patients with AD (3.5%). Attenuation of phobic reactivity was reported for individuals in all participant groups, however new phobias developed only in the FTD cohort. Altered phobic reactivity was significantly associated with relative preservation of grey matter in left posterior middle temporal gyrus, right temporo-occipital junction and right anterior cingulate gyrus, brain regions previously implicated in contextual decoding, salience processing and reward valuation. CONCLUSION Altered phobic reactivity is a relatively common issue in patients with FTD, particularly bvFTD. This novel paradigm of strong fear experience has broad implications: clinically, for diagnosis and patient well-being; and neurobiologically, for our understanding of the pathophysiology of aversive sensory signal processing in FTD and the neural mechanisms of fear more generally.
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Affiliation(s)
- Daniel A Jimenez
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Rebecca L Bond
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Mai-Carmen Requena-Komuro
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Harri Sivasathiaseelan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Charles R Marshall
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom; Preventive Neurology Unit, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, United Kingdom
| | - Lucy L Russell
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Caroline Greaves
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Katrina M Moore
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Ione Oc Woollacott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Rachelle Shafei
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Chris Jd Hardy
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jonathan D Rohrer
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jason D Warren
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.
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Bauduin SEEC, van der Pal Z, Pereira AM, Meijer OC, Giltay EJ, van der Wee NJA, van der Werff SJA. Cortical thickness abnormalities in long-term remitted Cushing's disease. Transl Psychiatry 2020; 10:293. [PMID: 32826851 PMCID: PMC7443132 DOI: 10.1038/s41398-020-00980-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 05/31/2020] [Accepted: 06/02/2020] [Indexed: 01/06/2023] Open
Abstract
Long-term remitted Cushing's disease (LTRCD) patients commonly continue to present persistent psychological and cognitive deficits, and alterations in brain function and structure. Although previous studies have conducted gray matter volume analyses, assessing cortical thickness and surface area of LTRCD patients may offer further insight into the neuroanatomical substrates of Cushing's disease. Structural 3T magnetic resonance images were obtained from 25 LTRCD patients, and 25 age-, gender-, and education-matched healthy controls (HCs). T1-weighted images were segmented using FreeSurfer software to extract mean cortical thickness and surface area values of 68 cortical gray matter regions and two whole hemispheres. Paired sample t tests explored differences between the anterior cingulate cortex (ACC; region of interest), and the whole brain. Validated scales assessed psychiatric symptomatology, self-reported cognitive functioning, and disease severity. After correction for multiple comparisons, ROI analyses indicated that LTRCD-patients showed reduced cortical thickness of the left caudal ACC and the right rostral ACC compared to HCs. Whole-brain analyses indicated thinner cortices of the left caudal ACC, left cuneus, left posterior cingulate cortex, right rostral ACC, and bilateral precuneus compared to HCs. No cortical surface area differences were identified. Cortical thickness of the left caudal ACC and left cuneus were inversely associated with anxiety symptoms, depressive symptoms, and disease duration, although certain associations did not persist after correction for multiple testing. In six of 68 regions examined, LTRCD patients had reduced cortical thickness in comparison to HCs. Cortical thickness of the left caudal ACC was inversely associated with disease duration. This suggests that prolonged and excessive exposure to glucocorticoids may be related to cortical thinning of brain structures involved in emotional and cognitive processing.
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Affiliation(s)
- S E E C Bauduin
- Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands.
| | - Z van der Pal
- Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - A M Pereira
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
- Department of Endocrinology and Metabolic Diseases and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
| | - O C Meijer
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
- Department of Endocrinology and Metabolic Diseases and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
| | - E J Giltay
- Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, The Netherlands
| | - N J A van der Wee
- Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - S J A van der Werff
- Department of Psychiatry, Leiden University Medical Center (LUMC), Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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Kaczkurkin AN, Park SS, Sotiras A, Moore TM, Calkins ME, Cieslak M, Rosen AF, Ciric R, Xia CH, Cui Z, Sharma A, Wolf DH, Ruparel K, Pine DS, Shinohara RT, Roalf DR, Gur RC, Davatzikos C, Gur RE, Satterthwaite TD. Evidence for Dissociable Linkage of Dimensions of Psychopathology to Brain Structure in Youths. Am J Psychiatry 2019; 176:1000-1009. [PMID: 31230463 PMCID: PMC6888993 DOI: 10.1176/appi.ajp.2019.18070835] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE High comorbidity among psychiatric disorders suggests that they may share underlying neurobiological deficits. Abnormalities in cortical thickness and volume have been demonstrated in clinical samples of adults, but less is known when these structural differences emerge in youths. The purpose of this study was to examine the association between dimensions of psychopathology and brain structure. METHODS The authors studied 1,394 youths who underwent brain imaging as part of the Philadelphia Neurodevelopmental Cohort. Dimensions of psychopathology were constructed using a bifactor model of symptoms. Cortical thickness and volume were quantified using high-resolution 3-T MRI. Structural covariance networks were derived using nonnegative matrix factorization and analyzed using generalized additive models with penalized splines to capture both linear and nonlinear age-related effects. RESULTS Fear symptoms were associated with reduced cortical thickness in most networks, and overall psychopathology was associated with globally reduced gray matter volume across all networks. Structural covariance networks predicted psychopathology symptoms above and beyond demographic characteristics and cognitive performance. CONCLUSIONS The results suggest a dissociable relationship whereby fear is most strongly linked to reduced cortical thickness and overall psychopathology is most strongly linked to global reductions in gray matter volume. Such results have implications for understanding how abnormalities of brain development may be associated with divergent dimensions of psychopathology.
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Affiliation(s)
- Antonia N. Kaczkurkin
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Sophia Seonyeong Park
- Department of Psychiatry, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19122, USA
| | - Aristeidis Sotiras
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Department of Radiology, Washington University, St. Louis, MO, 63130, USA
| | - Tyler M. Moore
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Monica E. Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Matthew Cieslak
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Adon F.G. Rosen
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rastko Ciric
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Cedric Huchuan Xia
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Zaixu Cui
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Anup Sharma
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Daniel H. Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Kosha Ruparel
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Daniel S. Pine
- Emotion and Development Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD 20892, USA
| | - Russell T. Shinohara
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - David R. Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Ruben C. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Philadelphia Veterans Administration Medical Center, Philadelphia, PA 19104
| | - Christos Davatzikos
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Raquel E. Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Theodore D. Satterthwaite
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
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Hilbert K, Evens R, Maslowski NI, Wittchen HU, Lueken U. Neurostructural correlates of two subtypes of specific phobia: a voxel-based morphometry study. Psychiatry Res 2015; 231:168-75. [PMID: 25561374 DOI: 10.1016/j.pscychresns.2014.12.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Revised: 11/13/2014] [Accepted: 12/04/2014] [Indexed: 01/08/2023]
Abstract
The animal and blood-injection-injury (BII) subtypes of specific phobia are both characterized by subjective fear but distinct autonomic reactions to threat. Previous functional neuroimaging studies have related these characteristic responses to shared and non-shared neural underpinnings. However, no comparative structural data are available. This study aims to fill this gap by comparing the two subtypes and also comparing them with a non-phobic control group. Gray and white matter data of 33 snake phobia subjects (SP), 26 dental phobia subjects (DP), and 37 healthy control (HC) subjects were analyzed with voxel-based morphometry. Especially DP differed from HC and SP by showing significantly increased grey matter volumes in widespread areas including the right subgenual anterior cingulate gyrus, left insula, left orbitofrontal and left prefrontal (PFC) cortices. In addition, white matter volume was significantly increased in the left PFC in DP compared with SP. These results are in line with functional changes observed in dental phobia and point toward those brain circuits associated with emotional processing and regulation. Future studies should aim to further delineate functional and structural connectivity alterations in specific phobia.
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Affiliation(s)
- Kevin Hilbert
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany; Behavioral Epidemiology, Technische Universität Dresden, Dresden, Germany.
| | - Ricarda Evens
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Nina Isabel Maslowski
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
| | - Ulrike Lueken
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Neuroimaging Center, Technische Universität Dresden, Dresden, Germany
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8
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Duval ER, Javanbakht A, Liberzon I. Neural circuits in anxiety and stress disorders: a focused review. Ther Clin Risk Manag 2015; 11:115-26. [PMID: 25670901 PMCID: PMC4315464 DOI: 10.2147/tcrm.s48528] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Anxiety and stress disorders are among the most prevalent neuropsychiatric disorders. In recent years, multiple studies have examined brain regions and networks involved in anxiety symptomatology in an effort to better understand the mechanisms involved and to develop more effective treatments. However, much remains unknown regarding the specific abnormalities and interactions between networks of regions underlying anxiety disorder presentations. We examined recent neuroimaging literature that aims to identify neural mechanisms underlying anxiety, searching for patterns of neural dysfunction that might be specific to different anxiety disorder categories. Across different anxiety and stress disorders, patterns of hyperactivation in emotion-generating regions and hypoactivation in prefrontal/regulatory regions are common in the literature. Interestingly, evidence of differential patterns is also emerging, such that within a spectrum of disorders ranging from more fear-based to more anxiety-based, greater involvement of emotion-generating regions is reported in panic disorder and specific phobia, and greater involvement of prefrontal regions is reported in generalized anxiety disorder and posttraumatic stress disorder. We summarize the pertinent literature and suggest areas for continued investigation.
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Affiliation(s)
- Elizabeth R Duval
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Arash Javanbakht
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
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