Structural and functional neuroimaging studies in generalized anxiety disorder: a systematic review.

Domenico Madonna, Giuseppe Delvecchio, Jair C Soares, Paolo Brambilla
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引用次数: 40

Abstract

Objectives: Brain imaging studies carried out in patients suffering from generalized anxiety disorder (GAD) have contributed to better characterize the pathophysiological mechanisms underlying this disorder. The present study reviews the available functional and structural brain imaging evidence on GAD, and suggests further strategies for investigations in this field.

Methods: A systematic literature review was performed in PubMed, PsycINFO, and Google Scholar, aiming to identify original research evaluating GAD patients with the use of structural and functional magnetic resonance imaging as well as diffusion tensor imaging.

Results: The available studies have shown impairments in ventrolateral and dorsolateral prefrontal cortex, anterior cingulate, posterior parietal regions, and amygdala in both pediatric and adult GAD patients, mostly in the right hemisphere. However, the literature is often tentative, given that most studies have employed small samples and included patients with comorbidities or in current use of various medications. Finally, different methodological aspects, such as the type of imaging equipment used, also complicate the generalizability of the findings.

Conclusions: Longitudinal neuroimaging studies with larger samples of both juvenile and adult GAD patients, as well as at risk individuals and unaffected relatives, should be carried out in order to shed light on the specific biological signature of GAD.

Abstract Image

Abstract Image

广泛性焦虑障碍的结构和功能神经影像学研究:系统综述。
目的:在广泛性焦虑障碍(GAD)患者中进行的脑成像研究有助于更好地表征这种疾病的病理生理机制。本研究回顾了现有的关于广泛性焦虑症的功能和结构脑成像证据,并提出了该领域进一步研究的策略。方法:在PubMed、PsycINFO和Google Scholar上进行系统的文献综述,旨在识别使用结构和功能磁共振成像以及弥散张量成像评估GAD患者的原始研究。结果:现有的研究表明,儿童和成人GAD患者的腹外侧和背外侧前额叶皮层、前扣带、后顶叶区和杏仁核均存在损伤,主要发生在右半球。然而,文献往往是尝试性的,因为大多数研究采用的是小样本,包括有合并症或目前正在使用各种药物的患者。最后,不同的方法方面,如所使用的成像设备的类型,也使研究结果的普遍性复杂化。结论:为了揭示GAD的特定生物学特征,应该对青少年和成年GAD患者,以及高危个体和未受影响的亲属进行纵向神经影像学研究。
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