特定恐惧症及其动物和血液注射损伤亚型的皮质和皮质下大脑变化:来自 ENIGMA 焦虑症工作组的大型分析。

IF 15.1 1区 医学 Q1 PSYCHIATRY
American Journal of Psychiatry Pub Date : 2024-08-01 Epub Date: 2024-06-11 DOI:10.1176/appi.ajp.20230032
Kevin Hilbert, Ole Jonas Boeken, Till Langhammer, Nynke A Groenewold, Janna Marie Bas-Hoogendam, Moji Aghajani, André Zugman, Fredrik Åhs, Volker Arolt, Katja Beesdo-Baum, Johannes Björkstrand, Jennifer U Blackford, Laura Blanco-Hinojo, Joscha Böhnlein, Robin Bülow, Marta Cano, Narcis Cardoner, Xavier Caseras, Udo Dannlowski, Katharina Domschke, Lydia Fehm, Brandee Feola, Mats Fredrikson, Liesbet Goossens, Hans J Grabe, Dominik Grotegerd, Raquel E Gur, Alfons O Hamm, Anita Harrewijn, Ingmar Heinig, Martin J Herrmann, David Hofmann, Andrea P Jackowski, Andreas Jansen, Antonia N Kaczkurkin, Merel Kindt, Ellen N Kingsley, Tilo Kircher, Anna L Klahn, Katja Koelkebeck, Axel Krug, Harald Kugel, Bart Larsen, Elisabeth J Leehr, Lieselotte Leonhardt, Martin Lotze, Jürgen Margraf, Jarosław Michałowski, Markus Muehlhan, Igor Nenadić, Pedro M Pan, Paul Pauli, Wenceslao Peñate, Andre Pittig, Jens Plag, Jesus Pujol, Jan Richter, Francisco L Rivero, Giovanni A Salum, Theodore D Satterthwaite, Axel Schäfer, Judith Schäfer, Anne Schienle, Silvia Schneider, Elisabeth Schrammen, Koen Schruers, Stefan M Schulz, Esther Seidl, Rudolf M Stark, Frederike Stein, Benjamin Straube, Thomas Straube, Andreas Ströhle, Boris Suchan, Sophia I Thomopoulos, Carlos Ventura-Bort, Renee Visser, Henry Völzke, Albert Wabnegger, André Wannemüller, Julia Wendt, Julian Wiemer, Hans-Ulrich Wittchen, Katharina Wittfeld, Barry Wright, Yunbo Yang, Anna Zilverstand, Peter Zwanzger, Dick J Veltman, Anderson M Winkler, Daniel S Pine, Neda Jahanshad, Paul M Thompson, Dan J Stein, Nic J A Van der Wee, Ulrike Lueken
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引用次数: 0

摘要

目的:特异性恐惧症是一种常见的焦虑症,但与之相关的脑结构改变方面的文献却存在很大差距。ENIGMA焦虑工作组研究了特定恐惧症患者与健康对照组之间的脑结构差异,以及特定恐惧症的动物亚型和血液注射损伤(BII)亚型之间的脑结构差异。此外,作者还研究了大脑结构与症状严重程度和年龄(青少年与成年人)之间的关联:方法:作者合并了31项原始研究的数据集,最终确定了1452名恐惧症患者和2991名健康患者(62.7%为女性,年龄在5-90岁之间)的样本。成像处理和质量控制均按照 ENIGMA 的既定方案进行。皮层下体积以及皮层表面积和厚度在预先登记的分析中进行了检测:结果:与健康对照组相比,恐惧症组的皮层下体积大多较小,表面差异不一,而皮层厚度在相当多的区域都较大。恐惧症亚组也显示出差异,包括如假设的那样,BII恐惧症(182人)与动物恐惧症(739人)相比,内侧眶额皮层厚度更大。所有研究结果都是由成人参与者得出的;在儿童和青少年中没有观察到显著的结果:结论:在可比分析中,与特定恐惧症相关的脑部改变在程度和效应大小上都超过了其他焦虑症,并且不局限于脑部结构的减少。此外,恐惧症亚组之间的现象差异反映在不同的神经基础上,包括与恐惧处理和高级认知过程相关的脑区。研究结果表明,大脑结构的改变与特定恐惧症有关,但皮层下的改变尤其可能与更广泛的内化性精神病理学有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cortical and Subcortical Brain Alterations in Specific Phobia and Its Animal and Blood-Injection-Injury Subtypes: A Mega-Analysis From the ENIGMA Anxiety Working Group.

Objective: Specific phobia is a common anxiety disorder, but the literature on associated brain structure alterations exhibits substantial gaps. The ENIGMA Anxiety Working Group examined brain structure differences between individuals with specific phobias and healthy control subjects as well as between the animal and blood-injection-injury (BII) subtypes of specific phobia. Additionally, the authors investigated associations of brain structure with symptom severity and age (youths vs. adults).

Methods: Data sets from 31 original studies were combined to create a final sample with 1,452 participants with phobia and 2,991 healthy participants (62.7% female; ages 5-90). Imaging processing and quality control were performed using established ENIGMA protocols. Subcortical volumes as well as cortical surface area and thickness were examined in a preregistered analysis.

Results: Compared with the healthy control group, the phobia group showed mostly smaller subcortical volumes, mixed surface differences, and larger cortical thickness across a substantial number of regions. The phobia subgroups also showed differences, including, as hypothesized, larger medial orbitofrontal cortex thickness in BII phobia (N=182) compared with animal phobia (N=739). All findings were driven by adult participants; no significant results were observed in children and adolescents.

Conclusions: Brain alterations associated with specific phobia exceeded those of other anxiety disorders in comparable analyses in extent and effect size and were not limited to reductions in brain structure. Moreover, phenomenological differences between phobia subgroups were reflected in diverging neural underpinnings, including brain areas related to fear processing and higher cognitive processes. The findings implicate brain structure alterations in specific phobia, although subcortical alterations in particular may also relate to broader internalizing psychopathology.

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来源期刊
American Journal of Psychiatry
American Journal of Psychiatry 医学-精神病学
CiteScore
22.30
自引率
2.80%
发文量
157
审稿时长
4-8 weeks
期刊介绍: The American Journal of Psychiatry, dedicated to keeping psychiatry vibrant and relevant, publishes the latest advances in the diagnosis and treatment of mental illness. The journal covers the full spectrum of issues related to mental health diagnoses and treatment, presenting original articles on new developments in diagnosis, treatment, neuroscience, and patient populations.
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