忧虑的认知回避理论认为,忧虑是一种用于控制与焦虑相关的生理唤醒的认知策略。根据这个理论,病态担忧,如在广泛性焦虑症(GAD)中,本质上是口头的,消极和抽象,而不是具体的。神经影像学研究将担忧的表达与大脑功能连接的特征模式联系起来,尤其是杏仁核.然而,忧虑的显著特征(口头,abstract,负),以及它们与生理唤醒的关系,到目前为止还没有被映射到大脑功能。
我们通过对19例GAD患者和21例对照进行静息态功能磁共振神经成像研究来解决这一遗漏。在恒心认知诱导之前和之后,同时从心率(HR)测量情绪身体唤醒。基于种子的分析量化了杏仁核的全脑功能连接的大脑变化。
在GAD,归纳增加了消极的想法和他们的口头内容。根据预测,GAD中担心的言语表达与基线时更高的HR相关,而在诱导持续认知后HR的增加减弱.在大脑中,在担心期间增加使用单词,诱导后相关的HR衰减是由杏仁核和默认模式网络\'hub\'和大脑皮层之间的功能连接强度介导的。忧虑的负含量进一步与杏仁核与扣带眼和颞叶皮层之间的功能交流有关。
研究结果为言语忧虑对GAD中HR的影响提供了神经生物学基础。
The Cognitive Avoidance Theory of Worry argues that worry is a cognitive strategy adopted to control the physiological arousal associated with anxiety. According to this theory, pathological worry, as in Generalized Anxiety Disorder (GAD), is verbal in nature, negative and abstract, rather than concrete. Neuroimaging studies link the expression of worry to characteristic modes of brain functional connectivity, especially in relation to the amygdala. However, the distinctive features of worry (verbal, abstract, negative), and their relationship to physiological arousal, have not so far been mapped to brain function.
We addressed this omission by undertaking a resting-state functional magnetic resonance neuroimaging study of 19 patients with GAD and 21 controls, before and after induction of perseverative cognitions, while measuring emotional bodily arousal from heart rate (HR). Seed-based analyses quantified brain changes in whole brain functional connectivity from the amygdala.
In GAD, the induction increased negative thoughts and their verbal content. In line with predictions, the verbal expression of worry in GAD was associated with higher HR at baseline and attenuated HR increases after induction of perseverative cognitions. Within brain, the increased use of words during worry, and the associated dampening of HR after induction were mediated by the strength of functional connectivity between the amygdala and default mode network \'hubs\' and the opercular cortex. The negative content of worry was further related to functional communication between amygdala and cingulo-opercular and temporal cortices.
Findings provide a neurobiological basis for the impact of verbal worry on HR in GAD.