期刊
PSYCHOLOGICAL MEDICINE
卷 45, 期 14, 页码 3059-3073出版社
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291715001026
关键词
Dorsolateral prefrontal cortex; emotion regulation; functional magnetic resonance imaging; obsessive compulsive disorder; transcranial magnetic stimulation
资金
- Netherlands Organisation for Scientific Research (NWO-ZonMw VENI grant) [916.86.036]
- Brain & Behavior Research Foundation (NARSAD Young Investigators Award)
- Netherlands Brain Foundation [(1)-50]
- Amsterdam Brain Imaging Platform
Background. Impaired emotion regulation may underlie exaggerated emotional reactivity in patients with obsessive compulsive disorder (OCD), yet instructed emotion regulation has never been studied in the disorder. Method. This study aimed to assess the neural correlates of emotion processing and regulation in 43 medication-free OCD patients and 38 matched healthy controls, and additionally test if these can be modulated by stimulatory (patients) and inhibitory (controls) repetitive transcranial magnetic stimulation (rTMS) over the left dorsolateral prefrontal cortex (dlPFC). Participants performed an emotion regulation task during functional magnetic resonance imaging before and after a single session of randomly assigned real or sham rTMS. Effect of group and rTMS were assessed on self-reported distress ratings and brain activity in frontal-limbic regions of interest. Results. Patients had higher distress ratings than controls during emotion provocation, but similar rates of distress reduction after voluntary emotion regulation. OCD patients compared with controls showed altered amygdala responsiveness during symptom provocation and diminished left dlPFC activity and frontal-amygdala connectivity during emotion regulation. Real v. sham dlPFC stimulation differentially modulated frontal-amygdala connectivity during emotion regulation in OCD patients. Conclusions. We propose that the increased emotional reactivity in OCD may be due to a deficit in emotion regulation caused by a failure of cognitive control exerted by the dorsal frontal cortex. Modulatory rTMS over the left dlPFC may influence automatic emotion regulation capabilities by influencing frontal-limbic connectivity.
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