Emotion regulation before and after transcranial magnetic stimulation in obsessive compulsive disorder

被引：63
作者：
de Wit, S. J. [1 ,2 ]
van der Werf, Y. D. [2 ,3 ]
Mataix-Cols, D. [4 ]
Trujillo, J. P. [1 ,3 ]
van Oppen, P. [1 ]
Veltman, D. J. [1 ,2 ]
van den Heuvel, O. A. [1 ,2 ,3 ]
机构：
[1] Vrije Univ Amsterdam, Med Ctr, Dept Psychiat, Amsterdam, Netherlands
[2] Neurosci Campus Amsterdam, Amsterdam, Netherlands
[3] Vrije Univ Amsterdam, Med Ctr, Dept Anat & Neurosci, Amsterdam, Netherlands
[4] Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res & Educ, Stockholm, Sweden
来源：
PSYCHOLOGICAL MEDICINE | 2015年 / 45卷 / 14期
关键词：
Dorsolateral prefrontal cortex; emotion regulation; functional magnetic resonance imaging; obsessive compulsive disorder; transcranial magnetic stimulation; COGNITIVE-BEHAVIORAL THERAPY; SOCIAL ANXIETY DISORDER; PREFRONTAL CORTEX; INDIVIDUAL-DIFFERENCES; MAJOR DEPRESSION; RELEVANT STIMULI; ATTENTIONAL BIAS; NEGATIVE EMOTION; NEURAL BASES; AMYGDALA;
D O I：
10.1017/S0033291715001026
中图分类号：
B849 [应用心理学];
学科分类号：
040203 ;
摘要：
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.
引用
收藏
页码：3059 / 3073
页数：15
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