Abstract

One of the hallmarks of anxiety disorders is impaired cognitive control, affecting working memory (WM). The dorsolateral prefrontal cortex (dlPFC) is critical for WM; however, it is still unclear how dlPFC activity relates to WM impairments in patients. Forty-one healthy volunteers and 32 anxiety (general and/or social anxiety disorder) patients completed the Sternberg WM paradigm during safety and unpredictable shock threat. On each trial, a series of letters was presented, followed by brief retention and response intervals. On low- and high-load trials, subjects retained the series (five and eight letters, respectively) in the original order, while on sort trials, subjects rearranged the series (five letters) in alphabetical order. We sampled the blood oxygenation level–dependent activity during retention using a bilateral anatomical dlPFC mask. Compared to controls, patients showed increased reaction time during high-load trials, greater right dlPFC activity and reduced dlPFC activity during threat. These results suggest that WM performance for patients and controls may rely on distinct patterns of dlPFC activity with patients requiring bilateral dlPFC activity. These results are consistent with reduced efficiency of WM in anxiety patients. This reduced efficiency may be due to an inefficient allocation of dlPFC resources across hemispheres or a decreased overall dlPFC capacity.

中文翻译：

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焦虑症患者在口头工作记忆过程中依赖双侧dlPFC激活

摘要

焦虑症的标志之一是认知控制受损，影响工作记忆（WM）。背外侧前额叶皮层（dlPFC）对于WM至关重要。但是，尚不清楚dlPFC活性与患者的WM损伤如何相关。41名健康志愿者和32名焦虑症（一般和/或社交焦虑症）患者在安全和不可预测的电击威胁期间完成了Sternberg WM范例。在每个试验中，均提出了一系列信函，随后是简短的保留和回复间隔。在低负荷和高负荷试验中，受试者按原始顺序保留序列（分别为五个字母和八个字母），而在分类试验中，受试者按字母顺序重新排列序列（五个字母）。我们使用双侧解剖dlPFC面罩对保留期间的血液氧合水平依赖性活动进行了采样。与对照组相比，患者在高负荷试验中反应时间增加，右侧dlPFC活性增加，而威胁期间dlPFC活性降低。这些结果表明，患者和对照组的WM表现可能取决于dlPFC活性的不同模式，而患者则需要双侧dlPFC活性。这些结果与焦虑症患者WM的效率降低一致。这种降低的效率可能是由于dlPFC资源在半球上的分配效率低下或总体dlPFC容量降低所致。这些结果表明，患者和对照组的WM表现可能取决于dlPFC活性的不同模式，而患者则需要双侧dlPFC活性。这些结果与焦虑症患者WM的效率降低一致。这种降低的效率可能是由于dlPFC资源在半球上的分配效率低下或总体dlPFC容量降低所致。这些结果表明，患者和对照组的WM表现可能取决于dlPFC活性的不同模式，而患者则需要双侧dlPFC活性。这些结果与焦虑症患者WM的效率降低一致。这种降低的效率可能是由于dlPFC资源在半球上的分配效率低下或总体dlPFC容量降低所致。