Much of the mechanistic research on anxiety focuses on subcortical structures such as the amygdala; however, less is known about the distributed cortical circuit that also contributes to anxiety expression. One way to learn about this circuit is to probe candidate regions using transcranial magnetic stimulation (TMS). In this study, we tested the involvement of the dorsolateral prefrontal cortex (dlPFC), in anxiety expression using 10 Hz repetitive TMS (rTMS). In a within-subject, crossover experiment, the study measured anxiety in healthy subjects before and after a session of 10 Hz rTMS to the right dorsolateral prefrontal cortex (dlPFC). It used threat of predictable and unpredictable shock to induce anxiety and anxiety potentiated startle to assess anxiety. Counter to our hypotheses, results showed an increase in anxiety-potentiated startle following active but not sham rTMS. These results suggest a mechanistic link between right dlPFC activity and physiological anxiety expression. This result supports current models of prefrontal asymmetry in affect, and lays the groundwork for further exploration into the cortical mechanisms mediating anxiety, which may lead to novel anxiety treatments.

中文翻译：

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在健康受试者中使用经颅磁刺激揭示了右前额叶皮层活动与焦虑唤醒之间的机制联系。

焦虑的许多机制研究都集中在皮质下结构，如杏仁核。然而，人们对分布式皮质回路知之甚少，它也有助于焦虑表达。了解此电路的一种方法是使用经颅磁刺激（TMS）探测候选区域。在这项研究中，我们使用10 Hz重复TMS（rTMS）测试了背外侧前额叶皮层（dlPFC）在焦虑表达中的参与。在一项受试者内部交叉实验中，该研究测量了健康受试者在右侧背外侧前额叶皮层（dlPFC）进行10 Hz rTMS训练前后的焦虑程度。它使用可预测和不可预测的电击威胁诱发焦虑，并通过增强焦虑的惊吓来评估焦虑。与我们的假设相反，结果显示，主动而非虚假rTMS后焦虑增强的惊吓增加。这些结果表明正确的dlPFC活性和生理焦虑表达之间的机制联系。该结果支持当前的前额叶不对称性情感模型，并为进一步探索介导焦虑的皮层机制奠定了基础，这可能会导致新的焦虑症治疗。