Objective:

Specific phobia is a common anxiety disorder, but the literature on associated brain structure alterations exhibits substantial gaps. The ENIGMA Anxiety Working Group examined brain structure differences between individuals with specific phobias and healthy control subjects as well as between the animal and blood-injection-injury (BII) subtypes of specific phobia. Additionally, the authors investigated associations of brain structure with symptom severity and age (youths vs. adults).

Methods:

Data sets from 31 original studies were combined to create a final sample with 1,452 participants with phobia and 2,991 healthy participants (62.7% female; ages 5–90). Imaging processing and quality control were performed using established ENIGMA protocols. Subcortical volumes as well as cortical surface area and thickness were examined in a preregistered analysis.

Results:

Compared with the healthy control group, the phobia group showed mostly smaller subcortical volumes, mixed surface differences, and larger cortical thickness across a substantial number of regions. The phobia subgroups also showed differences, including, as hypothesized, larger medial orbitofrontal cortex thickness in BII phobia (N=182) compared with animal phobia (N=739). All findings were driven by adult participants; no significant results were observed in children and adolescents.

Conclusions:

Brain alterations associated with specific phobia exceeded those of other anxiety disorders in comparable analyses in extent and effect size and were not limited to reductions in brain structure. Moreover, phenomenological differences between phobia subgroups were reflected in diverging neural underpinnings, including brain areas related to fear processing and higher cognitive processes. The findings implicate brain structure alterations in specific phobia, although subcortical alterations in particular may also relate to broader internalizing psychopathology.

中文翻译：

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特定恐惧症及其动物和血液注射损伤亚型的皮质和皮质下大脑改变：来自 ENIGMA 焦虑工作组的大型分析

 客观的：

特定恐惧症是一种常见的焦虑症，但有关相关大脑结构改变的文献存在很大差距。 ENIGMA 焦虑工作组检查了患有特定恐惧症的个体和健康对照受试者之间以及特定恐惧症的动物和血液注射损伤 (BII) 亚型之间的大脑结构差异。此外，作者还研究了大脑结构与症状严重程度和年龄（青少年与成人）的关联。

 方法：

来自 31 项原始研究的数据集被合并起来，创建了一个最终样本，其中包括 1,452 名患有恐惧症的参与者和 2,991 名健康参与者（62.7% 为女性；年龄 5-90 岁）。使用既定的 ENIGMA 协议进行成像处理和质量控制。在预先注册的分析中检查皮质下体积以及皮质表面积和厚度。

 结果：

与健康对照组相比，恐惧症组的皮质下体积大多较小，表面差异混合，并且在相当多的区域中皮质厚度较大。恐惧症亚组也显示出差异，包括如假设的那样，与动物恐惧症 (N=739) 相比，BII 恐惧症 (N=182) 的内侧眶额皮层厚度更大。所有研究结果均由成年参与者推动；在儿童和青少年中没有观察到显着的结果。

 结论：

在可比分析中，与特定恐惧症相关的大脑改变在程度和影响大小方面超过了其他焦虑症，并且不限于大脑结构的减少。此外，恐惧症亚组之间的现象学差异反映在不同的神经基础上，包括与恐惧处理和高级认知过程相关的大脑区域。这些发现暗示了特定恐惧症中大脑结构的改变，尽管皮层下的改变也可能与更广泛的内化精神病理学有关。