J Clin Invest. 2021 Jul 15;131(14). doi: 10.1172/JCI145692.
Anxiety-related disorders can be treated by cognitive therapies and transcranial magnetic stimulation, which involve the medial prefrontal cortex (mPFC). Subregions of the mPFC have been implicated in mediating different and even opposite roles in anxiety-related behaviors. However, precise causal targets of these top-down connections among diverse possibilities have not been established. Here, we show that the lateral septum (LS) and the central nucleus of the amygdala (CeA) represent 2 direct targets of the infralimbic cortex (IL), a subregion of the mPFC that modulates anxiety and fear. Two projections were unexpectedly found to exert opposite effects on the anxious state and learned freezing: the IL-LS projection promoted anxiety-related behaviors and fear-related freezing, whereas the IL-CeA projection exerted anxiolytic and fear-releasing effects for the same features. Furthermore, selective inhibition of corresponding circuit elements showed opposing behavioral effects compared with excitation. Notably, the IL-CeA projection implemented top-down control of the stress-induced high-anxiety state. These results suggest that distinct IL outputs exert opposite effects in modulating anxiety and fear and that modulating the excitability of these projections with distinct strategies may be beneficial for the treatment of anxiety disorders.
焦虑相关障碍可以通过认知疗法和经颅磁刺激来治疗,这些治疗方法都涉及到内侧前额叶皮层(mPFC)。mPFC 的亚区被认为在介导焦虑相关行为的不同甚至相反的作用中发挥作用。然而,这些自上而下的连接的精确因果靶点在各种可能性中尚未确定。在这里,我们表明,外侧隔核(LS)和杏仁核中央核(CeA)是 mPFC 的一个亚区——边缘下皮层(IL)的 2 个直接靶点,它调节焦虑和恐惧。出乎意料的是,我们发现两个投射对焦虑状态和习得性冻结有相反的影响:IL-LS 投射促进与焦虑相关的行为和与恐惧相关的冻结,而 IL-CeA 投射对相同的特征表现出抗焦虑和释放恐惧的作用。此外,与兴奋相比,对应电路元件的选择性抑制表现出相反的行为效应。值得注意的是,IL-CeA 投射对应激诱导的高焦虑状态实施了自上而下的控制。这些结果表明,不同的 IL 输出在调节焦虑和恐惧方面表现出相反的作用,并且用不同的策略调节这些投射的兴奋性可能对治疗焦虑障碍有益。