Ventrolateral Prefrontal Cortex Activation and Attentional Bias in Response to Angry Faces in Adolescents With Generalized Anxiety Disorder

BackgroundGeneralized anxiety disorder (GAD) is under-researched despite its high prevalence and large impact on the healthcare system. There is a paucity of functional magnetic resonance imaging (fMRI) studies that explore the neural correlates of emotional processing in GAD. The present study investigated the blood oxygen level dependent (BOLD) response to processing positive and negative facial emotions in patients with GAD.MethodA total of 15 female GAD patients and 16 female controls undertook an implicit face emotion task during fMRI scanning. They also performed a face emotion recognition task outside the scanner.ResultsThe only behavioural difference observed in GAD patients was less accurate detection of sad facial expressions compared with control participants. However, GAD patients showed an attenuated BOLD signal in the prefrontal cortex to fearful, sad, angry and happy facial expressions and an attenuated signal in the anterior cingulate cortex to happy and fearful facial expressions. No differences were found in amygdala response.ConclusionsIn contrast with previous research, this study found BOLD signal attenuation in the ventrolateral and medial prefrontal cortex and the anterior cingulate cortex during face emotion processing, consistent with a hypothesis of hypo-responsivity to external emotional stimuli in GAD. These decreases were in areas that have been implicated in emotion and cognition and may reflect an altered balance between internally and externally directed attentional processes.

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The relation of worry to prefrontal cortex volume in older adults with and without generalized anxiety disorder

Psychiatry Research Neuroimaging ◽

10.1016/j.pscychresns.2008.09.010 ◽

2009 ◽

Vol 173 (2) ◽

pp. 121-127 ◽

Cited By ~ 39

Author(s):

Jan Mohlman ◽

Rebecca B. Price ◽

Dana A. Eldreth ◽

Daniel Chazin ◽

Dorie M. Glover ◽

...

Keyword(s):

Older Adults ◽

Prefrontal Cortex ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Generalized Anxiety

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P.1.i.055 Generalized anxiety disorder is characterised by a non-discriminative response of the ventromedial prefrontal cortex during fear learning

European Neuropsychopharmacology ◽

10.1016/s0924-977x(15)30411-9 ◽

2015 ◽

Vol 25 ◽

pp. S331-S332

Author(s):

E. Via Virgili ◽

M. Fullana ◽

C. Soriano-Mas ◽

C. López-Solà ◽

X. Goldberg ◽

...

Keyword(s):

Prefrontal Cortex ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Ventromedial Prefrontal Cortex ◽

Fear Learning ◽

Generalized Anxiety ◽

Discriminative Response

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Directed threat imagery in generalized anxiety disorder

Psychological Medicine ◽

10.1017/s0033291717001957 ◽

2017 ◽

Vol 48 (4) ◽

pp. 617-628 ◽

Cited By ~ 8

Author(s):

C. Buff ◽

C. Schmidt ◽

L. Brinkmann ◽

B. Gathmann ◽

S. Tupak ◽

...

Keyword(s):

Prefrontal Cortex ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Emotional Reactivity ◽

Behavioral Therapy ◽

Brain Activity ◽

Neural Correlates ◽

Anterior Cingulate ◽

Generalized Anxiety ◽

Initial Exposure

BackgroundWorrying has been suggested to prevent emotional and elaborative processing of fears. In cognitive-behavioral therapy (CBT), generalized anxiety disorder (GAD) patients are exposed to their fears during the method of directed threat imagery by inducing emotional reactivity. However, studies investigating neural correlates of directed threat imagery and emotional reactivity in GAD patients are lacking. The present functional magnetic resonance imaging (fMRI) study aimed at delineating neural correlates of directed threat imagery in GAD patients.MethodNineteen GAD patients and 19 healthy controls (HC) were exposed to narrative scripts of either disorder-related or neutral content and were encouraged to imagine it as vividly as possible.ResultsRating results showed that GAD patients experienced disorder-related scripts as more anxiety inducing and arousing than HC. These results were also reflected in fMRI data: Disorder-related v. neutral scripts elicited elevated activity in the amygdala, dorsomedial prefrontal cortex, ventrolateral prefrontal cortex and the thalamus as well as reduced activity in the ventromedial prefrontal cortex/subgenual anterior cingulate cortex in GAD patients relative to HC.ConclusionThe present study presents the first behavioral and neural evidence for emotional reactivity during directed threat imagery in GAD. The brain activity pattern suggests an involvement of a fear processing network as a neural correlate of initial exposure during directed imagery in CBT in GAD.

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Intrinsic connectivity of the prefrontal cortex and striato-limbic system respectively differentiate Major Depressive from Generalized Anxiety Disorder

10.1101/2020.05.19.105148 ◽

2020 ◽

Author(s):

Xiaolei Xu ◽

Jing Dai ◽

Yuanshu Chen ◽

Congcong Liu ◽

Fei Xin ◽

...

Keyword(s):

Prefrontal Cortex ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Brain Connectivity ◽

Data Driven ◽

Generalized Anxiety ◽

Major Depressive ◽

Whole Brain ◽

Treatment Targets ◽

Intrinsic Connectivity

AbstractMajor Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD) are highly prevalent and debilitating disorders. The high overlap on the symptomatic and neurobiological level led to ongoing debates about their diagnostic and neurobiological uniqueness. The present study aims to identify common and disorder-specific neuropathological mechanisms and treatment targets in MDD and GAD. The present study combined categorial and dimensional disorder models with a fully data-driven intrinsic network level analysis (Intrinsic Connectivity Contrast, ICC) to resting state fMRI data acquired in 108 partn = 35 and n = 38 unmedicated patients with first-episode GAD, MDD respectively and n=35 healthy controls). Convergent evidence from categorical and dimensional analyses revealed MDD-specific decreased whole-brain connectivity profiles of the medial prefrontal and dorsolateral prefrontal cortex while GAD was specifically characterized by decreased whole-brain connectivity profiles of the putamen and decreased communication of this region with the amygdala. Together, findings from the present data-driven analysis suggest that intrinsic communication of frontal regions engaged in executive functions and emotion regulation represent depression-specific neurofunctional markers and treatment targets whereas dysregulated intrinsic communication of the striato-amygdala system engaged in reinforcement-based and emotional learning processes represent GAD-specific markers and a promising treatment target.

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The Association Between Generalized Anxiety Disorder and Resting-State Prefrontal Cortex Oxygenation Is Modified by Self-Reported Physical Activity: Results From The Irish Longitudinal Study on Ageing

The Journals of Gerontology Series A ◽

10.1093/gerona/glab090 ◽

2021 ◽

Author(s):

Cillian P McDowell ◽

Louise Newman ◽

Derek C Monroe ◽

John D O’Connor ◽

Silvin P Knight ◽

...

Keyword(s):

Physical Activity ◽

Prefrontal Cortex ◽

Longitudinal Study ◽

Anxiety Disorder ◽

Generalized Anxiety Disorder ◽

Resting State ◽

Short Form ◽

Saturation Index ◽

World Health ◽

Generalized Anxiety

Abstract Individuals with anxiety disorders exhibit lower intrinsic functional connectivity between prefrontal cortical areas and subcortical regions. The prefrontal cortex (PFC) is sensitive to the acute and chronic effects of physical activity (PA), while the anxiolytic effects of PA are well known. The current study examined the association of generalized anxiety disorder (GAD) and its interaction with PA, with resting-state, left PFC oxygenation. This cross-sectional study used data from participants (N = 2444) from The Irish Longitudinal Study on Ageing, a nationally representative prospective study of community-living adults aged 50 and older in Ireland. The Composite International Diagnostic Interview Short-Form determined fulfillment of criteria for GAD. The short-form International Physical Activity Questionnaire determined adherence to the World Health Organization PA guidelines. Resting-state, left PFC oxygenation was continuously measured via a Portalite. Tissue saturation index (TSI) was calculated as the ratio of oxygenated hemoglobin to total tissue hemoglobin (expressed as a percentage) for the final minute of a 5-minute supine-rest period. Multivariable linear regression quantified associations of GAD with TSI in the total population and population stratified by PA status. Participants with GAD had lower TSI (b = −1.416, p = .008) compared to those without GAD. However, this association was modified by PA. Among participants who met the PA guidelines, TSI did not differ according to GAD status (b = −0.800, p = .398). For participants who did not meet the guidelines, TSI was significantly lower among those with GAD (b = −1.758, p = .004). These findings suggest that PA may help to protect brain health among older adults with GAD.

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