AbstractBackgroundFunctional neuroimaging research on anxiety has traditionally focused on brain networks associated with the complex psychological aspects of anxiety. In this study, instead, we target the somatic aspects of anxiety. Motivated by the growing recognition that top-down cortical processing plays crucial roles in perception and action, we investigate effective connectivity among hierarchically organized sensorimotor regions and its association with (trait) anxiety.MethodsWe selected 164 participants from the Human Connectome Project based on psychometric measures. We used their resting-state functional MRI data and Dynamic Causal Modeling (DCM) to assess effective connectivity within and between key regions in the exteroceptive, interoceptive, and motor hierarchy. Using hierarchical modeling of between-subject effects in DCM with Parametric Empirical Bayes we first established the architecture of effective connectivity in sensorimotor networks and investigated its association with fear somatic arousal (FSA) and fear affect (FA) scores. To probe the robustness of our results, we implemented a leave-one-out cross validation analysis.ResultsAt the group level, the top-down connections in exteroceptive cortices were inhibitory in nature whereas in interoceptive and motor cortices they were excitatory. With increasing FSA scores, the pattern of top-down effective connectivity was enhanced in all three networks: an observation that corroborates well with anxiety phenomenology. Anxiety associated changes in effective connectivity were of effect size sufficiently large to predict whether somebody has mild or severe somatic anxiety. Interestingly, the enhancement in top-down processing in sensorimotor cortices were associated with FSA but not FA scores, thus establishing the (relative) dissociation between somatic and cognitive dimensions of anxiety.ConclusionsOverall, enhanced top-down effective connectivity in sensorimotor cortices emerges as a promising and quantifiable candidate marker of trait somatic anxiety. These results pave the way for a novel approach into investigating the neural underpinnings of anxiety based on the recognition of anxiety as an embodied phenomenon and the emerging interest in top-down cortical processing.