Neurocognitive mechanisms of anxiety: an integrative account

Threat Anticipation in Pulvinar and in Superficial Layers of Primary Visual Cortex (V1). Evidence from Layer-Specific Ultra-High Field 7T fMRI

The perceptual system gives priority to threat-relevant signals with survival value. In addition to the processing initiated by sensory inputs of threat signals, prioritization of threat signals may also include processes related to threat anticipation. These neural mechanisms remain largely unknown. Using ultra-high-field 7 tesla (7T) fMRI, we show that anticipatory processing takes place in the early stages of visual processing, specifically in the pulvinar and V1.

The perceptual system gives priority to threat-relevant signals with survival value. In addition to the processing initiated by sensory inputs of threat signals, prioritization of threat signals may also include processes related to threat anticipation. These neural mechanisms remain largely unknown. Using ultra-high-field 7 tesla (7T) fMRI, we show that anticipatory processing takes place in the early stages of visual processing, specifically in the pulvinar and V1. When anticipation of a threat-relevant fearful face target triggered false perception of not-presented target, there was enhanced activity in the pulvinar as well as in the V1 superficial-cortical-depth (layers 1–3). The anticipatory activity was absent in the LGN or higher visual cortical areas (V2–V4). The effect in V1 was specific to the perception of fearful face targets and did not generalize to happy face targets. A preliminary analysis showed that the connectivity between the pulvinar and V1 superficial-cortical-depth was enhanced during false perception of threat, indicating that the pulvinar and V1 may interact in preparation of anticipated threat. The anticipatory processing supported by the pulvinar and V1 may play an important role in non-sensory-input-driven anxiety states.

Reduced Glutamate in the Medial Prefrontal Cortex Is Associated With Emotional and Cognitive Dysregulation in People With Chronic Pain

A decrease in glutamate in the medial prefrontal cortex (mPFC) has been extensively found in animal models of chronic pain. Given that the mPFC is implicated in emotional appraisal, cognition and extinction of fear, could a potential decrease in glutamate be associated with increased pessimistic thinking, fear and worry symptoms commonly found in people with chronic pain? To clarify this question, 19 chronic pain subjects and 19 age- and gender-matched control subjects without pain underwent magnetic resonance spectroscopy. Both groups also completed the Temperament and Character, the Beck Depression and the State Anxiety Inventories to measure levels of harm avoidance, depression, and anxiety, respectively. People with chronic pain had significantly higher scores in harm avoidance, depression and anxiety compared to control subjects without pain. High levels of harm avoidance are characterized by excessive worry, pessimism, fear, doubt and fatigue. Individuals with chronic pain showed a significant decrease in mPFC glutamate levels compared to control subjects without pain. In people with chronic pain mPFC glutamate levels were significantly negatively correlated with harm avoidance scores. This means that the lower the concentration of glutamate in the mPFC, the greater the total scores of harm avoidance. High scores are associated with fearfulness, pessimism, and fatigue-proneness. We suggest that chronic pain, particularly the stress-induced release of glucocorticoids, induces changes in glutamate transmission in the mPFC, thereby influencing cognitive, and emotional processing. Thus, in people with chronic pain, regulation of fear, worry, negative thinking and fatigue is impaired.

Alterations in heart-brain interactions under mild stress during a cognitive task are reflected in entropy of heart rate dynamics

Many people experience mild stress in modern society which raises the need for an improved understanding of psychophysiological responses to stressors. Heart rate variability (HRV) may be associated with a flexible network of intricate neural structures which are dynamically organized to cope with diverse challenges. HRV was obtained in thirty-three healthy participants performing a cognitive task both with and without added stressors. Markers of neural autonomic control and neurovisceral complexity (entropy) were computed from HRV time series. Based on individual anxiety responses to the experimental stressors, two subgroups were identified: anxiety responders and non-responders. While both vagal and entropy markers rose during the cognitive task alone in both subgroups, only entropy decreased when stressors were added and exclusively in anxiety responders. We conclude that entropy may be a promising marker of cognitive tasks and acute mild stress. It brings out a new central question: why is entropy the only marker affected by mild stress? Based on the neurovisceral integration model, we hypothesized that neurophysiological complexity may be altered by mild stress, which is reflected in entropy of the cardiac output signal. The putative role of the amygdala during mild stress, in modulating the complexity of a coordinated neural network linking brain to heart, is discussed.

Cognitive conflict could facilitate negative stimulus processing: evidence from trait anxiety in the flanker paradigm

The present study used event-related potentials to investigate the affective priming effect of cognitive conflict and the influence of trait anxiety during the early stage of conflict processing. Participants with relatively high-trait or low-trait anxiety were tested using a combination of flanker task (congruent or incongruent arrows) as primes presented 200 ms before positive or negative words as targets. Behavioral results showed that response times were shorter for negative targets following incongruent primes relative to congruent primes, and vice versa, suggesting that conflicts facilitated the processing of negative targets. Event-related potential results revealed that the N2 amplitudes (280-320 ms) for incongruent stimuli were significantly more negative than those for congruent stimuli, indicating a significant conflict effect. Moreover, the N400 amplitudes (580-680 ms) for positive targets after congruent primes were significantly more negative than those after incongruent primes, but no significant difference was found in the N400 amplitudes after congruent primes and incongruent primes for negative targets, indicating that conflicts had a negative effect on the subsequent processing. In addition, in the high-trait anxiety, the N400 amplitudes for negative targets after incongruent primes were significantly more negative than those after incongruent primes, and vice versa, indicating that conflicts facilitated the processing of negative targets. These findings showed that conflicts could facilitate the processing of negative targets and be viewed as aversive signals during the early stage of conflict processing and that high-trait anxiety promoted the negative effect induced by conflicts.

Regional cerebral perfusion correlates with anxiety in neuropsychiatric SLE: evidence for a mechanism distinct from depression

The study examined the hypothesis that hypoperfusion in brain areas known to be involved in emotional disturbances in primary psychiatric disorders is also linked to emotional difficulties in systemic lupus erythematosus (SLE) and that these are not secondary to the physical and social burden incurred by the disease. Nineteen SLE patients without overt neuropsychiatric manifestations (non-NPSLE), 31 NPSLE patients, and 23 healthy controls were examined. Dynamic susceptibility contrast MRI was used and cerebral blood flow and cerebral blood volume values were estimated in six manually selected regions of interest of brain regions suspected to play a role in anxiety and depression (dorsolateral prefrontal cortex, ventromedial prefrontal cortex, anterior cingulate cortex, hippocampi, caudate nuclei and putamen). NPSLE patients reported high rates of anxiety and depression symptomatology. Significantly reduced cerebral blood flow and cerebral blood volume values were detected in the NPSLE group compared to healthy controls in the dorsolateral prefrontal cortex and ventromedial prefrontal cortex, bilaterally. Within the NPSLE group, anxiety symptomatology was significantly associated with lower perfusion in frontostriatal regions and in the right anterior cingulate gyrus. Importantly, the latter associations appeared to be specific to anxiety symptoms, as they persisted after controlling for depression symptomatology and independent of the presence of visible lesions on conventional MRI. In conclusion, hypoperfusion in specific limbic and frontostriatal regions is associated with more severe anxiety symptoms in the context of widespread haemodynamic disturbances in NPSLE.

Overanxious and underslept

Are you feeling anxious? Did you sleep poorly last night? Sleep disruption is a recognized feature of all anxiety disorders. Here, we investigate the basic brain mechanisms underlying the anxiogenic impact of sleep loss. Additionally, we explore whether subtle, societally common reductions in sleep trigger elevated next-day anxiety. Finally, we examine what it is about sleep, physiologically, that provides such an overnight anxiety-reduction benefit. We demonstrate that the anxiogenic impact of sleep loss is linked to impaired medial prefrontal cortex activity and associated connectivity with extended limbic regions. In contrast, non-rapid eye movement (NREM) slow-wave oscillations offer an ameliorating, anxiolytic benefit on these brain networks following sleep. Of societal relevance, we establish that even modest night-to-night reductions in sleep across the population predict consequential day-to-day increases in anxiety. These findings help contribute to an emerging framework explaining the intimate link between sleep and anxiety and further highlight the prospect of non-rapid eye movement sleep as a therapeutic target for meaningfully reducing anxiety.

Nature and specificity of altered cognitive functioning in IBS

BACKGROUND

It is unknown whether cognitive dysfunction found in patients with irritable bowel syndrome (IBS) was attributable to the different subtypes, ongoing pathophysiological processes, trait characteristics, or psychiatric comorbidity.

METHODS

Forty Rome-III patients with IBS (20 diarrhea-predominant [IBS-D] and 20 constipation-predominant [IBS-C]) and 40 age-, sex-, education-matched healthy controls were systematically recruited and compared on their cognitive function with continuous performance test (CPT), Wisconsin Card Sorting Test (WCST) and emotional Stroop test. Beck Anxiety Inventory (BAI), Beck Depression Inventory-II (BDI-II), Patient Health Questionnaire-15 (PHQ-15) and a structured bowel symptom questionnaire were performed to measure anxiety, depressive, somatization, and bowel symptoms, respectively. Psychiatric diagnoses were ascertained with SCID-I (Structured Clinical Interview for DSM-IV Axis I Disorders).

KEY RESULTS

Patients with IBS showed significantly increased standard deviation of reaction time (SDRT) (P = .003) on CPT, increased failure to maintain set (FMS) (P=.002), and percentage of perseverative errors (P = .003) on WCST. SDRT did not correlate with illness chronicity or bowel symptoms. FMS correlated with bowel symptom severity. In logistic regression models controlled for BAI, BDI-II, and PHQ-15, SDRT (AOR = 1.08, P = .025), but not FMS (P = .25) or percentage of perseverative errors (P = .24), significantly differentiated IBS from controls. Cognitive function was not significantly different between IBS-C and IBS-D (P > .05), or between pure IBS (n = 22) and IBS with generalized anxiety disorder (GAD) (n = 17) (P > .05).

CONCLUSIONS & INFERENCES

Patients with IBS showed attentional and executive function impairment irrespective of subtypes but otherwise heterogeneous in terms of its state-trait correlations and overlap with anxiety comorbidity.

The neural substrates responsible for how trait anxiety affects delay discounting: Right hippocampal and cerebellar connectivity with bistable right inferior parietal lobule

Delay discounting, an indicator of impulsivity, refers to the extent of devaluing future rewards. Studies have found that individuals with trait anxiety generally depreciate the later larger rewards, showing steeper delay discounting rates. However, little is known about the neural substrates responsible for how trait anxiety affects individuals' delay discounting. To address this question, we employed the voxel-based morphometry (VBM) and resting-state functional connectivity (RSFC) methods to explore the neural substrates of trait anxiety responsible for delay discounting. Behavioral results showed that trait anxiety was significantly positively correlated with delay discounting rates. The VBM analysis revealed that gray matter volumes of the right hippocampus (RHPC) and right cerebellum (RCere) were significantly positively correlated with trait anxiety. Moreover, the RSFC results showed that bistable right inferior parietal lobule (RIPL) connectivity with the RHPC and RCere were all inversely associated with trait anxiety. More importantly, mediation analysis indicated that trait anxiety played a completely mediating role in the relation between functional connectivity of RHPC-RIPL and RCere-RIPL and delay discounting. These results suggested that bistable RIPL connectivity with RHPC and RCere could be neural substrates underlying the effect of trait anxiety on delay discounting. On the whole, the current study yields insights into how trait anxiety affects delay discounting and provides a novel account from a neural basis perspective.

Corticolimbic circuit structure moderates an association between early life stress and later trait anxiety

Childhood adversity is associated with a wide range of negative behavioral and neurodevelopmental consequences. However, individuals vary substantially in their sensitivity to such adversity. Here, we examined how individual variability in structural features of the corticolimbic circuit, which plays a key role in emotional reactivity, moderates the association between childhood adversity and later trait anxiety in 798 young adult university students. Consistent with prior research, higher self-reported childhood adversity was significantly associated with higher self-reported trait anxiety. However, this association was attenuated in participants with higher microstructural integrity of the uncinate fasciculus and greater thickness of the orbitofrontal cortex. These structural properties of the corticolimbic circuit may capture a neural profile of relative resiliency to early life stress, especially against the negative effects of childhood adversity on later trait anxiety.

Reward-related distracters and working memory filtering

Reward-related stimuli capture attention, even when they are task irrelevant. A consequence of attentional prioritization of reward-related stimuli is that they may also have preferential access to working memory like other forms of emotional information. However, whether reward-related distracters leak into working memory remains unknown. Here, using a well-validated change detection task of visual working memory capacity and filtering, we conducted two studies to directly assess the impact of reward-related distracters on working memory. In both studies, the distracters consisted of colored bars or circles that were previously associated with monetary reward. In Experiment 1, results indicated that previously rewarded distracters did not impact behavioral measures of working memory filtering efficiency compared to neutral distracters. In Experiment 2, using ERPs, we measured the contralateral delay activity (CDA), a psychophysiological index of the number of items retained in working memory, to further assess filtering efficiency. We observed that the CDA for high reward distracters was similar to low reward and neutral distracters. However, in early trials, behavioral measures revealed that previously rewarded stimuli negatively impacted working memory capacity, an effect not observed with neutral distracters. This effect, though, was not found for the CDA in early trials. In summary, our findings across two studies suggest that attentional capture by task-irrelevant reward may have minimal impact on visual working memory-findings that have important implications for delineating the boundaries of reward-cognition interactions.

Effects of Ego-Depletion and State Anxiety on Performance Changes in Dart-Throwing Tasks: A Latent Curve Model Approach Reporting Trial Data for Human Participants

This study examined the effects ego depletion (ED) and state anxiety (SA)have on performance changes in dart-throwing, a perceptual-motor task, using a Latent Curve Model (LCM). Twenty-two men, who had never played darts before, were recruited and randomly assigned to two counterbalanced groups: Group A was exposed first to ED and then to non-ED (NED), and Group B was exposed first to NED and then to ED. We found that the number of trials had a non-linear effect on darts performance, which improved as the number of trials increased before declining again; that is, mean radial error decreased first and then increased. Therefore, motor performance was sustained in the form of a quadratic curve as the number of task executions increased. In general, the higher the degree of ED and SA, the greater the negative effect on performance. However, this phenomenon was observed only in the early-phase trials, and the interacting influence of ED and SA appeared in the late-phase trials. Thus, this study demonstrated that ED and SA have direct effects on performance curves in early-phase trials only, and that their interacting influence appears in late-phase trials.

Effects of MDMA on attention to positive social cues and pleasantness of affective touch

The psychostimulant drug ±3,4-methylenedioxymethamphetamine (MDMA) reportedly produces distinctive feelings of empathy and closeness with others. MDMA increases social behavior in animal models and has shown promise in psychiatric disorders, such as autism spectrum disorder (ASD) and post-traumatic stress disorder (PTSD). How it produces these prosocial effects is not known. This behavioral and psychophysiological study examined the effects of MDMA, compared with the prototypical stimulant methamphetamine (MA), on two measures of social behavior in healthy young adults: (i) responses to socially relevant, "affective" touch, and (ii) visual attention to emotional faces. Men and women (N = 36) attended four sessions in which they received MDMA (0.75 or 1.5 mg/kg), MA (20 mg), or a placebo in randomized order under double-blind conditions. Responses to experienced and observed affective touch (i.e., being touched or watching others being touched) were assessed using facial electromyography (EMG), a proxy of affective state. Responses to emotional faces were assessed using electrooculography (EOG) in a measure of attentional bias. Subjective ratings were also included. We hypothesized that MDMA, but not MA, would enhance the ratings of pleasantness and psychophysiological responses to affective touch and increase attentional bias toward positive facial expressions. Consistent with this, we found that MDMA, but not MA, selectively enhanced ratings of pleasantness of experienced affective touch. Neither drug altered the ratings of pleasantness of observed touch. On the EOG measure of attentional bias, MDMA, but not MA, increased attention toward happy faces. These results provide new evidence that MDMA can enhance the experience of positive social interactions; in this case, pleasantness of physical touch and attentional bias toward positive facial expressions. The findings are consistent with evidence that the prosocial effects are unique to MDMA relative to another stimulant. Understanding the behavioral and neurobiological processes underlying the distinctive social effects of MDMA is a key step to developing the drug for psychiatric disorders.

Nicotine prevents anxiety-like behavioral responses in zebrafish

Anxiety-related disorders are severe psychiatric conditions that involve complex physiological and behavioral maladaptive responses. The use of conspecific alarm substance (CAS) for inducing anxiety-like behaviors in fish species provides important translational insights of how aversive conditions modulate neurobehavioral functions. Because nicotine may elicit anxiolytic-like responses, here we investigated whether acute nicotine exposure prevents CAS-induced anxiogenic-like behaviors in zebrafish. We used both novel tank and light-dark tests as two well-established paradigms for measuring anxiety-like phenotypes. Fish were individually exposed to 1 mg/L nicotine or non-chlorinated water for 3 min and then transferred to other tanks in the absence or presence of 3.5 mL/L CAS for 5 min. Later, the behavior of fish was tested in the novel tank test or in the light-dark preference test. As expected, CAS triggered aversive behaviors by increasing bottom-dwelling, freezing, erratic movements, scototaxis, and risk assessment episodes. Nicotine alone elicited anxiolytic-like behaviors since it increased the time spent in the top, as well as the average duration of entry in the lit compartment. Moreover, nicotine pretreatment prevented CAS-induced aversive responses without changing locomotion, suggesting that anxiolysis could play a role, at least in part, to the behavioral effects of nicotine observed here. Overall, these novel findings show the beneficial effects of nicotine on anxiogenic responses in zebrafish. We also reinforce the practical advantages of this aquatic species to explore the relieving properties of nicotine, as well as to understand the neurobiological bases involved in anxiety-related disorders and associated therapeutic targets.

Brain structural abnormalities in emotional regulation and sensory processing regions associated with anxious depression

BACKGROUND

Considerable patients with major depressive disorder (MDD) comorbid with anxious symptoms, referred as anxious depression. The neural structural basis of this MDD specifier remains largely unknown.

METHODS

104 patients with anxious depression, 57 MDD patients without significant anxious symptoms, and 160 healthy controls from single research center participated in the study with age and sex well-matched. We investigated gray matter alterations in anxious and non-anxious depression, explored different brain alterations between these two patient groups, and possible relationships between brain structural parameter and clinical information in patients.

RESULTS

Gray matter volumes differed in the right inferior frontal gyrus, right orbital frontal gyrus, left postcentral gyrus, bilateral culmen and left cuneus among the three groups. Anxious depression had smaller gray matter volumes in the right inferior frontal gyrus and orbital frontal gyrus relative to both non-anxious depression and healthy controls. Patients with anxious depression presented larger gray matter volumes in the left postcentral gyrus than non-anxious depression, and larger gray matter volumes in the left cuneus than healthy controls. In addition, both patient groups showed larger gray matter volumes in bilateral culmen relative to healthy controls. Gray matter volumes in the left postcentral gyrus were positively associated with overall depression severity and anxiety factor scores in anxious depression.

CONCLUSION

Our study revealed brain structural abnormalities in emotional regulation and sensory processing regions of anxious depression, which may suggested distinct neurobiological mechanisms of this MDD specifier and could help explain different clinical manifestations in anxious depression from pure depression.

[Anxiety in the elderly]

Anxiety occurs in about one third of people over 65 years of age. However, its identification in this age has significant difficulties. The clinical manifestations, pathogenetic mechanisms, approaches to the diagnosis and treatment of various types of anxiety are described in the article. Particular attention is paid to the comorbidity of anxiety disorders in elderly patients. A comprehensive approach to the treatment of elderly patients with anxiety includes psychotherapeutic and pharmacotherapeutic approaches. Special attention should be paid to the efficacy and safety of the drugs, which is especially important in this category of patients.

Structural Brain Alterations Before and After Total Knee Arthroplasty: A Longitudinal Assessment

Objective

Many studies have provided evidence of altered brain structure in chronic pain conditions, as well as further adaptations following treatment that are coincident with changes in pain. Less is known regarding how these structural brain adaptations relate to assessments of nociceptive processing. The current study aimed to investigate brain structure in people with knee osteoarthritis (OA) before and after total knee arthroplasty (TKA) and to investigate the relationships between these findings and quantitative sensory testing (QST) of the nociceptive system.

Methods

Twenty-nine people with knee OA underwent magnetic resonance imaging (MRI) scans and QST before and six months after TKA and were compared with a pain-free control group (N = 18). MRI analyses involved voxel-based morphometry and fractional anisotropy.

Results

Before TKA, there was reduced gray matter volume and impaired fractional anisotropy in areas associated with nociceptive processing, with further gray matter adaptations and improvements in fractional anisotropy evident after TKA. QST revealed increased nociceptive facilitation and impaired inhibition in knee OA that was reversed after TKA. There were minimal relationships found between MRI data and QST assessments or pain report.

Conclusions

In people with end-stage knee OA, region-specific gray matter atrophy was detected, with further changes in gray matter volume and improvements in white matter integrity observed after joint replacement. Despite coincident alterations in nociceptive inhibition and facilitation processes, there did not appear to be any association between these functional assessments of the nociceptive system and changes in brain structure.

Transcranial Direct Current Stimulation Modulates the Effect of Unreasonable Request in the Context of Peer Punishment

Making a request is a common occurrence during social interactions. In most social contexts, requesters may impose punishments and many behavioral studies have focused on the differential effects of reasonable and unreasonable requests during such interactions. However, few studies have explored whether reasonable or unreasonable requests involve differential neurocognitive mechanisms. In this study, we used transcranial direct current stimulation (tDCS) to investigate the mechanistic effects of request within the context of peer punishment. We used a modified ultimatum game (UG) task as well as a modified dictator game (DG) task. Both unreasonable and reasonable requests induced the proposer to increase their monetary offer for both tasks. Moreover, in the modified UG task, cathodal tDCS over the right dorsolateral prefrontal cortex (rDLPFC) significantly decreased the effect of an unreasonable request when compared to sham stimulation. Cathodal stimulation did not impact the effect of a reasonable request on the modified UG task. For the modified DG task, no tDCS effect for either an unreasonable or reasonable request was observed. These findings suggest that rDLPFC was only involved in decision-making processes during unreasonable requests when there was an opportunity for peer punishment. Moreover, our results indicate that reasonable and unreasonable requests involve differential neurocognitive mechanisms in the context of possible peer punishment.

Pre-specified Anxiety Predicts Future Decision-Making Performances Under Different Temporally Constrained Conditions

In real-life circumstances, people occasionally require making forced decisions when encountering unpredictable events and situations that yield socially and privately unfavorable consequences. In order to prevent future negative consequences, it is beneficial to successfully predict future decision-making behaviors based on various types of information, including behavioral traits and/or psychological states. For this prospective purpose, the present study used the Iowa Gambling Task, which simulates multiple aspects of real-life decision-making processes, such as choice preference, selection and evaluation of output feedback, and investigated how anxiety profiles predict decision-making performances under conditions with different temporal pressures on task execution. To conduct a temporally causal analysis, we assessed the trait and state anxiety profiles of 33 young participants prior to the task and analyzed their subsequent decision-making performances. We separated two disadvantageous card decks with high rewards and losses into high- and middle-risk decks, and calculated local performance indexes for decision-making immediately after salient penalty events for the high-risk deck in addition to traditional global performance indexes concerning overall trial outcomes such as final winnings and net scores. For global decision-making, higher trait anxiety predicted more risky choices solely in the self-paced condition without temporal pressure. For local decision-making, state anxiety predicted risk-taking performances differently in the self- and forced-paced conditions. In the self-paced condition, higher state anxiety predicted higher risk-avoidance. In the forced-paced condition, higher state anxiety predicted more frequent choices of the middle-risk deck. These findings suggest not only that pre-specified anxiety profiles can effectively predict future decision-making behaviors under different temporal pressures, but also newly indicate that behavioral mechanisms for moderate risk-taking under an emergent condition should be focused on to effectively prevent future unfavorable consequences when actually encountering negative events.

Sex-Dependent Associations among Maternal Depressive Symptoms, Child Reward Network, and Behaviors in Early Childhood

Maternal depression is associated with disrupted neurodevelopment in offspring. This study examined relationships among postnatal maternal depressive symptoms, the functional reward network and behavioral problems in 4.5-year-old boys (57) and girls (65). We employed canonical correlation analysis to evaluate whether the resting-state functional connectivity within a reward network, identified through an activation likelihood estimation (ALE) meta-analysis of fMRI studies, was associated with postnatal maternal depressive symptoms and child behaviors. The functional reward network consisted of three subnetworks, that is, the mesolimbic, mesocortical, and amygdala–hippocampus reward subnetworks. Postnatal maternal depressive symptoms were associated with the functional connectivity of the mesocortical subnetwork with the mesolimbic and amygdala–hippocampus complex subnetworks in girls and with the functional connectivity within the mesocortical subnetwork in boys. The functional connectivity of the amygdala–hippocampus subnetwork with the mesocortical and mesolimbic subnetworks was associated with both internalizing and externalizing problems in girls, while in boys, the functional connectivity of the mesocortical subnetwork with the amygdala–hippocampus complex and the mesolimbic subnetworks was associated with the internalizing and externalizing problems, respectively. Our findings suggest that the functional reward network might be a promising neural phenotype for effects of maternal depression and potential intervention to nurture child behavioral development.

microRNA and mRNA profiles in the amygdala are associated with stress-induced depression and resilience in juvenile mice

OBJECTIVES

Major depressive disorder characterized as recurrent negative mood is one of the prevalent psychiatric diseases. Chronic stress plus lack of reward may induce long-term imbalance between reward and penalty circuits in the brain, leading to persistent negative mood. Numerous individuals demonstrate resilience to chronic mild stress. Molecular mechanisms for major depression and resilience in the brain remain unclear.

METHODS

After juvenile mice were treated by the chronic unpredictable mild stress (CUMS) for 4 weeks, they were screened by sucrose preference, Y-maze and forced swimming tests to examine whether their behaviors were depression-like or not. mRNA and miRNA profiles were quantified by high-throughput sequencing in amygdala tissues harvested from control, CUMS-susceptible, and CUMS-resilience mice.

RESULTS

1.5-fold ratio in reads per kilo-base per million reads was set to be the threshold to judge the involvement of mRNAs and miRNAs in the CUMS, major depression, or resilience. In the amygdala from CUMS-susceptible mice, the expression of genes relevant to GABAergic, cholinergic, glutamatergic, dopaminergic, and serotonergic synapses was changed, as well as the expression of genes that encoded signal pathways of PI3K-Akt, calcium, cAMP, MAPK, and drug addiction was imbalanced. The expression of these genes in the amygdala form CUMS-resilience mice was less changed.

CONCLUSIONS

The downregulation of genes relevant to synaptic functions and the imbalance of intra-signaling pathway in the amygdala are associated with major depression. Consistent results through sequencing mRNA and miRNA and using different methods validate our finding and conclusion.

Effects of State Anxiety and Ego Depletion on Performance Change in Golf Putting: A Hierarchical Linear Model Application

This study employed a hierarchical linear model analysis to examine the effects of ego depletion and state anxiety on performance changes in golf putting. We randomly assigned 51 female college students with no previous golf putting experience to either an ego-depletion (experimental) group ( n = 26) or a non-ego-depletion (control) group ( n = 25). Putting performance changes over repeated trials displayed a quadratic curve, and both ego depletion and state anxiety exerted negative effects on early, but not late, putting performance. Contrary to previous findings, the interaction effect between ego depletion and state anxiety on performance was nonsignificant.

Anxiety and Brain Networks of Attentional Control

Advances in the study of brain networks can be applied to our understanding of anxiety disorders (eg, generalized anxiety, obsessive-compulsive, and posttraumatic stress disorders) to enable us to create targeted treatments. These disorders have in common an inability to control thoughts, emotions, and behaviors related to a perceived threat. Here we review animal and human imaging studies that have revealed separate brain networks related to various negative emotions. Research has supported the idea that brain networks of attention serve to control emotion networks as well as the thoughts and behaviors related to them. We discuss how attention networks can modulate both positive and negative affect. Disorders arise from both abnormal activation of negative affect and a lack of attentional control. Training attention has been one way to foster improved attentional control. We review attention training studies as well as efforts to generally improve attention networks through stimulation in self-regulation.

Enhanced cognitive control over task-irrelevant emotional distractors in generalized anxiety disorder versus obsessive-compulsive disorder

Generalized anxiety disorder (GAD) is defined in part by excessive and uncontrollable worry. However, little is known about cognitive control abilities in adults with GAD. The present study examined cognitive control over negative and neutral material in a mixed clinical sample of adults with GAD and/or obsessive-compulsive disorder and a comparison healthy control sample. Participants completed a novel emotional variant of the AX-CPT (eAX-CPT) to index proactive and reactive cognitive control in the presence of negative and neutral distractor stimuli. Participants with GAD demonstrated enhanced cognitive control specifically over negative emotional distractors, relative to neutral distractors (within-subjects) and relative to OCD and controls (between-subjects). Findings were specific to GAD versus trait worry; however, higher trait worry predicted better cognitive control in GAD only. These findings are inconsistent with deficit-based cognitive models of GAD and may be better accounted for by models that conceptualize worry as an intentional (albeit maladaptive) cognitive control or emotion regulation strategy that is actively maintained by individuals with GAD in order to avoid engaging with more distressing emotional information.

A pilot randomized trial of a dual n-back emotional working memory training program for veterans with elevated PTSD symptoms

Anxiety is characterized by excessive attention to threatening information, leading to impaired working memory (WM) performance and elevated anxious thoughts. Preliminary research indicates that individuals with PTSD show particular difficulty with WM in emotional contexts (Schweizer et al., 2011). Although several studies show that computerized training can improve WM capacity for anxious individuals (Owens et al., 2013; Schweizer et al., 2011; 2013), there has been very little research on WM training for PTSD or with Veterans (Saunders et al., 2015). In a pilot randomized trial, we assigned Veterans with elevated PTSD symptoms to an online emotional WM training, either adaptive (n-back; n = 11) or a less potent training (1-back; n = 10). Overall, both groups showed significant decreases in PTSD symptoms. The n-back group showed a trend of outperforming the 1-back group in improving reexperiencing symptoms (which are likely to be associated with impaired WM functioning). This population anecdotally found the intervention quite challenging, which may be why even the less potent 1-back was still helpful. These preliminary findings justify the effort for developing new WM-focused PTSD intervention for complex, vulnerable populations, particularly as online training can improve accessibility.

Clinical correlates of noise sensitivity in patients with acute TBI

Primary objective: The impact of noise sensitivity (NS) on the daily functioning of people who have experienced a traumatic brain injury (mTBI) is an understudied area, particularly following mTBI. The primary objective of this cross-sectional study was to investigate clinical markers of NS in a sample of New Zealand adults following mTBI. Research design: Cross-sectional study. Methods and procedures: A community-based sample of 151 adults who had experienced a brain injury in the last two weeks completed assessments estimating cognitive functioning, postconcussion symptoms (including NS), and affective state. Results: Over half the sample (59%) reported some degree of NS. Exploratory statistical analyses indicated that NS was associated with being female, living in a rural area, number of previous brain injuries, cognitive flexibility scores, reaction time, perceptions of recovery, anxiety, and depression. Regression analyses revealed that anxiety was the dominant correlate of NS (B = .120, p < .001, 95% CI [0.069, 1.71]). Conclusions: As the first study to explore the correlates of NS following mild TBI, the findings have important clinical and research implications. The present findings suggest that treatment approaches targeting anxiety may be effective in reducing NS in people who have experienced a brain injury. Moreover, evidence is presented suggesting that NS is unlikely to reflect malingering, and should be treated as a genuine somatic symptom of brain injury.

Uncertainty Modulates the Effect of Transcranial Stimulation Over the Right Dorsolateral Prefrontal Cortex on Decision-Making Under Threat

Threat is a strategy that can be used to impact decision-making processes in bargaining. Abundant evidence suggests that credible threat and incredible threat both influence the obeisance of others. However, it is not clear whether the decision-making processes under credible threat and incredible threat during bargaining involve differential neurocognitive mechanisms. Here, we employed cathodal transcranial direct current stimulation (tDCS) to deactivate the right dorsolateral prefrontal cortex (rDLPFC) to address this question while subjects allocated and reported the subjective probability of future rejection under incredible threat and credible threat. We found that application of cathodal tDCS over the rDLPFC decreased the proposer's subjective inference of probability of rejection and the offer to the responder under incredible threat. Conversely, the same stimulation did not lead to a significant difference compared to the sham group in subjective probability and offer under credible threat. These results suggested that decision-making processes under the two types of threat during bargaining were associated with different neurocognitive substrates, because the punishment for non-compliance was uncertain under incredible threat, whereas it was certain under credible threat. We decreased activity in the rDLPFC, which is involved in decision-making processes related to bargaining under incredible threats, and observed significantly impacted behavior. The differential neurocognitive bases of subjective probability of rejection under incredible threat and credible threat resulted in different tDCS effects.

Copper accumulation in the brain causes the elevation of oxidative stress and less anxious behavior in Ts1Cje mice, a model of Down syndrome

Elevated oxidative stress (OS) is widely accepted to be involved in the pathogenesis of Down syndrome (DS). However, the mechanisms underlying the elevation of OS in DS are poorly understood. Biometals, in particular copper and iron, play roles in OS. We therefore focused on biometals in the brain with DS. In this study, we analyzed the profile of elements, including biometals, in the brain of Ts1Cje mice, a widely used genetic model of DS. An inductively coupled plasma-mass spectrometry (ICP-MS)-based comparative metallomic/elementomic analysis of Ts1Cje mouse brain revealed a higher level of copper in the hippocampus and cerebral cortex, but not in the striatum, in comparison to wild-type littermates. The expression of the copper transporter CTR1, which is involved in the transport of copper into cells, was decreased in the ependymal cells of Ts1Cje mice, suggesting a decrease in the CTR1-mediated transport of copper into the ependymal cells, which excrete copper into the cerebrospinal fluid. To evaluate the pathological significance of the accumulation of copper in the brain of Ts1Cje mice, we examined the effects of a diet with a low copper content (LoCD) on the elevated lipid peroxidation, the accumulation of hyperphosphorylated tau, and some behavioral anomalies. Reducing the copper concentration in the brain by an LoCD restored the enhanced lipid peroxidation and phosphorylation of tau in the brain and reduced anxiety-like behavior, but not hyperactivity or impaired spatial leaning, in Ts1Cje mice. The findings highlight the reduction of accumulation of copper in the brain may be a novel therapeutic strategy for DS.

Anticipation of difficult tasks: neural correlates of negative emotions and emotion regulation

BACKGROUND

Difficult cognitive tasks are often associated with negative feelings. This can be already the case for the mere anticipation of having to do a difficult task. For the case of difficult math tasks, it was recently suggested that such a negative emotional response may be exclusive to highly math-anxious individuals. However, it is also conceivable that negative emotional responses simply reflect that math is perceived as difficult. Here we investigated whether non-math-anxious individuals also experience negative emotional responses when anticipating to do difficult math tasks.

METHODS

We compared brain activation following the presentation of a numerical cue indicating either difficult or easy upcoming proportion magnitude comparison tasks.

RESULTS

Comparable to previous results for highly math-anxious individuals we observed a network associated with negative emotions to be activated in non-math-anxious individuals when facing cues indicating a difficult upcoming task. Importantly, however, math anxiety scores did not predict the neural response. Furthermore, we observed activation in areas associated with processes of cognitive control areas such as anterior cingulate cortex, which were suggested to play a key role in emotion regulation.

CONCLUSION

Activation in the emotion processing network was observed when anticipating an upcoming difficult (math) task. However, this activation was not predicted by individual' degree of math anxiety. Therefore, we suggest that negative emotional responses to difficult math tasks might be a rather common reaction not specific to math-anxious individuals. Whether or not this initial negative response impairs math performance, however, might depend on the ability to regulate those emotions effectively.

Rapid saccadic response with fearful gaze cue

It has been shown that an averted gaze with emotional expression guides our attention toward a gazed-at location, and the effect of a gaze with fearful expression has been well-investigated. However, the findings are not consistent, and most studies used the manual response measure. Recent studies suggest that examining eye movements is more suitable to capture the early stage of the effect of threat-related stimuli on attentional process. Therefore, in the present study, we investigated the effects of static neutral and fearful gaze on overt attention orienting by examining the saccadic responses in an unselected sample of people. Our results found the gaze congruency effects for both expressions, and importantly, enhanced attention orienting by fearful gaze at a short stimulus onset asynchrony (SOA): participants looked faster at the fearful gaze-cued target than the neutral gaze-cued one at the 300 ms SOA. These findings provide the first evidence that fearful averted gaze elicits rapid overt attention orienting toward the target, and suggest that the information of gaze direction and emotional expression are rapidly integrated and modulate the oculomotor system.

The effect of a six-week focused meditation training on depression and anxiety symptoms in Brazilian university students with 6 and 12 months of follow-up

BACKGROUND

Evidence shows high prevalence of depression and anxiety symptoms among university students. This study investigated whether a meditation-based program would help reducing these symptoms in this population.

METHODS

Non-randomized controlled trial investigating the effects of a six-week focused meditation training on depression (Beck Depression Inventory) and anxiety (Beck Anxiety Inventory) outcomes among university students. Participants were allocated into a meditation or waiting list control group. Assessment occurred pre and post intervention and only for the meditation group at 6 and 12 months follow-up. General linear model for repeated measures evaluated the intervention effect considering group and time factors, controlling for minor psychiatric disorders, gender and absence at meetings.

RESULTS

The meditation group presented a reduction in depression and anxiety symptoms after intervention compared to controls. Among the meditation group, depression (at 6 months follow-up) and anxiety (at 6 and 12 months follow-up) scores were lower for those who continued practicing.

LIMITATIONS

Non-randomization and absence of daily practice record (precluding dose-response gradient evaluation).

CONCLUSION

The meditation training was effective in reducing depression and anxiety symptoms, but the maintanance of these reductions only occurred for those who continued meditating. Permanent meditation programs may be an alternative for promoting mental health for university students.

The relationship of anxious and depressive symptoms in Parkinson's disease with voxel-based neuroanatomical and functional connectivity measures

BACKGROUND

Anxiety and depression are two frequent comorbidities of Parkinson's disease (PD). However, the underlying neural mechanism is still unclear and the studies on their neural correlates were insufficient.

METHODS

Using voxel-based neuroanatomical and functional connectivity (FC) measures, i.e. grey matter volume, fractional anisotropy, and weighted degree centrality (WD), we examined their correlations with the severity levels of anxious and depressive symptoms in 36 PD patients.

RESULTS

Positive correlations were shown between anxiety and the WDs in the left amygdala, and between depression and short-ranged WDs in the left parahippocampal gyrus. Using these two regions as the seeds, we found that the severity levels of anxiety and depression were positively correlated with the FCs between the two seeds and the areas in the default mode network (DMN), while negatively correlated with the FCs between the two seeds and the prefrontal and superior temporal cortices. Anxiety was also positively correlated with the FC between the amygdala and the superior parietal lobule.

LIMITATIONS

The severity levels of anxious and depressive symptoms of our participants is relatively mild than some previous studies. The cross-sectional design of this study cannot clarify the etiological relationship between PD and two comorbidities.

CONCLUSIONS

Our results were in line with the key roles of the amygdala and parahippocampal gyrus in anxiety and depression, and reflected the distinct effects of the DMN, prefrontal and superior temporal cortices, and sensory-motor regions on emotional regulation. The identification of these neural substrates might assist clinical monitoring mood disturbances in PD.

Dopaminergic Mechanisms Underlying Normal Variation in Trait Anxiety

Trait anxiety has been associated with altered activity within corticolimbic pathways connecting the amygdala and rostral anterior cingulate cortex (rACC), which receive rich dopaminergic input. Though the popular culture uses the term "chemical imbalance" to describe the pathophysiology of psychiatric conditions such as anxiety disorders, we know little about how individual differences in human dopamine neurochemistry are related to variation in anxiety and activity within corticolimbic circuits. We addressed this issue by examining interindividual variability in dopamine release at rest using [¹¹C]raclopride positron emission tomography (PET), functional connectivity between amygdala and rACC using resting-state functional magnetic resonance imaging (fMRI), and trait anxiety measures in healthy adult male and female humans. To measure endogenous dopamine release, we collected two [¹¹C]raclopride PET scans per participant. We contrasted baseline [¹¹C]raclopride D2/3 receptor binding and D2/3 receptor binding following oral methylphenidate administration. Methylphenidate blocks the dopamine transporter, which increases extracellular dopamine and leads to reduced [¹¹C]raclopride D2/3 receptor binding via competitive displacement. We found that individuals with higher dopamine release in the amygdala and rACC self-reported lower trait anxiety. Lower trait anxiety was also associated with reduced rACC-amygdala functional connectivity at baseline. Further, functional connectivity showed a modest negative relationship with dopamine release such that reduced rACC-amygdala functional connectivity was accompanied by higher levels of dopamine release in these regions. Together, these findings contribute to hypodopaminergic models of anxiety and support the utility of combining fMRI and PET measures of neurochemical function to advance our understanding of basic affective processes in humans.SIGNIFICANCE STATEMENT It is common wisdom that individuals vary in their baseline levels of anxiety. We all have a friend or colleague we know to be more "tightly wound" than others, or, perhaps, we are the ones marveling at others' ability to "just go with the flow." Although such observations about individual differences within nonclinical populations are commonplace, the neural mechanisms underlying normal variation in trait anxiety have not been established. Using multimodal brain imaging in humans, this study takes initial steps in linking intrinsic measures of neuromodulator release and functional connectivity within regions implicated in anxiety disorders. Our findings suggest that in healthy adults, higher levels of trait anxiety may arise, at least in part, from reduced dopamine neurotransmission.

Basolateral amygdalar inactivation blocks chronic stress-induced lamina-specific reduction in prefrontal cortex volume and associated anxiety-like behavior

Chronic exposure to stress causes cognitive deficits, anxiety and depression. Earlier studies have suggested that the prefrontal cortex (PFC) and basolateral amygdala (BLA) can differentially modulate the stress-induced alterations either by their action on HPA axis or via direct reciprocal connections between them. The PFC dysfunction and BLA hypertrophy following stress are known to cause anxiety and affective symptoms. Recent studies indicate that inactivation of BLA projections to PFC remarkably decreases anxiety. However, the effect of BLA inactivation on stress-induced anxiety and associated volume loss in prelimbic (PrL) and anterior cingulate (ACC) subregions of PFC is not known. Accordingly, we evaluated the effect of BLA lesion or inactivation during chronic immobilization stress (CIS) on an approach-avoidance task and associated volume loss in the PFC. The stressed rats showed a significant volumetric reduction in layer I and II of the PrL and ACC. Interestingly, BLA lesion prior to stress prevented the volume loss in PrL and ACC. Further, BLA lesion blocked the anxiety-like behavior in stressed rats. However, in the absence of stress, BLA lesion increased the number of shocks as compared to controls. As BLA lesion produced an anticonflict effect, we performed temporary inactivation of BLA specifically during stress. Similar to BLA lesion, lidocaine-induced inactivation prevented the stress-induced volume loss and anxiety-like behavior. We demonstrate that inactivation of BLA during stress prevents CIS-induced anxiety and associated structural correlates in the PFC. The present study extends the hypothesis of amygdalar silencing as a possible management strategy for stress and associated disorders.

The Altered Somatic Brain Network in State Anxiety

Highly anxious individuals often show excessive emotional arousal, somatic arousal, and characteristics of mental illness. Previous researches have extensively investigated the emotional and cognitive biases of individuals with high anxiety, but overlooked the spontaneous brain activity and functional connections associated with somatic arousal. In this study, we investigated the relationship between state anxiety and the spontaneous brain activity of the somatosensory cortex in a non-clinical healthy population with state anxiety. Furthermore, we also explored the functional connections of the somatosensory cortex. We found that state anxiety was positively correlated with the amplitude of low-frequency fluctuations (ALFFs) of somatic related brain regions, including the right postcentral gyrus (somatosensory cortex) and the right precentral gyrus (somatic motor cortex). Furthermore, we found that state anxiety was positively correlated with the connections between the postcentral gyrus and the left cerebellum gyrus, whereas state anxiety was negatively correlated with the connectivity between the postcentral gyrus and brain regions including the left inferior frontal cortex and left medial superior frontal cortex. These results revealed the association between the anxious individuals' body-loop and state anxiety in a healthy population, which revealed the importance of somatic brain regions in anxiety symptoms and provided a new perspective on anxiety for further study.

Biased emotional attention in patients with dental phobia

Biased motivated attention towards phobia-relevant pictures is a typical finding in specific phobia. In the visual system, the allocation of motivated attention is indexed by two event-related potential components - the Early Posterior Negativity and the Late Positive Potential. Enhanced Early Posterior Negativity and Late Positive Potential amplitudes are reliably observed in specific phobia such as, for instance, snake, spider, or blood-injection-injury phobia and to some extent also in dental phobia. However, regarding dental phobia results are sparse and its theoretical concept is not undisputed. To further elucidate the electrophysiological characteristics of dental phobia, we investigated visual emotional processing in dental phobia patients and controls. Subjects viewed neutral, phobia-irrelevant and phobia-relevant pictures while magnetoencephalographic and behavioural measures were recorded. All patients reported a history of traumatic experiences and depressive and anxiety symptoms, as well as dissociative and posttraumatic symptoms. In the magnetoencephalography, patients showed generally less evoked neural activation at parietal and temporal regions and a reduced differentiation between picture categories compared to controls. At the behavioural level, patients rated phobia-relevant pictures as clearly more negative as did controls. In contrast to previous reports, our results suggest that dental phobia cannot be associated with the typical effects of biased motivated attention seen in other specific phobias. Instead, results indicate that dental phobia shares typical characteristics with mild forms of posttraumatic stress disorder.

Altered Working Memory Processing of Emotion in Adolescents with Dysphoric Symptomatology: An Eye Tracking Study

It has been suggested that altered processing of emotion during cognitive control plays an important role in the etiology of depressive symptoms. The current study investigates the influence of emotional stimuli on working memory (WM) in adolescents with dysphoric symptomatology (DS). Twenty-five adolescents with DS and 40 adolescents with no dysphoric symptomatology (NDS) completed a memory-guided eye movement task. This task assessed the influence of irrelevant affective information on WM processes during high and low cognitive load. Latency analyses showed that, in the high load WM condition, negative distractors disturbed WM performance in adolescents with NDS, but not in adolescents with DS. Accuracy analyses revealed that adolescents with NDS had higher accuracy rates in the presence of positive distractors relative to negative and neutral distractors, and in comparison to adolescents with DS. The findings indicated altered WM performance in the context of emotional distractors in adolescents with DS and may contribute to theoretical knowledge and early prevention of youth depression.

Trait anxiety is associated with a decreased visual working memory capacity for faces

Recent work has suggested that anxiety restricts working memory capacity, which may underlie a wide range of cognitive symptoms in anxiety. However, previous literature on the anxiety-visual working memory association yielded mixed results, with some studies demonstrating an anxiety-related increase in visual working memory capacity. In an attempt to gain a more thorough understanding of the relationship between anxiety and visual working memory maintenance function, the current study examined the influence of trait anxiety on visual working memory capacity and resolution for negative, positive, and neutral faces in a large unselected sample, by conducting two different experiments. Experiment 1 used a change-detection task to estimate visual working memory capacity, while Experiment 2 used a modified time-delay estimation task to measure memory precision. Hierarchical linear modeling was used to analyze the relationship between trait anxiety, emotional valence, and visual working memory. Results showed that trait anxiety was associated with decreased visual working memory capacity for faces in a valence-independent manner, whereas anxiety-related change in visual working memory resolution was not significant. This pattern of results was discussed in light of the theories of anxiety and visual working memory.

Anxious brain networks: A coordinate-based activation likelihood estimation meta-analysis of resting-state functional connectivity studies in anxiety

Anxiety and anxiety disorders are associated with specific alterations to functional brain networks, including intra-networks and inter-networks. Given the heterogeneity within anxiety disorders and inconsistencies in functional network differences across studies, identifying common patterns of altered brain networks in anxiety is imperative. Here, we conducted an activation likelihood estimation meta-analysis of resting-state functional connectivity studies in anxiety and anxiety disorders (including 835 individuals with different levels of anxiety or anxiety disorders and 508 controls). Results show that anxiety can be characterized by hypo-connectivity of the affective network with executive control network (ECN) and default mode network (DMN), as well as decoupling of the ECN with the DMN. The connectivity within the salience network and its connectivity with sensorimotor network are also attenuated. These results reveal consistent dysregulations of affective and cognitive control related networks over networks related to emotion processing in anxiety and anxiety disorders. The current findings provide an empirical foundation for an integrated model of brain network alterations that are common across anxiety and anxiety disorders.

Solving the prefrontal conundrum of high-order anxiety: conciliating HOTEC and hypofrontality. A theoretical review

INTRODUCTION

According to the High-order Theory of Emotional Consciousness (HOTEC), every emotional process is a conscious and high-order state of mind carried out by the General Networks of Cognition (GNC), which consists mainly of prefrontal mechanisms. This means that anxiety is also an emotional state of mind carried out by the GNC (positive correlation). However, numerous studies have suggested what is commonly called "hypofrontality" during states of anxiety (negative correlation), which seems to give rise to a theoretical and empirical contraction.

METHODS

I present a theoretical review to address the following issue: how to advocate a HOTEC view of anxiety in the face of a growing paradigm of hypofrontality during states of anxiety?

RESULTS

Here I propose that dmPFC, the dACC, and the anterior insula are GNC areas positively correlated with anxiety, which, along with the prefrontal areas responsible for regulating the activation of survival circuits and driving the attention to adaptive ways to overcome potential threats, form an interconnective model of anticipatory and regulatory mechanisms related to learned threats based on autobiographical memories.

CONCLUSIONS

Through this model, I propose that HOTEC is still a valid way to approach and understand both healthy and unhealthy anxious states of mind.

Cognitive impairment in psychiatric patients in the United Arab Emirates

Cognitive impairment is central to the discussion of most psychiatric disorders, because of the implications it has for diagnostic, therapeutic, and rehabilitative progression. In the present study, we compared the levels of cognitive impairment between psychiatric patients and a healthy control group. Thirty psychiatric patients and 30 matching healthy controls participated in this study. Their ages ranged from 17 to 55 years (M_age = 29.17; SD = 8.87). The Brief Neuropsychological Cognitive Examination (BNCE) was used to measure cognitive impairment in both groups. A t-test revealed significant differences between the two groups for all Part I subtests (except comprehension), all Part II subtests, and the BNCE total score, with the patients showing greater cognitive impairment. A Kruskal-Wallis H-test also revealed significant differences in the orientation, comprehension, constructive praxis, shifting sets, attention, Part I total, Part II total, and BNCE total scores within the psychiatric patients: patients with schizophrenia consistently displayed significantly greater cognitive impairment compared to patients with mood, anxiety, and substance use disorders. Results need to be investigated further to clarify the nature of the relationship between mood disorders and orientation. Psychiatric patients may exhibit similar types of cognitive impairments but with different severity.

Early effects of exposure-based cognitive behaviour therapy on the neural correlates of anxiety

Exposure-based cognitive-behaviour therapy (CBT) for anxiety disorders is an effective intervention, but the brain mechanisms driving recovery are largely unknown. In this experimental medicine study, we investigated to what degree CBT affects neural markers of anxiety at an early stage of treatment, to identify dynamic mechanistic changes which might be crucial in the process of recovery as opposed to those seen following full treatment completion. In a randomised controlled trial, unmedicated patients with panic disorder either received four weekly sessions of exposure-based CBT (N = 14) or were allocated to a waiting group (N = 14). Symptom severity was measured before and after the intervention. During functional magnetic resonance imaging (fMRI), patients performed an emotion regulation task, either viewing negative images naturally, or intentionally down-regulating negative affect using previously taught strategies. Four-session CBT led to marked reductions in symptoms and 71% of patients reached recovery status (versus 7% in the control group). This intervention normalised brain hyperactivation previously seen in panic disorder, particularly in areas linked to threat monitoring, fear memory, and maladaptive emotion regulation, such as amygdala, dorsomedial and dorsolateral prefrontal cortex, and temporal gyrus. Our findings suggest that optimal treatment doses for panic disorder might be much lower than previously thought. Furthermore, this is the first study to show that neural markers of anxiety change very early during CBT, highlighting potential neural mechanisms that might drive clinical recovery. Such knowledge is important for the development of more compact combination treatments targeting these mechanisms more effectively. (Neural Effects of Cognitive-behaviour Therapy in Panic Disorder; clinicaltrials.gov; NCT03251235).

Inhibitory attentional control in anxiety: Manipulating cognitive load in an antisaccade task

Theorists have proposed that heightened anxiety vulnerability is characterised by reduced attentional control performance and have made the prediction in turn that elevating cognitive load will adversely impact attentional control performance for high anxious individuals to a greater degree than low anxious individuals. Critically however, existing attempts to test this prediction have been limited in their methodology and have presented inconsistent findings. Using a methodology capable of overcoming the limitations of previous research, the present study sought to investigate the effect of manipulating cognitive load on inhibitory attentional control performance of high anxious and low anxious individuals. High and low trait anxious participants completed an antisaccade task, requiring the execution of prosaccades towards, or antisaccades away from, emotionally toned stimuli while eye movements were recorded. Participants completed the antisaccade task under conditions that concurrently imposed a lesser cognitive load, or greater cognitive load. Analysis of participants' saccade latencies revealed high trait anxious participants demonstrated generally poorer inhibitory attentional control performance as compared to low trait anxious participants. Furthermore, conditions imposing greater cognitive load, as compared to lesser cognitive load, resulted in enhanced inhibitory attentional control performance across participants generally. Crucially however, analyses did not reveal an effect of cognitive load condition on anxiety-linked differences in inhibitory attentional control performance, indicating that elevating cognitive load did not adversely impact attentional control performance for high anxious individuals to a greater degree than low anxious individuals. Hence, the present findings are inconsistent with predictions made by some theorists and are in contrast to the findings of earlier investigations. These findings further highlight the need for research into the relationship between anxiety, attentional control, and cognitive load.

Attentional bias modification alters intrinsic functional network of attentional control: A randomized controlled trial

INTRODUCTION

Attentional bias modification (ABM) alleviates anxiety by moderating biased attentional processing toward threat; however, its neural mechanisms remain unclear. We examined how ABM changes functional connectivity (FC) and functional network measures, leading to anxiety reduction.

METHODS

Fifty-four healthy anxious individuals received either ABM or sham training for 1 month in a double-blind randomized controlled trial. Anxious traits, attentional control, and attentional bias were assessed. Thirty-five participants completed resting-state functional magnetic resonance imaging (MRI) scans before and after training.

RESULTS

ABM significantly mitigated an anxious traits regarding physical stress vulnerability (η² = 0.12, p = 0.009). As compared to sham training, ABM significantly strengthened FC between the pulvinar and transverse temporal gyrus along the temporoparietal junction (T = 3.90, ^{FDR-corrected}p = 0.010), whereas it decreased FC between the postCG and ventral fronto-parietal network (vFPN) regions such as the anterior insula and ventrolateral prefrontal cortex (all T ≤ - 3.19, ^{FDR-corrected}p ≤ 0.034). Although ABM diminished network measures of the postcentral gyrus (postCG) (all T ≤ - 4.30, ^{FDR-corrected}p ≤ 0.006), only the pulvinar-related FC increase was specifically correlated with anxiety reduction (r = - 0.46, p = 0.007).

LIMITATIONS

Per-protocol analysis and reduced sample size in MRI analysis.

CONCLUSIONS

ABM might augment the pulvinar's control over vFPN to maintain endogenous attention to a behavioral goal, while diminishing the information exchanges of the postCG with vFPN to inhibit the capture of exogenous attention by potential threats. The pulvinar might play a critical role in ABM anxiolytic efficacy.