How cognitive performance-induced stress can influence right VLPFC activation: an fMRI study in healthy subjects and in patients with social phobia

Connection of social anxiety to impaired pattern of cognitive control and underlying motivational deficiencies: Evidence from event-related potentials

Numerous studies have established a correlation between social anxiety and poor cognitive control. However, little is known about the cognitive control pattern of individuals with high social anxiety (HSAs) and the underlying mechanisms. Based on the Dual Mechanisms of Control framework and the Expected Value of Control theory, this study explored whether HSAs have an impaired cognitive control pattern (Experiment 1) and whether motivational deficiencies underlie the impaired control pattern (Experiment 2). In Experiment 1, 21 individuals with low social anxiety (LSAs) and 21 HSAs completed an AX-Continuous Performance Task. Results showed that HSAs had a smaller P3b amplitude than LSAs, indicating their weakened proactive control in the cue processing stage, but a larger contingent negative variation (CNV) on cue B as compensation for the negative effects of anxiety in the response preparation stage. No group difference was found in N2 and P3a amplitude on probes, suggesting that reactive control in HSAs was not affected compared to LSAs. In Experiment 2, 21 LSAs and 21 HSAs completed a cued-flanker task, where the likelihood of proactive control engagement was manipulated. The results revealed that HSAs exhibited motivation deficiencies in engaging in proactive control, as evidenced by P3b, CNV amplitude, and response times. These findings shed light on the impaired cognitive control pattern of HSAs and suggest that motivational deficiencies may be the crucial underlying factor.

Electro-Acupuncture Effects Measured by Functional Magnetic Resonance Imaging-A Systematic Review of Randomized Clinical Trials

INTRODUCTION

Electro-acupuncture, an innovative adaptation of traditional acupuncture, combines electrical stimulation with acupuncture needles to enhance therapeutic effects. While acupuncture is widely used, its biological mechanisms remain incompletely understood. Recent research has explored the neurophysiological aspects of acupuncture, particularly through functional magnetic resonance imaging (fMRI) to investigate its effects on brain activity.

METHODS

In this systematic review, we conducted an extensive search for randomized clinical trials examining electro-acupuncture effects measured by fMRI. We employed strict eligibility criteria, quality assessment, and data extraction.

RESULTS

Five studies met our inclusion criteria and were analyzed. The selected studies investigated electro-acupuncture in various medical conditions, including carpal tunnel syndrome, fibromyalgia, Crohn's disease, irritable bowel syndrome, and obesity. Notably, electro-acupuncture was found to modulate brain activity and connectivity in regions associated with pain perception, emotional regulation, and cognitive processing. These findings align with the holistic approach of traditional Chinese medicine, emphasizing the interconnectedness of body and mind.

DISCUSSION

In carpal tunnel syndrome, electro-acupuncture at both local and distal sites showed neurophysiological improvements, suggesting distinct neuroplasticity mechanisms. In fibromyalgia, somatosensory electro-acupuncture correlated with reduced pain severity, enhanced brain connectivity, and increased gamma-aminobutyric acid levels. For Crohn's disease, electro-acupuncture influenced the homeostatic afferent processing network, potentially mitigating gut inflammation. Electro-acupuncture for irritable bowel syndrome led to decreased activity in the anterior cingulate cortex, offering pain relief, while electro-acupuncture for obesity impacted brain regions associated with dietary inhibition and emotional regulation.

CONCLUSION

This systematic review provides evidence that electro-acupuncture can positively impact a range of medical conditions, possibly by modulating brain activity and connectivity. While the quality of the reviewed studies is generally good, further research with larger sample sizes and longer-term assessments is needed to better understand the mechanisms and optimize electro-acupuncture protocols for specific health conditions. The limited number of studies in this review emphasizes the need for broader investigations in this promising field. The research protocol was registered in PROSPERO (CRD42023465866).

Preventing prefrontal dysfunction by tDCS modulates stress-induced creativity impairment in women: an fNIRS study

Stress is a major external factor threatening creative activity. The study explored whether left-lateralized activation in the dorsolateral prefrontal cortex manipulated through transcranial direct current stimulation could alleviate stress-induced impairment in creativity. Functional near-infrared spectroscopy was used to explore the underlying neural mechanisms. Ninety female participants were randomly assigned to three groups that received stress induction with sham stimulation, stress induction with true stimulation (anode over the left and cathode over the right dorsolateral prefrontal cortex), and control manipulation with sham stimulation, respectively. Participants underwent the stress or control task after the transcranial direct current stimulation manipulation, and then completed the Alternative Uses Task to measure creativity. Behavioral results showed that transcranial direct current stimulation reduced stress responses in heart rate and anxiety. The functional near-infrared spectroscopy results revealed that transcranial direct current stimulation alleviated dysfunction of the prefrontal cortex under stress, as evidenced by higher activation of the dorsolateral prefrontal cortex and frontopolar cortex, as well as stronger inter-hemispheric and intra-hemispheric functional connectivity within the prefrontal cortex. Further analysis demonstrated that the cortical regulatory effect prevented creativity impairment induced by stress. The findings validated the hemispheric asymmetry hypothesis regarding stress and highlighted the potential for brain stimulation to alleviate stress-related mental disorders and enhance creativity.

Effects of Workstation Type on Mental Stress: FNIRS Study

OBJECTIVE

The purpose of this study is to examine the effect of the workstation type on the severity of mental stress by means of measuring prefrontal cortex (PFC) activation using functional near-infrared spectroscopy.

BACKGROUND

Workstation type is known to influence worker's health and performance. Despite the practical implications of ergonomic workstations, limited information is available regarding their impact on brain activity and executive functions.

METHOD

Ten healthy participants performed a Montreal imaging stress task (MIST) in ergonomic and nonergonomic workstations to investigate their effects on the severity of the induced mental stress.

RESULTS

Cortical hemodynamic changes in the PFC were observed during the MIST in both the ergonomic and nonergonomic workstations. However, the ergonomic workstation exhibited improved MIST performance, which was positively correlated with the cortical activation on the right ventrolateral and the left dorsolateral PFC, as well as a marked decrease in salivary alpha-amylase activity compared with that of the nonergonomic workstation. Further analysis using the NASA Task Load Index revealed a higher weighted workload score in the nonergonomic workstation than that in the ergonomic workstation.

CONCLUSION

The findings suggest that ergonomic workstations could significantly improve cognitive functioning and human capabilities at work compared to a nonergonomic workstation.

APPLICATION

Such a study could provide critical information on workstation design and development of mental stress that can be overlooked during traditional workstation design and mental stress assessments.

Cognitive Neural Mechanism of Social Anxiety Disorder: A Meta-Analysis Based on fMRI Studies

Objective: The present meta-analysis aimed to explore the cognitive and neural mechanism of social anxiety disorder (SAD) from a whole-brain view, and compare the differences in brain activations under different task paradigms. Methods: We searched Web of Science Core Collection and other databases with the keywords related to social anxiety, social phobia, and functional magnetic resonance imaging (fMRI) for comparing persons with SAD to healthy controls and used the activation likelihood estimation method. Thirty-seven papers met the inclusion criteria, including 15 with emotional faces as stimuli, 8 presenting specific situations as stimuli, and 14 using other types of tasks as stimuli. Among these papers, 654 participants were in the SAD group and 594 participants were in the control group with 335 activation increase points and 115 activation decrease points. Results: Whole-brain analysis showed that compared with healthy controls, persons with SAD showed significantly lower activation of the left anterior cingulate gyrus (MNI coordinate: x = −6, y = 22, z = 38; p 0.001). Sub-group analysis based on task indicated that when performing tasks with emotional faces as stimuli, persons with SAD showed significantly lower activation of the left cerebellar slope and fusiform gyrus (MNI coordinate: x = −26, y = −68, z = −12; p 0.001), and significantly higher activation of the right supramarginal gyrus and angular gyrus, than healthy controls (MNI coordinate: x = 58, y = −52, z = 30; p 0.001). Conclusion: Individuals with social anxiety disorder show abnormal activation in the cingulate gyrus, which is responsible for the process of attention control, and task type can influence the activation pattern.

Heart rate variability in late pregnancy: exploration of distinctive patterns in relation to maternal mental health

Exploration of photoplethysmography (PPG), a technique that can be translated to the clinic, has the potential to assess the autonomic nervous system (ANS) through heart rate variable (HRV) in pregnant individuals. This novel study explores the complexity of mental health of individuals in a clinical sample responding to a task in late pregnancy; finding those with several types of past or current anxiety disorders, greater trait anxiety, or greater exposure to childhood traumatic events had significantly different HRV findings from the others in the cohort. Lower high frequency (HF), a measure of parasympathetic activity, was found for women who met the criteria for the history of obsessive-compulsive disorder (OCD) (p = 0.004) compared with women who did not meet the criteria for OCD, and for women exposed to greater than five childhood traumatic events (p = 0.006) compared with those exposed to four or less childhood traumatic events. Conversely higher low frequency (LF), a measure thought to be impacted by sympathetic system effects, and the LF/HF ratio was found for those meeting criteria for a panic disorder (p = 0.006), meeting criteria for social phobia (p = 0.002), had elevated trait anxiety (p = 0.006), or exposure to greater than five childhood traumatic events (p = 0.004). This study indicates further research is needed to understand the role of PPG and in assessing ANS functioning in late pregnancy. Study of the impact of lower parasympathetic functioning and higher sympathetic functioning separately and in conjunction at baseline and in relation to tasks during late pregnancy has the potential to identify individuals that require more support and direct intervention.

Differentiating between bipolar and unipolar depression using prefrontal activation patterns: Promising results from functional near infrared spectroscopy (fNIRS) findings

BACKGROUND

Bipolar depression (BD) is a unique, severe and prevalent mental illness that shares many similarities in symptoms with unipolar depression (UD). Improving precision of their diagnoses would enhance treatment outcome and prognosis for both conditions. This study aims to provide evidence from functional Near-Infrared Spectroscopy (fNIRS) as a potential tool to differentiate UD and BD based on their differences in hemodynamic change in the prefrontal cortex during verbal fluency tasks (VFT).

METHODS

We enrolled 179 participants with clinically confirmed diagnoses, including 69 UD patients, 68 BD patients and 42 healthy controls(HC). Every participant was assessed using a 45-channel fNIRS and various clinical scales.

FINDINGS

Compared with HC, region-specific fNIR leads show UD patients had significant lower hemodynamic activation in 4 particular pre-frontal regions: 1) the left dorsolateral prefrontal cortex (DLPFC), 2) orbitofrontal cortex (OFC), 3) bilateral ventrolateral prefrontal cortex (VLPFC) and 4) left inferior frontal gyrus (IFG). In contrast, BD vs. HC comparisons showed only significant lower hemodynamic activation in the LIFG area. Furthermore, compared to BD patients, UD patients showed decreased hemodynamic activation changes in the VLPFC region.

CONCLUSION

Our results show significant frontal lobe activation pattern differences between UD and BD groups. fNIRS can be a potential tool to increase diagnostic precision for these conditions. In particular, the VLPFC area holds promise to be a useful site for such differentiation for further investigations.

The functional connectome predicts feeling of stress on regular days and during the COVID-19 pandemic

Although many studies have explored the neural mechanism of the feeling of stress, to date, no effort has been made to establish a model capable of predicting the feeling of stress at the individual level using the resting-state functional connectome. Although individuals may be confronted with multidimensional stressors during the coronavirus disease 2019 (COVID-19) pandemic, their appraisal of the impact and severity of these events might vary. In this study, connectome-based predictive modeling (CPM) with leave-one-out cross-validation was conducted to predict individual perceived stress (PS) from whole-brain functional connectivity data from 817 participants. The results showed that the feeling of stress could be predicted by the interaction between the default model network and salience network, which are involved in emotion regulation and salience attribution, respectively. Key nodes that contributed to the prediction model comprised regions mainly located in the limbic systems and temporal lobe. Critically, the CPM model of PS based on regular days can be generalized to predict individual PS levels during the COVID-19 pandemic, which is a multidimensional, uncontrollable stressful situation. The stability of the results was demonstrated by two independent datasets. The present work not only expands existing knowledge regarding the neural mechanism of PS but also may help identify high-risk individuals in healthy populations.

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Perceived stress (PS) can be predicated by resting-state functional connectome.

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PS can be predicated by interaction between default model and salience network.

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Key nodes of the prediction model located in limbic systems and temporal lobe.

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psCPM of regular days generalized to predict PS level in the COVID-19 pandemic.

Stress Changes the Resting-State Cortical Flow of Information from Distributed to Frontally Directed Patterns

Despite converging evidence on the involvement of large-scale distributed brain networks in response to stress, the effect of stress on the components of these networks is less clear. Although some studies identify higher regional activities in response to stress, others observe an opposite effect in the similar regions. Studies based on synchronized activities and coactivation of these components also yield similar differing results. However, these differences are not necessarily contradictory once we observe the effect of stress on these functional networks in terms of the change in information processing capacity of their components. In the present study, we investigate the utility of such a shift in the analysis of the effect of stress on distributed cortical regions through quantification of the flow of information among them. For this purpose, we use the self-assessed responses of 216 individuals to stress-related questionnaires and systematically select 20 of them whose responses showed significantly higher and lower susceptibility to stress. We then use these 20 individuals' resting-state multi-channel electroencephalography (EEG) recordings (both Eyes-Closed (EC) and Eyes-Open (EO) settings) and compute the distributed flow of information among their cortical regions using transfer entropy (TE). The contribution of the present study is three-fold. First, it identifies that the stress-susceptibility is characterized by the change in flow of information in fronto-parietal brain network. Second, it shows that these regions are distributed bi-hemispherically and are sufficient to significantly differentiate between the individuals with high versus low stress-susceptibility. Third, it verifies that the high stress-susceptibility is markedly associated with a higher parietal-to-frontal flow of information. These results provide further evidence for the viewpoint in which the brain's modulation of information is not necessarily accompanied by the change in its regional activity. They further construe the effect of stress in terms of a disturbance that disrupts the flow of information among the brain's distributed cortical regions. These observations, in turn, suggest that some of the differences in the previous findings perhaps reflect different aspects of impaired distributed brain information processing in response to stress. From a broader perspective, these results posit the use of TE as a potential diagnostic/prognostic tool in identification of the effect of stress on distributed brain networks that are involved in stress-response.

Brain moderators supporting the relationship between depressive mood and pain

Pain and depressive mood commonly exhibit a comorbid relationship. Yet, the brain mechanisms that moderate the relationship between dysphoric mood and pain remain unknown. An exploratory analysis of functional magnetic resonance imaging, behavioral, and psychophysical data was collected from a previous study in 76 healthy, nondepressed, and pain-free individuals. Participants completed the Beck Depression Inventory-II (BDI), a measure of negative mood/depressive symptomology, and provided pain intensity and pain unpleasantness ratings in response to noxious heat (49°C) during perfusion-based, arterial spin-labeled functional magnetic resonance imaging. Moderation analyses were conducted to determine neural mechanisms involved in facilitating the hypothesized relationship between depressive mood and pain sensitivity. Higher BDI-II scores were positively associated with pain intensity (R = 0.10; P = 0.006) and pain unpleasantness (R = 0.12; P = 0.003) ratings. There was a high correlation between pain intensity and unpleasantness ratings (r = 0.94; P < 0.001); thus, brain moderation analyses were focused on pain intensity ratings. Individuals with higher levels of depressive mood exhibited heightened sensitivity to experimental pain. Greater activation in regions supporting the evaluation of pain (ventrolateral prefrontal cortex; anterior insula) and sensory-discrimination (secondary somatosensory cortex; posterior insula) moderated the relationship between higher BDI-II scores and pain intensity ratings. This study demonstrates that executive-level and sensory-discriminative brain mechanisms play a multimodal role in facilitating the bidirectional relationship between negative mood and pain.

Stress-induced changes in modular organizations of human brain functional networks

Humans inevitably go through various stressful events, which initiates a chain of neuroendocrine reactions that may affect brain functions and lead to psychopathological symptoms. Previous studies have shown stress-induced changes in activation of individual brain regions or pairwise inter-regional connectivity. However, it remains unclear how large-scale brain network is reconfigured in response to stress. Using a within-subjects design, we combined the Trier Social Stress Test and graph theoretical method to characterize stress-induced topological alterations of brain functional network. Modularity analysis revealed that the brain network can be divided into frontoparietal, default mode, occipital, subcortical, and central-opercular modules under control and stress conditions, corresponding to several well-known functional systems underpinning cognitive control, self-referential mental processing, visual, salience processing, sensory and motor functions. While the frontoparietal module functioned as a connector module under stress, its within-module connectivity was weakened. The default mode module lost its connector function and its within-module connectivity was enhanced under stress. Moreover, stress altered the capacity to control over information flow in a few regions important for salience processing and self-referential metal processing. Furthermore, there was a trend of negative correlation between modularity and stress response magnitude. These findings demonstrate that acute stress prompts large-scale brain-wide reconfiguration involving multiple functional modules.

Absence of default mode downregulation in response to a mild psychological stressor marks stress-vulnerability across diverse psychiatric disorders

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Maladaptation to acute stress constitutes an important vulnerability and maintenance factor for psychiatric disorders.

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We show transdiagnostic and disorder specific aspects of the brain's acute stress response.

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Our results mainly suggest shared, transdiagnostic aspects of a maladaptive stress response.

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Patients show relatively decreased frontoparietal network connectivity under stress.

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Absence of default mode network downregulation marks a maladaptive stress response across disorders.

Clinically, it is well-established that vulnerability to stress is a common feature across a broad spectrum of psychiatric disorders. However, this link has been mechanistically studied almost exclusively in patients with so-called stress-related disorders such as depression and anxiety. To probe transdiagnostic mechanisms, we set out to study the acute stress response across a broader range of psychiatric disorders taking a large-scale brain network perspective. We investigated the brain's response to a mild, experimentally well-controlled psychological stressor in the form of an aversive movie. We studied 168 patients with stress-related and/or neurodevelopmental disorders (including comorbidity) and 46 control subjects. We focused on three networks that have a central role in the brain's stress response and are affected in a wide range of psychiatric disorders: the salience network (SN), default mode network (DMN) and frontoparietal network (FPN). Our results support an increased vulnerability to stress across all patients, indicated by a higher subjective stress level at baseline and follow-up compared to matched controls. At the brain systems level, the stress response was characterized by a relatively decreased FPN connectivity and an absence of a decrease in the within DMN connectivity across all disorders compared to controls. At the neurocognitive level, these findings may reflect a diminished top-down control and a tendency to more pronounced (negative) self-referential processing. Besides these shared aspects of the maladaptive stress response, we also discuss indications for disorder-specific aspects. Taken together, our results emphasize the importance of investigating the mechanistic underpinnings of psychiatric disorders transdiagnostically as recently done in neurogenetics.

Acute psychosocial stress alters thalamic network centrality

Acute stress triggers a broad psychophysiological response that is adaptive if rapidly activated and terminated. While the brain controls the stress response, it is strongly affected by it. Previous research of stress effects on brain activation and connectivity has mainly focused on pre-defined brain regions or networks, potentially missing changes in the rest of the brain. We here investigated how both stress reactivity and stress recovery are reflected in whole-brain network topology and how changes in functional connectivity relate to other stress measures. Healthy young males (n = 67) completed the Trier Social Stress Test or a control task. From 60 min before until 105 min after stress onset, blocks of resting-state fMRI were acquired. Subjective, autonomic, and endocrine measures of the stress response were assessed throughout the experiment. Whole-brain network topology was quantified using Eigenvector centrality (EC) mapping, which detects central hubs of a network. Stress influenced subjective affect, autonomic activity, and endocrine measures. EC differences between groups as well as before and after stress exposure were found in the thalamus, due to widespread connectivity changes in the brain. Stress-driven EC increases in the thalamus were significantly correlated with subjective stress ratings and showed non-significant trends for a correlation with heart rate variability and saliva cortisol. Furthermore, increases in thalamic EC and in saliva cortisol persisted until 105 min after stress onset. We conclude that thalamic areas are central for information processing after stress exposure and may provide an interface for the stress response in the rest of the body and in the mind.

Brain connection pattern under interoceptive attention state predict interoceptive intensity and subjective anxiety feeling

Interoception involves the processing of a variety of different types of information ascending from the body. Accumulating evidence has indicated that interoception plays a fundamental role in cognitive and emotional processes, such as anxiety, but how different functional connectivity patterns contribute to emotions and visceral feelings during an interoceptive attention state is still unclear. In the present study, an interoceptive attention task was performed during functional magnetic resonance imaging of healthy subjects, and the participants' subjective ratings of the intensity of interoception and feelings of anxiety were recorded. Several network nodes were selected, based on previous studies, to construct task-dependent functional connectivity patterns, which were processed by support vector regression to predict the corresponding feeling scores. The results showed that for interoception, the cingulo-opercular task control network provided the greatest contribution, whereas the most important feature for anxiety was the connections between the sensorimotor area (SSM) and the salience network (SN). There existed four overlapping connections between the two predictions: two negative connections between the default mode network (DMN) and the SSM, one negative connection between the DMN and the SN, and one positive connection between the ventral attention network and the SN; this overlap might suggest common bodily attention processing that is involved in both interoception and anxiety. This study remediates the lack of network-level biomarkers of interoception and provides a reference at the level of the brain for further understanding anxiety from an interoceptive perspective.

Increased Functional Connectivity Between Ventral Attention and Default Mode Networks in Adolescents With Bulimia Nervosa

OBJECTIVE

Bulimia nervosa (BN) is characterized by excessive attention to self and specifically to body shape and weight, but the ventral attention (VAN) and default mode (DMN) networks that support attentional and self-referential processes are understudied in BN. This study assessed whether altered functional connectivity within and between these networks contributes to such excessive concerns in adolescents with BN early the course of the disorder.

METHOD

Resting-state functional magnetic resonance images were acquired from 33 adolescents with BN and 37 healthy control adolescents (12-21 years) group matched by age and body mass index. Region-of-interest analyses were performed to examine group differences in functional connectivity within and between the VAN and DMN. In addition associations of VAN-DMN connectivity with BN symptoms, body shape/weight concerns, and sustained attention were explored using the Continuous Performance Test (CPT).

RESULTS

Compared with control adolescents, those with BN showed significantly increased positive connectivity between the right ventral supramarginal gyrus and all DMN regions and between the right ventrolateral prefrontal cortex and the left lateral parietal cortex. Within-network connectivity did not differ between groups. VAN-DMN connectivity was associated with BN severity and body shape/weight concerns in the BN group. No significant group-by-CPT interactions on VAN-DMN connectivity were detected.

CONCLUSION

Increased positive VAN-DMN connectivity in adolescents with BN could reflect abnormal engagement of VAN-mediated attentional processes at rest, perhaps related to their excessive attention to self-referential thoughts about body shape/weight. Future studies should further investigate these circuits as targets for the development of early interventions aimed at decreasing excessive body shape/weight concerns.

vmPFC activation during a stressor predicts positive emotions during stress recovery

Despite accruing evidence showing that positive emotions facilitate stress recovery, the neural basis for this effect remains unclear. To identify the underlying mechanism, we compared stress recovery for people reflecting on a stressor while in a positive emotional context with that for people in a neutral context. While blood-oxygen-level dependent data were being collected, participants (N = 43) performed a stressful anagram task, which was followed by a recovery period during which they reflected on the stressor while watching a positive or neutral video. Participants also reported positive and negative emotions throughout the task as well as retrospective thoughts about the task. Although there was no effect of experimental context on emotional recovery, we found that ventromedial prefrontal cortex (vmPFC) activation during the stressor predicted more positive emotions during recovery, which in turn predicted less negative emotions during recovery. In addition, the relationship between vmPFC activation and positive emotions during recovery was mediated by decentering-the meta-cognitive detachment of oneself from one's feelings. In sum, successful recovery from a stressor seems to be due to activation of positive emotion-related regions during the stressor itself as well as to their downstream effects on certain cognitive forms of emotion regulation.

How the brain connects in response to acute stress: A review at the human brain systems level

The brain's response to stress is a matter of extensive neurocognitive research in an attempt to unravel the mechanistic underpinnings of neural adaptation. In line with the broadly defined concept of acute stress, a wide variety of induction procedures are used to mimic stress experimentally. We set out to review commonalities and diversities of the stress-related functional activity and connectivity changes of functional brain networks in healthy adults across procedures. The acute stress response is consistently associated with both increased activity and connectivity in the salience network (SN) and surprisingly also with increased activity in the default mode network (DMN), while most studies show no changes in the central executive network. These results confirm earlier findings of an essential, coordinating role of the SN in the acute stress response and indicate a dynamic role of the DMN whose function is less clear. Moreover, paradigm specific brain responses have to be taken into account when investigating the role and the within and between network connectivity of these three networks.

Neural responses to social threat and predictors of cognitive behavioral therapy and acceptance and commitment therapy in social anxiety disorder

Previous research has often highlighted hyperactivity in emotion regions to simple, static social threat cues in social anxiety disorder (SAD). Investigation of the neurobiology of SAD using more naturalistic paradigms can further reveal underlying mechanisms and how these relate to clinical outcomes. We used fMRI to investigate responses to novel dynamic rejection stimuli in individuals with SAD (N=70) and healthy controls (HC; N=17), and whether these responses predicted treatment outcomes following cognitive behavioral therapy (CBT) or acceptance and commitment therapy (ACT). Both HC and SAD groups reported greater distress to rejection compared to neutral social stimuli. At the neural level, HCs exhibited greater activations in social pain/rejection regions, including dorsal anterior cingulate cortex and anterior insula, to rejection stimuli. The SAD group evidenced a different pattern, with no differences in these rejection regions and relatively greater activations in the amygdala and other regions to neutral stimuli. Greater responses in anterior cingulate cortex and the amygdala to rejection vs. neutral stimuli predicted better CBT outcomes. In contrast, enhanced activity in sensory-focused posterior insula predicted ACT responses.

Defining biotypes for depression and anxiety based on large-scale circuit dysfunction: a theoretical review of the evidence and future directions for clinical translation

Complex emotional, cognitive and self-reflective functions rely on the activation and connectivity of large-scale neural circuits. These circuits offer a relevant scale of focus for conceptualizing a taxonomy for depression and anxiety based on specific profiles (or biotypes) of neural circuit dysfunction. Here, the theoretical review first outlines the current consensus as to what constitutes the organization of large-scale circuits in the human brain identified using parcellation and meta-analysis. The focus is on neural circuits implicated in resting reflection (default mode), detection of "salience," affective processing ("threat" and "reward"), "attention," and "cognitive control." Next, the current evidence regarding which type of dysfunctions in these circuits characterize depression and anxiety disorders is reviewed, with an emphasis on published meta-analyses and reviews of circuit dysfunctions that have been identified in at least two well-powered case:control studies. Grounded in the review of these topics, a conceptual framework is proposed for considering neural circuit-defined "biotypes." In this framework, biotypes are defined by profiles of extent of dysfunction on each large-scale circuit. The clinical implications of a biotype approach for guiding classification and treatment of depression and anxiety is considered. Future research directions will develop the validity and clinical utility of a neural circuit biotype model that spans diagnostic categories and helps to translate neuroscience into clinical practice in the real world.

Functional neuroanatomy associated with the interaction between emotion and cognition in explicit memory tasks in patients with generalized anxiety disorder

BACKGROUND

The functional neuroanatomy for explicit memory in conjunction with the major anxiety symptoms in patients with generalized anxiety disorder (GAD) has not yet been clearly identified.

PURPOSE

To investigate the brain activation patterns on the interaction between emotional and cognitive function during the explicit memory tasks, as well as its correlation with clinical characteristics in GAD.

MATERIAL AND METHODS

The participants comprised GAD patients and age-matched healthy controls. The fMR images were obtained while the participants performed an explicit memory task with neutral and anxiety-inducing words.

RESULTS

Patients showed significantly decreased functional activities in the putamen, head of the caudate nucleus, hippocampus, and middle cingulate gyrus during the memory tasks with the neutral and anxiety-inducing words, whereas the precentral gyrus and ventrolateral prefrontal cortex were significantly increased only in the memory tasks with the anxiety-inducing words. Also, the blood oxygenation level-dependent (BOLD) signal changes in the hippocampus were positively correlated with the recognition accuracy for both neutral and anxiety-inducing words.

CONCLUSION

This study identified the brain areas associated with the interaction between emotional regulation and cognitive function in the explicit memory tasks in patients with GAD. These findings would be helpful to understand the neural mechanism on the explicit memory-related cognitive deficits and emotional dysfunction with GAD symptoms.

The neural basis of improved cognitive performance by threat of shock

Anxiety can have both detrimental and facilitatory cognitive effects. This study investigates the neural substrates of a replicated facilitatory effect of anxiety on sustained attention and response inhibition. This effect consisted of improved performance on the Sustained Attention to Response Task (a Go-NoGo task consisting of 91% Go and 9% NoGo trials) in threat (unpredictable electrical shock) vs safe (no shock) conditions. This study uses the same experimental design with fMRI and relies on an event-related analysis of BOLD signal changes. Findings reveal that threat-related cognitive facilitation (improved NoGo accuracy) is associated with greater activation of a right-lateralized frontoparietal group of regions previously implicated in sustained attention and response inhibition. Moreover, these same regions show decreased activation in the Go trials preceding NoGo errors. During NoGo trials, striatal activity is also greater in the threat vs safe condition, consistent with the notion of enhanced inhibitory processing under threat. These findings identify potential mechanisms by which threat of unpredictable shock can facilitate distinct cognitive functions. A greater understanding of the complex interaction of the anxious state and cognitive processes may have critical clinical implications.

The Structural and Functional Organization of Cognition

This article proposes that what have been historically and contemporarily defined as different domains of human cognition are served by one of four functionally- and structurally-distinct areas of the prefrontal cortex (PFC). Their contributions to human intelligence are as follows: (a) BA9, enables our emotional intelligence, engaging the psychosocial domain; (b) BA47, enables our practical intelligence, engaging the material domain; (c) BA46 (or BA46-9/46), enables our abstract intelligence, engaging the hypothetical domain; and (d) BA10, enables our temporal intelligence, engaging in planning within any of the other three domains. Given their unique contribution to human cognition, it is proposed that these areas be called the, social (BA9), material (BA47), abstract (BA46-9/46) and temporal (BA10) mind. The evidence that BA47 participates strongly in verbal and gestural communication suggests that language evolved primarily as a consequence of the extreme selective pressure for practicality; an observation supported by the functional connectivity between BA47 and orbital areas that negatively reinforce lying. It is further proposed that the abstract mind (BA46-9/46) is the primary seat of metacognition charged with creating adaptive behavioral strategies by generating higher-order concepts (hypotheses) from lower-order concepts originating from the other three domains of cognition.

Neural Plastic Effects of Working Memory Training Influenced by Self-perceived Stress in Stroke: A Case Illustration

This case study examined the effects of auditory working memory (WM) training on neuroplastic changes in stroke survivors and how such effects might be influenced by self-perceived stress. Two participants with a history of stroke participated in the study. One of them had a higher level of self-perceived stress. Both participants underwent a course of auditory WM training and completed baseline and post-training assessments such as self-perceived stress, performance satisfaction questionnaires, behavioral task performance, and functional magnetic resonance imaging. They were trained on a computerized auditory WM task (n-back) 5 days a week for 6 weeks, for a total of 20 h. Participant 1 had high levels of perceived stress, both pre- and post-training, and showed improvement on the satisfaction aspect of functional engagement only. Participant 2 had lower levels of perceived stress and demonstrated improvements on all performance tasks. Neuroimaging results showed evidence of improved neural efficiency on the trained task for participant 2. The results shed light on the need to evaluate psychological influences, e.g., stress, when studying the neuroplastic changes in people with stroke. However, the case design approach and other factors that might have positively influenced outcomes mean that these results must be interpreted with a great deal of caution. Future studies using a larger sample are recommended to verify the findings.

Higher burnout scores in paediatric residents are associated with increased brain activity during attentional functional magnetic resonance imaging task

AIM

Burnout syndrome is common in healthcare workers. We evaluated its prevalence in paediatric residents and investigated its influence on cerebral function correlations, using functional magnetic resonance imaging (MRI), when they carried out an attentional paradigm.

METHODS

This cross-sectional descriptive study involved 28 residents from the Department of Paediatrics at the University of São Paulo. The functional MRI was carried out while the residents completed the Stroop colour word task paradigm to investigate their attentional task performance. The Maslach Burnout Inventory (MBI) was applied, and stress was assessed using the Lipp Inventory of Stress Symptoms for Adults and by a visual analogue mood scale.

RESULTS

The MBI subscales of depersonalisation and emotional exhaustion indicated that 53.1% of the residents had moderate or high burnout syndrome. The whole-brain multivariate analysis showed positive correlations between the blood oxygenation level dependent effect and the MBI depersonalisation and emotional exhaustion indices in the dorsolateral prefrontal cortex, which controls for anxiety.

CONCLUSION

Increased brain activation during an attention task, measured using functional MRI, was associated with higher burnout scores in paediatric residents. This study provides a biological basis for the implementation of measures to reduce burnout syndrome at the start of residency training programmes.

Neural activity during self-referential working memory and the underlying role of the amygdala in social anxiety disorder

Self-referential processing, theory of mind, and working memory are distorted in social anxiety disorder (SAD). This study aimed to investigate characteristics of altered self-referential working memory processing and resting-state functional connectivity in patients with SAD. Twenty patients and 20 healthy controls underwent functional magnetic resonance imaging at resting-state and while performing a working memory task containing faces with self-referential positive or negative comments and three memory phases (encoding, maintenance, and retrieval). Task-related results were compared between groups and tested for correlations. Resting-state connectivity between amygdala subregions and regions showing a task-related difference was also compared between groups. Patients compared to controls showed augmented memory for the negative comments, hyperactivation of the dorsomedial prefrontal cortex and temporo-parietal junction during encoding, and hypoactivation of the dorsolateral prefrontal cortex and insula during retrieval. At resting-state, increased connectivity of amygdala subregions with multiple task-related regions was found in patients. These findings suggest that the encoding process in SAD is accompanied by altered involvement of self-referential processing and theory of mind, whereas the retrieval process reflects impaired cognitive control. These memory-related processing may be affected by predisposing resting-state hyperconnectivity with the amygdala, and may underlie a hypersensitivity to negative comments and post-event reflection in SAD.

A novel semi-immersive virtual reality visuo-motor task activates ventrolateral prefrontal cortex: a functional near-infrared spectroscopy study

OBJECTIVE

In the last few years, the interest in applying virtual reality systems for neurorehabilitation is increasing. Their compatibility with neuroimaging techniques, such as functional near-infrared spectroscopy (fNIRS), allows for the investigation of brain reorganization with multimodal stimulation and real-time control of the changes occurring in brain activity. The present study was aimed at testing a novel semi-immersive visuo-motor task (VMT), which has the features of being adopted in the field of neurorehabilitation of the upper limb motor function.

APPROACH

A virtual environment was simulated through a three-dimensional hand-sensing device (the LEAP Motion Controller), and the concomitant VMT-related prefrontal cortex (PFC) response was monitored non-invasively by fNIRS. Upon the VMT, performed at three different levels of difficulty, it was hypothesized that the PFC would be activated with an expected greater level of activation in the ventrolateral PFC (VLPFC), given its involvement in the motor action planning and in the allocation of the attentional resources to generate goals from current contexts. Twenty-one subjects were asked to move their right hand/forearm with the purpose of guiding a virtual sphere over a virtual path. A twenty-channel fNIRS system was employed for measuring changes in PFC oxygenated-deoxygenated hemoglobin (O2Hb/HHb, respectively).

MAIN RESULTS

A VLPFC O2Hb increase and a concomitant HHb decrease were observed during the VMT performance, without any difference in relation to the task difficulty.

SIGNIFICANCE

The present study has revealed a particular involvement of the VLPFC in the execution of the novel proposed semi-immersive VMT adoptable in the neurorehabilitation field.

Developing a clinical translational neuroscience taxonomy for anxiety and mood disorder: protocol for the baseline-follow up Research domain criteria Anxiety and Depression ("RAD") project

BACKGROUND

Understanding how brain circuit dysfunctions relate to specific symptoms offers promise for developing a brain-based taxonomy for classifying psychopathology, identifying targets for mechanistic studies and ultimately for guiding treatment choice. The goal of the Research Domain Criteria (RDoC) initiative of the National Institute of Mental Health is to accelerate the development of such neurobiological models of mental disorder independent of traditional diagnostic criteria. In our RDoC Anxiety and Depression ("RAD") project we focus trans-diagnostically on the spectrum of depression and anxiety psychopathology. Our aims are a) to use brain imaging to define cohesive dimensions defined by dysfunction of circuits involved in reactivity to and regulation of negatively valenced emotional stimulation and in cognitive control, b) to assess the relationships between these dimension and specific symptoms, behavioral performance and the real world capacity to function socially and at work and c) to assess the stability of brain-symptom-behavior-function relationships over time.

METHODS AND DESIGN

Here we present the protocol for the "RAD" project, one of the first RDoC studies to use brain circuit functioning to define new dimensions of psychopathology. The RAD project follows baseline-follow up design. In line with RDoC principles we use a strategy for recruiting all clients who "walk through the door" of a large community mental health clinic as well as the surrounding community. The clinic attends to a broad spectrum of anxiety and mood-related symptoms. Participants are unmedicated and studied at baseline using a standardized battery of functional brain imaging, structural brain imaging and behavioral probes that assay constructs of threat reactivity, threat regulation and cognitive control. The battery also includes self-report measures of anxiety and mood symptoms, and social and occupational functioning. After baseline assessments, therapists in the clinic apply treatment planning as usual. Follow-up assessments are undertaken at 3 months, to establish the reliability of brain-based subgroups over time and to assess whether these subgroups predict real-world functional capacity over time. First enrollment was August 2013, and is ongoing.

DISCUSSION

This project is designed to advance knowledge toward a neural circuit taxonomy for mental disorder. Data will be shared via the RDoC database for dissemination to the scientific community. The clinical translational neuroscience goals of the project are to develop brain-behavior profile reports for each individual participant and to refine these reports with therapist feedback. Reporting of results is expected from December 2016 onward.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02220309 . Registered: August 13, 2014.

Beyond the Medial Regions of Prefrontal Cortex in the Regulation of Fear and Anxiety

Fear and anxiety are adaptive responses but if left unregulated, or inappropriately regulated, they become biologically and socially maladaptive. Dysregulated emotions are manifest in a wide variety of psychiatric and neurological conditions but the external expression gives little indication of the underlying causes, which are inevitably multi-determined. To go beyond the overt phenotype and begin to understand the causal mechanisms leading to conditions characterized by anxiety and disorders of mood, it is necessary to identify the base psychological processes that have become dysregulated, and map them on to their associated neural substrates. So far, attention has been focused primarily on the medial regions of prefrontal cortex (PFC) and in particular their contribution to the expression and extinction of conditioned fear. However, functional neuroimaging studies have shown that the sphere of influence within the PFC is not restricted to its medial regions, but extends into dorsal, ventrolateral (vlPFC) and orbitofrontal (OFC) regions too; although the causal role of these other areas in the regulation of fear and anxiety remains to be determined and in the case of the OFC, existing findings are conflicting. Here, we review the evidence for the contribution of these other regions in negative emotion regulation in rodents and old world and new world monkeys. We consider a variety of different contexts, including conditioned and innate fear, learned and unlearned anxiety and cost-benefit decision-making, and a range of physiological and behavioral measures of emotion. It is proposed that both the OFC and vlPFC contribute to emotion regulation via their involvement, respectively, in the prediction of future outcomes and higher-order attentional control. The fractionation of these neurocognitive and neurobehavioral systems that regulate fear and anxiety opens up new opportunities for diagnostic stratification and personalized treatment strategies.

Right ventrolateral prefrontal cortex involvement in the integration of emotional processing: Parametric mediation analysis of fMRI

Emotion plays an important role in goal-directed behavior. Although numerous neuroimaging studies have been conducted, the neural mechanisms behind emotion generation and regulation are still elusive. This is partly explained by large individual variations in emotional responses in addition to the fact that emotion is a complex process. The present functional magnetic resonance imaging study aimed firstly to specify valence-dependent brain activation, and secondly to clarify the interactions between the regions underlying emotional processing. We measured brain activation in 12 healthy adults while passively viewing affective pictures. The individual valence ratings were negatively correlated with activation in the frontal, parietal, occipital lobes, and in the subcortical regions including the amygdalae. The parametric mediation analysis performed on these regions showed that the right ventrolateral prefrontal cortex (Brodmann area 47) was main mediator of the valence ratings with other regions. Interestingly, there was no mediator region for the ventrolateral prefrontal cortex. These results indicated the possibility that the right ventrolateral prefrontal cortex mainly participated in the integration of visually induced emotional processes in the valence dimension.

Source analysis of P3a and P3b components to investigate interaction of depression and anxiety in attentional systems

This study examined the impact of depressive disorders, anxiety disorders and the comorbidity of these disorders on the regional electrophysiological features of brain activity. Sixty-four-channel event-related potentials (ERP) were acquired during a visual oddball task in patients with depressive disorder, patients with anxiety disorders, patients with comorbid depressive and anxiety disorders and healthy subjects. An fMRI-constrained source model was applied to ERP to identify different cortical activities in the patient and control groups. Comorbid patients showed an abnormal frontal-greater-than-parietal P3b topography in the right hemisphere and the highest P3a amplitude at frontal and central sites at the scalp midline. For P3b, depressed patients showed decreased right-lateralized activity in the precentral sulcus (PrCS) and posterior parietal cortex (PPC). Anxious patients demonstrated hyperactive prefrontal cortices (PFC). Comorbid patients presented decreased activity in the cingulate gyrus, right PrCS and right PPC and increased activity in the left PFC and left insular (INS). For P3a, hyperactive left PrCS was found in comorbid patients. Comorbid patients showed both anxiety-related and depression-related activity. A superimposition effect of depression and anxiety was identified with (1) aggravated hypo-function of the right-lateralized dorsal attention and salience networks and (2) complicated anxiety-related hyper-function of the left-lateralized ventral attention and salience networks.

Explicit verbal memory impairments associated with brain functional deficits and morphological alterations in patients with generalized anxiety disorder

BACKGROUND

Generalized anxiety disorder (GAD) is associated with brain function and morphological alterations. This study investigated explicit verbal memory impairment in patients with GAD in terms of brain functional deficits in combination with morphologic changes.

METHODS

Seventeen patients with GAD and 17 healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted MRI and fMR imaging at 3 T during explicit verbal memory tasks with emotionally neutral and anxiety-inducing words.

RESULTS

In response to the neutral words, the patients showed significantly lower activities in the regions of the hippocampus (Hip), middle cingulate gyrus (MCG), putamen (Pu) and head of the caudate nucleus (HCd) compared with healthy controls. In response to the anxiety-inducing words, the patients showed significantly higher activities in the ventrolateral prefrontal cortex and precentral gyrus. However, they showed lower activities in the Hip, MCG, Pu and HCd. In addition, patients with GAD showed a significant reduction in gray matter volumes, especially in the regions of the Hip, midbrain, thalamus, insula and superior temporal gyrus, compared with healthy controls.

LIMITATIONS

This study examined a small sample sizes in each of the groups, and there was no consideration of a medication effect on brain activity and volume changes.

CONCLUSIONS

This study provides evidence for the association between brain functional deficits and morphometric alterations in an explicit verbal memory task for patients with GAD. This finding is helpful for understanding explicit verbal memory impairment in connection with GAD symptoms.

Psychosocial versus physiological stress - Meta-analyses on deactivations and activations of the neural correlates of stress reactions

Stress is present in everyday life in various forms and situations. Two stressors frequently investigated are physiological and psychosocial stress. Besides similar subjective and hormonal responses, it has been suggested that they also share common neural substrates. The current study used activation-likelihood-estimation meta-analysis to test this assumption by integrating results of previous neuroimaging studies on stress processing. Reported results are cluster-level FWE corrected. The inferior frontal gyrus (IFG) and the anterior insula (AI) were the only regions that demonstrated overlapping activation for both stressors. Analysis of physiological stress showed consistent activation of cognitive and affective components of pain processing such as the insula, striatum, or the middle cingulate cortex. Contrarily, analysis across psychosocial stress revealed consistent activation of the right superior temporal gyrus and deactivation of the striatum. Notably, parts of the striatum appeared to be functionally specified: the dorsal striatum was activated in physiological stress, whereas the ventral striatum was deactivated in psychosocial stress. Additional functional connectivity and decoding analyses further characterized this functional heterogeneity and revealed higher associations of the dorsal striatum with motor regions and of the ventral striatum with reward processing. Based on our meta-analytic approach, activation of the IFG and the AI seems to indicate a global neural stress reaction. While physiological stress activates a motoric fight-or-flight reaction, during psychosocial stress attention is shifted towards emotion regulation and goal-directed behavior, and reward processing is reduced. Our results show the significance of differentiating physiological and psychosocial stress in neural engagement. Furthermore, the assessment of deactivations in addition to activations in stress research is highly recommended.

fMRI Study of Social Anxiety during Social Ostracism with and without Emotional Support

Social anxiety is characterized by an excessive fear of being embarrassed in social interactions or social performance situations. Emotional support can help to decrease or diminish social distress. Such support may play an important role at different points of social interaction. However, it is unclear how the beneficial effects of social support are represented in the brains of socially anxious individuals. To explore this, we used the same paradigm previously used to examine the effects of emotional support on social pain caused by exclusion. Undergraduates (n = 46) showing a wide range of social anxiety scores underwent functional magnetic resonance imaging (fMRI) while participating in a Cyberball game. Participants were initially included and later excluded from the game. In the latter half of the session in which participants were excluded, they were provided with supportive messages. In line with our previous work, we found that social exclusion led to increased anterior cingulate cortex (ACC) activity, whereas emotional support led to increased left dorsolateral prefrontal cortex (DLPFC) activity. Despite validation of the paradigm, social anxiety was not associated with increased ACC activity during social exclusion, or during perceived emotional support. Instead, fear of negative evaluation as assessed by the Brief Fear of Negative Evaluation (BFNE) scale showed positive associations with left DLPFC activation while receiving emotional support, compared to while being socially excluded. The more socially anxious an individual was, the greater was the left DLPFC activity increased during receipt of messages. This suggests that highly socially anxious people still have the ability to perceive social support, but that they are nevertheless susceptible to negative evaluation by others.

Of 'disgrace' and 'pain'--corticolimbic interaction patterns for disorder-relevant and emotional words in social phobia

Limbic hyperactivation and an impaired functional interplay between the amygdala and the prefrontal cortex are discussed to go along with, or even cause, pathological anxiety. Within the multi-faceted group of anxiety disorders, the highly prevalent social phobia (SP) is characterized by excessive fear of being negatively evaluated. Although there is widespread evidence for amygdala hypersensitivity to emotional faces in SP, verbal material has rarely been used in imaging studies, in particular with an eye on disorder-specificity. Using functional magnetic resonance imaging (fMRI) and a block design consisting of (1) overall negative, (2) social-phobia related, (3) positive, and (4) neutral words, we studied 25 female patients with social phobia and 25 healthy female control subjects (HC). Results demonstrated amygdala hyperactivation to disorder-relevant but not to generally negative words in SP patients, with a positive correlation to symptom severity. A functional connectivity analysis revealed a weaker coupling between the amygdala and the left middle frontal gyrus in patients. Symptom severity was negatively related to connectivity strength between the amygdala and the ventromedial prefrontal and orbitofrontal cortex (Brodmann Area 10 and 11). The findings clearly support the view of a hypersensitive threat-detection system, combined with disorder-related alterations in amygdala-prefrontal cortex connectivity in pathological anxiety.

Have we met before? Neural correlates of emotional learning in women with social phobia

BACKGROUND

Altered memory processes are thought to be a key mechanism in the etiology of anxiety disorders, but little is known about the neural correlates of fear learning and memory biases in patients with social phobia. The present study therefore examined whether patients with social phobia exhibit different patterns of neural activation when confronted with recently acquired emotional stimuli.

METHODS

Patients with social phobia and a group of healthy controls learned to associate pseudonames with pictures of persons displaying either a fearful or a neutral expression. The next day, participants read the pseudonames in the magnetic resonance imaging scanner. Afterwards, 2 memory tests were carried out.

RESULTS

We enrolled 21 patients and 21 controls in our study. There were no group differences for learning performance, and results of the memory tests were mixed. On a neural level, patients showed weaker amygdala activation than controls for the contrast of names previously associated with fearful versus neutral faces. Social phobia severity was negatively related to amygdala activation. Moreover, a detailed psychophysiological interaction analysis revealed an inverse correlation between disorder severity and frontolimbic connectivity for the emotional > neutral pseudonames contrast.

LIMITATIONS

Our sample included only women.

CONCLUSION

Our results support the theory of a disturbed cortico limbic interplay, even for recently learned emotional stimuli. We discuss the findings with regard to the vigilance-avoidance theory and contrast them to results indicating an oversensitive limbic system in patients with social phobia.

Spatially distributed effects of mental exhaustion on resting-state FMRI networks

Brain activity during rest is spatially coherent over functional connectivity networks called resting-state networks. In resting-state functional magnetic resonance imaging, independent component analysis yields spatially distributed network representations reflecting distinct mental processes, such as intrinsic (default) or extrinsic (executive) attention, and sensory inhibition or excitation. These aspects can be related to different treatments or subjective experiences. Among these, exhaustion is a common psychological state induced by prolonged mental performance. Using repeated functional magnetic resonance imaging sessions and spatial independent component analysis, we explored the effect of several hours of sustained cognitive performances on the resting human brain. Resting-state functional magnetic resonance imaging was performed on the same healthy volunteers in two days, with and without, and before, during and after, an intensive psychological treatment (skill training and sustained practice with a flight simulator). After each scan, subjects rated their level of exhaustion and performed an N-back task to evaluate eventual decrease in cognitive performance. Spatial maps of selected resting-state network components were statistically evaluated across time points to detect possible changes induced by the sustained mental performance. The intensive treatment had a significant effect on exhaustion and effort ratings, but no effects on N-back performances. Significant changes in the most exhausted state were observed in the early visual processing and the anterior default mode networks (enhancement) and in the fronto-parietal executive networks (suppression), suggesting that mental exhaustion is associated with a more idling brain state and that internal attention processes are facilitated to the detriment of more extrinsic processes. The described application may inspire future indicators of the level of fatigue in the neural attention system.

Resting state functional connectivity of the ventral attention network in children with a history of depression or anxiety

OBJECTIVE

We examined whether depression and anxiety disorders in early childhood were associated with changes in resting state functional connectivity (RSFC) of the ventral attention network (VAN), and whether RSFC in the VAN was associated with alterations in attention specific to these disorders. Important clinical features of these illnesses, including changes in attention toward novel stimuli and changes in attention to stimuli of negative valence (threat/sad bias), indirectly implicate the VAN.

METHOD

We collected resting state functional magnetic resonance imaging data in children aged 8 to 12 years. Data were volume censored to reduce artifact from submillimeter movement, resulting in analyzable data from 30 children with a history of depression and/or anxiety and 42 children with no psychiatric history. We compared pairwise RSFC among the following VAN regions: right ventro-lateral prefrontal cortex (VLPFC), right posterior superior temporal gyrus (pSTG), and right ventral supramarginal gyrus (vSMG). We also collected measures of threat bias and current clinical symptoms.

RESULTS

Children with a history of depression and/or anxiety had reduced RSFC among the regions of the VAN compared to children with no psychiatric history. The magnitude of VAN RSFC was correlated with measures of attention bias toward threat but not with current depressive, internalizing, or externalizing symptoms. No RSFC changes were detected between groups among homotopic left hemisphere regions.

CONCLUSIONS

Disruption in the VAN may be an early feature of depression and anxiety disorders. VAN changes were associated with attention bias and clinical history but not with current symptoms of depression and anxiety.

Examination of spatial working memory performance in children and adolescents with attention deficit hyperactivity disorder, combined type (ADHD-CT) and anxiety

Spatial working memory (SWM) is known to be impaired in children with ADHD-CT, whether anxiety is present or not. Yet, it remains unclear whether anxiety disorders add to the SWM impairments evident in ADHD-CT and whether these findings extend into adolescents with ADHD-CT and anxiety. Further, it is not yet known whether children and adolescents with carefully defined anxiety disorders alone, demonstrate SWM deficits. This study explored the association of SWM and its strategy and spatial span components in carefully defined children and adolescents (age 6-16 years) with ADHD-CT alone (N = 163; 14 % female), ADHD-CT and anxiety (N = 243; 23 % female), anxiety disorders alone (N = 69; 25 % female) compared to age- and gender-matched healthy control participants (N = 116; 19 % female). The relationship between SWM and its strategy and span components and core ADHD-CT symptoms and anxiety symptoms were also examined. There was no evidence of an additive effect of ADHD and anxiety on SWM, strategy and spatial span deficits. But, anxiety disorders alone were associated with impaired SWM and span performance compared to healthy control participants. In contrast, strategy did not differ between children and adolescents with anxiety disorders alone and healthy control participants, suggesting that with anxiety span is the most affected component. Further, these findings were age-independent. This study concurs with and extends current influential models about the cognitive effects of anxiety on performance in the setting of ADHD-CT. Clinical implications and future research directions are discussed.

Functional network dysfunction in anxiety and anxiety disorders

A recent paradigm shift in systems neuroscience is the division of the human brain into functional networks. Functional networks are collections of brain regions with strongly correlated activity both at rest and during cognitive tasks, and each network is believed to implement a different aspect of cognition. We propose here that anxiety disorders and high trait anxiety are associated with a particular pattern of functional network dysfunction: increased functioning of the cingulo-opercular and ventral attention networks as well as decreased functioning of the fronto-parietal and default mode networks. This functional network model can be used to differentiate the pathology of anxiety disorders from other psychiatric illnesses such as major depression and provides targets for novel treatment strategies.

Modelling neural correlates of working memory: a coordinate-based meta-analysis

Working memory subsumes the capability to memorize, retrieve and utilize information for a limited period of time which is essential to many human behaviours. Moreover, impairments of working memory functions may be found in nearly all neurological and psychiatric diseases. To examine what brain regions are commonly and differently active during various working memory tasks, we performed a coordinate-based meta-analysis over 189 fMRI experiments on healthy subjects. The main effect yielded a widespread bilateral fronto-parietal network. Further meta-analyses revealed that several regions were sensitive to specific task components, e.g. Broca's region was selectively active during verbal tasks or ventral and dorsal premotor cortex were preferentially involved in memory for object identity and location, respectively. Moreover, the lateral prefrontal cortex showed a division in a rostral and a caudal part based on differential involvement in task set and load effects. Nevertheless, a consistent but more restricted "core" network emerged from conjunctions across analyses of specific task designs and contrasts. This "core" network appears to comprise the quintessence of regions, which are necessary during working memory tasks. It may be argued that the core regions form a distributed executive network with potentially generalized functions for focussing on competing representations in the brain. The present study demonstrates that meta-analyses are a powerful tool to integrate the data of functional imaging studies on a (broader) psychological construct, probing the consistency across various paradigms as well as the differential effects of different experimental implementations.