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Ou CH, Cheng CS, Lin PL, Lee CL. Grey matter alterations in generalized anxiety disorder: A voxel-wise meta-analysis of voxel-based morphometry studies. Int J Dev Neurosci 2024; 84:281-292. [PMID: 38638086 DOI: 10.1002/jdn.10330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 03/09/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024] Open
Abstract
OBJECTIVE Grey matter, a crucial component of the brain, has been found altered in generalized anxiety disorder (GAD) of several voxel-based morphometry studies. The conclusive and consistent grey matter alterations in GAD have not been confirmed. METHOD Eleven voxel-based morphometry studies of GAD patients were included in the current systematic review and meta-analysis. The linear model of anxiety severity scores was applied to explore the relationship of grey matter alterations and anxiety severity. The subgroup analysis of adult GAD and adolescent GAD was also performed. RESULTS Significantly modest grey matter alterations in the left superior temporal gyrus of patients with GAD were found. The anxiety severity score was significantly correlated with grey matter alterations in the right insula, lenticular nucleus, putamen and striatum. The subgroup analysis of adult GAD and adolescent GAD all failed to show significant grey matter alterations. However, in the adult GAD subgroup, anxiety severity score was significantly correlated with grey matter alterations in the right insula. CONCLUSION GAD might have the modest grey matter alterations in the left superior temporal gyrus. Anxiety severity might be related to the grey matter alterations in the limbic regions, such as the right insula, lenticular nucleus, putamen and striatum. This kind of correlation might be related to the effects of adult GAD. Future studies with adequate sample sizes and sophisticated GAD categories will be needed.
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Affiliation(s)
- Chang-Hsien Ou
- Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chiu-Shih Cheng
- Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Pei-Ling Lin
- Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Cheng-Lung Lee
- Department of Neuroradiology, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
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Liu H, Hao Z, Qiu S, Wang Q, Zhan L, Huang L, Shao Y, Wang Q, Su C, Cao Y, Sun J, Wang C, Lv Y, Li M, Shen W, Li H, Jia X. Grey matter structural alterations in anxiety disorders: a voxel-based meta-analysis. Brain Imaging Behav 2024; 18:456-474. [PMID: 38150133 DOI: 10.1007/s11682-023-00842-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
Anxiety disorders (ADs) are a group of prevalent and destructive mental illnesses, but the current understanding of their underlying neuropathology is still unclear. Employing voxel-based morphometry (VBM), previous studies have demonstrated several common brain regions showing grey matter volume (GMV) abnormalities. However, contradictory results have been reported among these studies. Considering that different subtypes of ADs exhibit common core symptoms despite different diagnostic criteria, and previous meta-analyses have found common core GMV-altered brain regions in ADs, the present research aimed to combine the results of individual studies to identify common GMV abnormalities in ADs. Therefore, we first performed a systematic search in PubMed, Embase, and Web of Science on studies investigating GMV differences between patients with ADs and healthy controls (HCs). Then, the anisotropic effect-size signed differential mapping (AES-SDM) was applied in this meta-analysis. A total of 24 studies (including 25 data sets) were included in the current study, and 906 patients with ADs and 1003 HCs were included. Compared with the HCs, the patients with ADs showed increased GMV in the left superior parietal gyrus, right angular gyrus, left precentral gyrus, and right lingual gyrus, and decreased GMV in the bilateral insula, bilateral thalamus, left caudate, and right putamen. In conclusion, the current study has identified some abnormal GMV brain regions that are related to the pathological mechanisms of anxiety disorders. These findings could contribute to a better understanding of the underlying neuropathology of ADs.
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Affiliation(s)
- Han Liu
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Zeqi Hao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Shasha Qiu
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Qianqian Wang
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Linlin Zhan
- School of Western Languages, Heilongjiang University, Heilongjiang, China
| | - Lina Huang
- Department of Radiology, Changshu No.2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Youbin Shao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Qing Wang
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Chang Su
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Yikang Cao
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Jiawei Sun
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Chunjie Wang
- Institute of Brain Science, Department of Psychology, School of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Yating Lv
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Mengting Li
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Wenbin Shen
- Department of Radiology, Changshu No.2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Huayun Li
- School of Psychology, Zhejiang Normal University, Jinhua, China.
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China.
| | - Xize Jia
- School of Psychology, Zhejiang Normal University, Jinhua, China.
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China.
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Cardoner N, Andero R, Cano M, Marin-Blasco I, Porta-Casteràs D, Serra-Blasco M, Via E, Vicent-Gil M, Portella MJ. Impact of Stress on Brain Morphology: Insights into Structural Biomarkers of Stress-related Disorders. Curr Neuropharmacol 2024; 22:935-962. [PMID: 37403395 PMCID: PMC10845094 DOI: 10.2174/1570159x21666230703091435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/04/2023] [Accepted: 01/23/2023] [Indexed: 07/06/2023] Open
Abstract
Exposure to acute and chronic stress has a broad range of structural effects on the brain. The brain areas commonly targeted in the stress response models include the hippocampus, the amygdala, and the prefrontal cortex. Studies in patients suffering from the so-called stress-related disorders -embracing post-traumatic stress, major depressive and anxiety disorders- have fairly replicated animal models of stress response -particularly the neuroendocrine and the inflammatory models- by finding alterations in different brain areas, even in the early neurodevelopment. Therefore, this narrative review aims to provide an overview of structural neuroimaging findings and to discuss how these studies have contributed to our knowledge of variability in response to stress and the ulterior development of stress-related disorders. There are a gross number of studies available but neuroimaging research of stress-related disorders as a single category is still in its infancy. Although the available studies point at particular brain circuitries involved in stress and emotion regulation, the pathophysiology of these abnormalities -involving genetics, epigenetics and molecular pathways-, their relation to intraindividual stress responses -including personality characteristics, self-perception of stress conditions…-, and their potential involvement as biomarkers in diagnosis, treatment prescription and prognosis are discussed.
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Affiliation(s)
- Narcís Cardoner
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Raül Andero
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- Departament de Psicobiologia i de Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
- ICREA, Barcelona, Spain
| | - Marta Cano
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Marin-Blasco
- Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Daniel Porta-Casteràs
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
- Unitat de Neurociència Traslacional, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Parc Taulí (I3PT), Institut de Neurociències, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Maria Serra-Blasco
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Programa eHealth ICOnnecta't, Institut Català d'Oncologia, Barcelona, Spain
| | - Esther Via
- Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Barcelona, Spain
- Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Muriel Vicent-Gil
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Maria J. Portella
- Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine Bellaterra, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica En Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Li Q, Zhang T, Meng J, Wang L, Hua Q, Xie XH, Ji GJ, Bai TJ, Wang K. Abnormal hemispheric specialization and inter-hemispheric functional cooperation in generalized anxiety disorder. Behav Brain Res 2023; 455:114660. [PMID: 37690701 DOI: 10.1016/j.bbr.2023.114660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 08/19/2023] [Accepted: 09/07/2023] [Indexed: 09/12/2023]
Abstract
Abnormal hemispheric specialization and inter-hemispheric interactions may contribute to the pathogenesis of general anxiety disorder (GAD). The current study investigated these abnormalities in GAD patients based on the two analytic approaches and examined whether such abnormalities are correlated with anxiety symptom severity. Seventy-three patients with GAD and 60 matched healthy controls were recruited. All participants completed anxiety symptoms assessment and resting-state functional magnetic resonance imaging (rs-fMRI). The autonomy index (AI) and Connectivity between Functionally Homotopic voxels (CFH) were applied to measure and compared between groups. Compared to controls, patients showed stronger AI in the right middle temporal gyrus (MTG). Seed-based analysis revealed stronger functional connectivity (FC) of the right MTG with both right precuneus and right dorsolateral prefrontal cortex (dlPFC) in patients. Patients also exhibited greater CFH in right anterior cingulate cortex (ACC) but decreased CFH in bilateral postcentral gyrus (PCG) and superior occipital gyrus (SOG). Further there were significant correlations between these regional CFH and anxiety symptoms severity. GAD patients demonstrate right hemispheric specialization and aberrant inter-hemispheric functional cooperation, and abnormal inter-hemispheric coordination is associated with anxiety symptom severity. These findings provide a clue to understanding the neuropathological mechanisms of GAD.
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Affiliation(s)
- Qianqian Li
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Ting Zhang
- Department of Psychiatry, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Jie Meng
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Lu Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Qiang Hua
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Xiao-Hui Xie
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China
| | - Gong-Jun Ji
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Tong-Jian Bai
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China.
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, Anhui Province, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China.
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5
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Vargas TG, Mittal VA. Brain morphometry points to emerging patterns of psychosis, depression, and anxiety vulnerability over a 2-year period in childhood. Psychol Med 2023; 53:3322-3334. [PMID: 37323064 PMCID: PMC10276191 DOI: 10.1017/s0033291721005304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Gray matter morphometry studies have lent seminal insights into the etiology of mental illness. Existing research has primarily focused on adults and then, typically on a single disorder. Examining brain characteristics in late childhood, when the brain is preparing to undergo significant adolescent reorganization and various forms of serious psychopathology are just first emerging, may allow for a unique and highly important perspective of overlapping and unique pathogenesis. METHODS A total of 8645 youth were recruited as part of the Adolescent Brain and Cognitive Development study. Magnetic resonance imaging scans were collected, and psychotic-like experiences (PLEs), depressive, and anxiety symptoms were assessed three times over a 2-year period. Cortical thickness, surface area, and subcortical volume were used to predict baseline symptomatology and symptom progression over time. RESULTS Some features could possibly signal common vulnerability, predicting progression across forms of psychopathology (e.g. superior frontal and middle temporal regions). However, there was a specific predictive value for emerging PLEs (lateral occipital and precentral thickness), anxiety (parietal thickness/area and cingulate), and depression (e.g. parahippocampal and inferior temporal). CONCLUSION Findings indicate common and distinct patterns of vulnerability for varying forms of psychopathology are present during late childhood, before the adolescent reorganization, and have direct relevance for informing novel conceptual models along with early prevention and intervention efforts.
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Affiliation(s)
- Teresa G Vargas
- Northwestern University, Swift Hall 102, 2029 Sheridan Road, Evanston, IL 60201, USA
| | - Vijay A Mittal
- Northwestern University, Swift Hall 102, 2029 Sheridan Road, Evanston, IL 60201, USA
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Zheng A, Chen X, Li Q, Ling Y, Liu X, Li W, Liu Y, Chen H. Neural correlates of Type A personality: Type A personality mediates the association of resting-state brain activity and connectivity with eating disorder symptoms. J Affect Disord 2023; 333:331-341. [PMID: 37086800 DOI: 10.1016/j.jad.2023.04.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/05/2023] [Accepted: 04/16/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Type A personality (TAP) was characterized by impatience, competitiveness, aggressiveness, and hostility. Higher TAP was proved to be associated with more eating disorder symptoms (EDS). While little is known about the underlying neural substrates of TAP and how TAP is linked to EDS at the neural level. METHODS To investigate the neural basis of TAP, we adopted fractional amplitude of low-frequency fluctuations (fALFF) and resting-state functional connectivity (RSFC) via resting-state functional magnetic resonance imaging (rs-fMRI) (N = 1620). Mediation models were examined to explore the relationship between TAP, EDS, and brain activity. RESULTS TAP was associated with decreased fALFF in the left middle frontal gyrus (MFG) and increased fALFF in the left precentral gyrus (PreCG). Furthermore, TAP was positively correlated to RSFC between the left MFG and left inferior temporal gyrus (ITG) and between the left PreCG and right middle temporal gyrus (MTG). Mediation analysis showed TAP fully mediated the association of the left MFG activity, MFG-ITG connectivity, and PreCG-MTG connectivity with EDS. LIMITATIONS The cross-sectional design of this study precludes us from specifying the causal relationship in the associations we observed. CONCLUSIONS Our results suggested spontaneous activity in the left MFG and PreCG is associated with TAP, and even in general sample, people with higher TAP showed more EDS. The present study is the first to investigate the neurobiological underpinnings of TAP in a large sample and further offered new insights into the relation between TAP and EDS from a neural basis perspective.
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Affiliation(s)
- Anqi Zheng
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Ximei Chen
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Qingqing Li
- School of Psychology, Central China Normal University, China
| | - Ying Ling
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Xinyuan Liu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Wei Li
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Yong Liu
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Hong Chen
- Key Laboratory of Cognition and Personality (SWU), Ministry of Education, Chongqing 400715, China; Faculty of Psychology, Southwest University, Chongqing 400715, China; Research Center of Psychology and Social Development, Chongqing 400715, China.
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Caulfield MK, Hallion LS. Impaired disengagement from worry: Dissociating the impacts of valence and internally-directed attention. Behav Res Ther 2023; 161:104242. [PMID: 36641981 PMCID: PMC9892290 DOI: 10.1016/j.brat.2022.104242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/30/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022]
Abstract
Worry is a repetitive, negative thought process that is widely experienced as difficult to control. Despite the adverse effects of uncontrollable worry on academic and other role functioning, the mechanisms by which worry becomes uncontrollable remain poorly understood. Previous experimental work has historically emphasized valence (negative versus positive or neutral). However, contemporary cognitive neuroscience also distinguishes between internally-directed attention (e.g., to thoughts) and externally-directed attention (e.g., to perceptual stimuli). To date, no studies have experimentally examined potential dissociable contributions of valence versus attentional direction to impaired disengagement from worry. In a 2 (negative or neutral valence) x 2 (internal or external attention) between-subjects, experimental and prospective design (https://osf.io/vdyfn/), participants (N = 200) completed alternating blocks of a randomly-assigned attention manipulation and validated sustained attention task. Participants also rated trait worry and distress during the experimental session (T1) and a naturalistic stressor (the week before finals; T2). There was a main effect, such that internally-directed attention impaired sustained attention (increased commission errors). Worry (internal x negative) also impaired sustained attention (faster and less accurate responding) in planned group contrasts. Trait worry did not moderate these effects. Sustained attention at T1 did not predict distress or worry during the T2 stressor. These findings augment the literature on the attentional consequences of worry and replicate and extend previous findings of altered speed-accuracy tradeoffs following experimentally-induced worry. We also find evidence for impaired disengagement from internally-directed (versus externally-directed) attention, which may help to explain impaired disengagement from related forms of perseverative thought (e.g., rumination).
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Affiliation(s)
- Mary K Caulfield
- Department of Psychology, University of Pittsburgh, United States
| | - Lauren S Hallion
- Department of Psychology, University of Pittsburgh, United States.
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Baggio T, Grecucci A, Meconi F, Messina I. Anxious Brains: A Combined Data Fusion Machine Learning Approach to Predict Trait Anxiety from Morphometric Features. SENSORS (BASEL, SWITZERLAND) 2023; 23:610. [PMID: 36679404 PMCID: PMC9863274 DOI: 10.3390/s23020610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/30/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
Trait anxiety relates to the steady propensity to experience and report negative emotions and thoughts such as fear and worries across different situations, along with a stable perception of the environment as characterized by threatening stimuli. Previous studies have tried to investigate neuroanatomical features related to anxiety mostly using univariate analyses and thus giving rise to contrasting results. The aim of this study is to build a predictive model of individual differences in trait anxiety from brain morphometric features, by taking advantage of a combined data fusion machine learning approach to allow generalization to new cases. Additionally, we aimed to perform a network analysis to test the hypothesis that anxiety-related networks have a central role in modulating other networks not strictly associated with anxiety. Finally, we wanted to test the hypothesis that trait anxiety was associated with specific cognitive emotion regulation strategies, and whether anxiety may decrease with ageing. Structural brain images of 158 participants were first decomposed into independent covarying gray and white matter networks with a data fusion unsupervised machine learning approach (Parallel ICA). Then, supervised machine learning (decision tree) and backward regression were used to extract and test the generalizability of a predictive model of trait anxiety. Two covarying gray and white matter independent networks successfully predicted trait anxiety. The first network included mainly parietal and temporal regions such as the postcentral gyrus, the precuneus, and the middle and superior temporal gyrus, while the second network included frontal and parietal regions such as the superior and middle temporal gyrus, the anterior cingulate, and the precuneus. We also found that trait anxiety was positively associated with catastrophizing, rumination, other- and self-blame, and negatively associated with positive refocusing and reappraisal. Moreover, trait anxiety was negatively associated with age. This paper provides new insights regarding the prediction of individual differences in trait anxiety from brain and psychological features and can pave the way for future diagnostic predictive models of anxiety.
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Affiliation(s)
- Teresa Baggio
- Clinical and Affective Neuroscience Lab (CLI.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
| | - Alessandro Grecucci
- Clinical and Affective Neuroscience Lab (CLI.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
- Centre for Medical Sciences, CISMed, University of Trento, 38122 Trento, Italy
| | - Federica Meconi
- Clinical and Affective Neuroscience Lab (CLI.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
| | - Irene Messina
- Clinical and Affective Neuroscience Lab (CLI.A.N. Lab), Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, 38068 Rovereto, Italy
- Department of Economics, Universitas Mercatorum, 00186 Rome, Italy
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9
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Kong Z, Zhu X, Chang S, Bao Y, Ma Y, Yu W, Zhu R, Sun Q, Sun W, Deng J, Sun H. Somatic symptoms mediate the association between subclinical anxiety and depressive symptoms and its neuroimaging mechanisms. BMC Psychiatry 2022; 22:835. [PMID: 36581819 PMCID: PMC9798660 DOI: 10.1186/s12888-022-04488-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 12/20/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Subclinical anxiety, depressive and somatic symptoms appear closely related. However, it remains unclear whether somatic symptoms mediate the association between subclinical anxiety and depressive symptoms and what the underlying neuroimaging mechanisms are for the mediating effect. METHODS Data of healthy participants (n = 466) and participants in remission of major depressive disorder (n = 53) were obtained from the Human Connectome Project. The Achenbach Adult Self-Report was adopted to assess anxiety, depressive and somatic symptoms. All participants completed four runs of resting-state functional magnetic resonance imaging. Mediation analyses were utilized to explore the interactions among these symptoms and their neuroimaging mechanisms. RESULTS Somatic symptoms partially mediated the association between subclinical anxiety and depressive symptoms in healthy participants (anxiety→somatic→depression: effect: 0.2785, Boot 95% CI: 0.0958-0.3729; depression→somatic→anxiety: effect: 0.0753, Boot 95% CI: 0.0232-0.1314) and participants in remission of MDD (anxiety→somatic→depression: effect: 0.2948, Boot 95% CI: 0.0357-0.7382; depression→somatic→anxiety: effect: 0.0984, Boot 95% CI: 0.0007-0.2438). Resting-state functional connectivity (FC) between the right medial superior frontal gyrus and the left thalamus and somatic symptoms as chain mediators partially mediated the effect of subclinical depressive symptoms on subclinical anxiety symptoms in healthy participants (effect: 0.0020, Boot 95% CI: 0.0003-0.0043). The mean strength of common FCs of subclinical depressive and somatic symptoms, somatic symptoms, and the mean strength of common FCs of subclinical anxiety and somatic symptoms as chain mediators partially mediated the effect of subclinical depressive symptoms on subclinical anxiety symptoms in remission of MDD (effect: 0.0437, Boot 95% CI: 0.0024-0.1190). These common FCs mainly involved the insula, precentral gyri, postcentral gyri and cingulate gyri. Furthermore, FC between the triangular part of the left inferior frontal gyrus and the left postcentral gyrus was positively associated with subclinical anxiety, depressive and somatic symptoms in remission of MDD (FDR-corrected p < 0.01). CONCLUSIONS Somatic symptoms partially mediate the interaction between subclinical anxiety and depressive symptoms. FCs involving the right medial superior frontal gyrus, left thalamus, triangular part of left inferior frontal gyrus, bilateral insula, precentral gyri, postcentral gyri and cingulate gyri maybe underlie the mediating effect of somatic symptoms.
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Affiliation(s)
- Zhifei Kong
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Ximei Zhu
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Suhua Chang
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Yanping Bao
- grid.11135.370000 0001 2256 9319National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, 100191 China ,grid.11135.370000 0001 2256 9319School of Public Health, Peking University, Beijing, 100191 China
| | - Yundong Ma
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Wenwen Yu
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Ran Zhu
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Qiqing Sun
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Wei Sun
- grid.459847.30000 0004 1798 0615Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191 China
| | - Jiahui Deng
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
| | - Hongqiang Sun
- Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, 100191, China.
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10
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Liu X, Klugah-Brown B, Zhang R, Chen H, Zhang J, Becker B. Pathological fear, anxiety and negative affect exhibit distinct neurostructural signatures: evidence from psychiatric neuroimaging meta-analysis. Transl Psychiatry 2022; 12:405. [PMID: 36151073 PMCID: PMC9508096 DOI: 10.1038/s41398-022-02157-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 11/24/2022] Open
Abstract
Internalizing disorders encompass anxiety, fear and depressive disorders, which exhibit overlap at both conceptual and symptom levels. Given that a neurobiological evaluation is lacking, we conducted a Seed-based D-Mapping comparative meta-analysis including coordinates as well as original statistical maps to determine common and disorder-specific gray matter volume alterations in generalized anxiety disorder (GAD), fear-related anxiety disorders (FAD, i.e., social anxiety disorder, specific phobias, panic disorder) and major depressive disorder (MDD). Results showed that GAD exhibited disorder-specific altered volumes relative to FAD including decreased volumes in left insula and lateral/medial prefrontal cortex as well as increased right putamen volume. Both GAD and MDD showed decreased prefrontal volumes compared to controls and FAD. While FAD showed less robust alterations in lingual gyrus compared to controls, this group presented intact frontal integrity. No shared structural abnormalities were found. Our study is the first to provide meta-analytic evidence for distinct neuroanatomical abnormalities underlying the pathophysiology of anxiety-, fear-related and depressive disorders. These findings may have implications for determining promising target regions for disorder-specific neuromodulation interventions (e.g. transcranial magnetic stimulation or neurofeedback).
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Affiliation(s)
- Xiqin Liu
- grid.54549.390000 0004 0369 4060The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, P. R. China
| | - Benjamin Klugah-Brown
- grid.54549.390000 0004 0369 4060The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, P. R. China
| | - Ran Zhang
- grid.54549.390000 0004 0369 4060The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, P. R. China
| | - Huafu Chen
- grid.54549.390000 0004 0369 4060The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, P. R. China
| | - Jie Zhang
- grid.8547.e0000 0001 0125 2443Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, 200433 Shanghai, P. R. China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Fudan University, Ministry of Education, 200433 Shanghai, P. R. China
| | - Benjamin Becker
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731, Chengdu, P. R. China.
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11
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Bashford‐Largo J, Zhang R, Mathur A, Elowsky J, Schwartz A, Dobbertin M, Blair RJR, Blair KS, Bajaj S. Reduced cortical volume of the default mode network in adolescents with generalized anxiety disorder. Depress Anxiety 2022; 39:485-495. [PMID: 35312127 PMCID: PMC9246827 DOI: 10.1002/da.23252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 03/03/2022] [Accepted: 03/06/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Widespread structural alterations have been shown to be implicated in individuals with generalized anxiety disorder (GAD). However, there have been inconsistent findings in cortical volume (CV) differences. Most structural neuroimaging studies looking at GAD used region-based approach with relatively small sample sizes, let alone be specific to adolescents with GAD. We believe this is the first study to look at CV measures using a network-based approach in a larger sample of adolescents with GAD. The goal of the current study was to focus on three different brain networks (i.e., Limbic, Frontoparietal, and Default Mode Network [DMN]) in adolescents with GAD. METHOD The study involved 81 adolescents with GAD and 112 typically developing (TD) comparison individuals matched on age (15.98 and 15.63 respective means), sex (42F/39M and 45F/67M), and IQ (101.90 and 103.94 respective means). Participants underwent structural MRI. Freesurfer was used to estimate CV (both network-specific and region-specific within networks) and region-specific sub-cortical volume measures. Multivariate analysis of covariance (MANCOVA; with sex, age, IQ, and intracranial volume [ICV] as potential covariates) was used to estimate group differences. RESULTS We found significantly lower CV for the DMN in adolescents with GAD, compared with TD individuals. Adolescents with GAD also showed significantly lower hemispheric mean CV of the default-mode regions (particularly the prefrontal and temporal regions) and the hippocampus, compared with TD individuals. CONCLUSION The current findings suggest structural alterations in adolescents with GAD. These structural alterations will need to be addressed when implementing and developing treatments for patients with GAD.
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Affiliation(s)
- Johannah Bashford‐Largo
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA,Center for Brain, Biology, and BehaviorUniversity of Nebraska‐LincolnLincolnNebraskaUSA
| | - Ru Zhang
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Avantika Mathur
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Jaimie Elowsky
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Amanda Schwartz
- Department of PsychologyUniversity of North DakotaGrand ForksNorth DakotaUSA
| | - Matthew Dobbertin
- Inpatient Psychiatric Care UnitBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Robert James R. Blair
- Child and Adolescent Mental Health Centre, Mental Health ServicesCapital Region of DenmarkCopenhagenDenmark
| | - Karina S. Blair
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
| | - Sahil Bajaj
- Multimodal Clinical Neuroimaging Laboratory (MCNL), Center for Neurobehavioral ResearchBoys Town National Research HospitalBoys TownNebraskaUSA
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12
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Kirk PA, Davidson Bryan A, Garfinkel SN, Robinson OJ. RapidHRV: an open-source toolbox for extracting heart rate and heart rate variability. PeerJ 2022; 10:e13147. [PMID: 35345583 PMCID: PMC8957280 DOI: 10.7717/peerj.13147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 03/01/2022] [Indexed: 01/12/2023] Open
Abstract
Heart rate and heart rate variability have enabled insight into a myriad of psychophysiological phenomena. There is now an influx of research attempting using these metrics within both laboratory settings (typically derived through electrocardiography or pulse oximetry) and ecologically-rich contexts (via wearable photoplethysmography, i.e., smartwatches). However, these signals can be prone to artifacts and a low signal to noise ratio, which traditionally are detected and removed through visual inspection. Here, we developed an open-source Python package, RapidHRV, dedicated to the preprocessing, analysis, and visualization of heart rate and heart rate variability. Each of these modules can be executed with one line of code and includes automated cleaning. In simulated data, RapidHRV demonstrated excellent recovery of heart rate across most levels of noise (>=10 dB) and moderate-to-excellent recovery of heart rate variability even at relatively low signal to noise ratios (>=20 dB) and sampling rates (>=20 Hz). Validation in real datasets shows good-to-excellent recovery of heart rate and heart rate variability in electrocardiography and finger photoplethysmography recordings. Validation in wrist photoplethysmography demonstrated RapidHRV estimations were sensitive to heart rate and its variability under low motion conditions, but estimates were less stable under higher movement settings.
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Affiliation(s)
- Peter A. Kirk
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom,Experimental Psychology, University College London, University of London, London, United Kingdom
| | | | - Sarah N. Garfinkel
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom
| | - Oliver J. Robinson
- Institute of Cognitive Neuroscience, University College London, University of London, London, United Kingdom,Clinical, Educational and Health Psychology, University College London, University of London, London, United Kingdom
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13
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Cao J, Huang Y, Hodges SA, Meshberg N, Kong J. Identify potential neuroimaging-based scalp acupuncture and neuromodulation targets for anxiety. BRAIN SCIENCE ADVANCES 2021. [DOI: 10.26599/bsa.2021.9050011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Anxiety is a common psychiatric symptom with unsatisfactory treatment. Scalp acupuncture is a new type of acupuncture based on the functions of different brain regions. However, recent brain neuroimaging findings have not been well-integrated into scalp acupuncture practice and research since it was developed. In parallel, recently developed brain stimulation methods have also been applied to treat anxiety. In this study, we integrated meta-analysis (using Neurosynth), resting-state functional connectivity, and diffusion tensor imaging (using the amygdala as the region of interest) to identify potential locations of scalp acupuncture/neuromodulation for anxiety. We found that the superior/middle frontal gyrus, middle/superior temporal gyrus, precentral gyrus, supplementary motor area, supramarginal gyrus, angular gyrus, and superior/inferior occipital gyrus are involved in the pathophysiology of anxiety, and, thus, may be used as the target areas of scalp stimulation for alleviating anxiety. Integrating multidisciplinary brain methods to identify key surface cortical areas associated with a certain disorder may shed light on the development of scalp acupuncture/neuromodulation, particularly in the domain of identifying stimulation locations.
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Affiliation(s)
- Jin Cao
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
| | - Yiting Huang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
| | - Sierra A. Hodges
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
| | - Nathaniel Meshberg
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
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14
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Zainal NH, Newman MG. Larger increase in trait negative affect is associated with greater future cognitive decline and vice versa across 23 years. Depress Anxiety 2021; 38:146-160. [PMID: 32840954 PMCID: PMC7902413 DOI: 10.1002/da.23093] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/16/2020] [Accepted: 08/03/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Trait negative affect (NA) is a central feature of anxiety and depression disorders. Neurocognitive and scar models propose that within-person increase in NA across one period of time relates to a decline in cognitive functioning at a future period of time and vice versa. Yet, there has been little research on whether a within-person change in trait NA across one time-lag precedes and is associated with a change in cognition across a future time lag and vice versa. Due to a growing aging population, such knowledge can inform evidence-based prevention. METHODS Participants were 520 dementia-free community-dwelling adults (mean age = 59.76 years [standard deviation = 8.96], 58.08% females). Trait-level NA (negative emotionality scale), spatial cognition (block design and card rotations), verbal working memory (WM; digit span backward), and processing speed (symbol digit modalities) were assessed at five time points (waves) across 23 years. Bivariate dual latent change score (LCS) approaches were used to adjust for regression to the mean, lagged outcomes, and between-person variability. RESULTS Unique bivariate LCS models showed that within-person increase in trait NA across two sequential waves was related to declines in spatial cognition, verbal WM, and processing speed across the subsequent two waves. Moreover, within-person reductions in spatial cognition, verbal WM, and processing speed across two sequential waves were associated with future increases in trait NA across the subsequent two waves. CONCLUSIONS Findings concur with neurobiological and scar theories of psychopathology. Furthermore, results support process-based emotion regulation models that highlight the importance of verbal WM, spatial cognition, and processing speed capacities for downregulating NA.
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Affiliation(s)
- Nur Hani Zainal
- To whom all correspondence should be addressed. 378 Moore Building, Department of Psychology, The Pennsylvania State University, University Park, PA 16802. . Telephone: 814-863-0115. Fax: (814) 863-7002
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15
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Fishback GM, Chriki L, Thayer JF, Vasey MW. Heart Rate Variability Moderates the Association Between Beliefs About Worry and Generalized Anxiety Disorder Symptoms. Front Neurosci 2020; 14:569359. [PMID: 33132829 PMCID: PMC7579429 DOI: 10.3389/fnins.2020.569359] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/07/2020] [Indexed: 01/04/2023] Open
Abstract
Paradoxically, some individuals who experience pathological worry also have good capacity for top-down control over their thoughts. Why such individuals would nevertheless worry excessively remains unclear. One explanation is suggested by research showing that those experiencing pathological worry are set apart from healthy controls by their beliefs that worry has utility and that effective worrying requires them to consider all possibilities before terminating a worry bout. This suggests that worriers with good capacity for cognitive control may engage in prolonged worry because they believe it is adaptive to do so. In a sample of 109 college students, among whom individuals reporting pathological worry were overrepresented, we tested this hypothesis using an objective index of top-down control capacity (i.e., resting vagally mediated heart rate variability [vmHRV]) and self-report measures of beliefs about worry and generalized anxiety disorder (GAD) symptom severity/status. As predicted, GAD symptom severity and vmHRV interacted to predict beliefs about worry. Specifically, high GAD symptoms were most strongly associated with beliefs that worry has utility at higher levels of vmHRV. Furthermore, this pattern was mostly a function of the belief that worry serves to distract the worrier from more emotional things. Similarly, high GAD symptoms were most strongly associated with endorsement of an ‘as many as can’ (AMAC) problem-solving rule when vmHRV was high. From the opposite perspective, both worry utility beliefs and AMAC rule endorsement were associated with the highest GAD symptom severity at higher levels of vmHRV. This was also true for the belief that worry distracts from more emotional things predicting analog GAD status. These results suggest that worriers who have higher levels of top-down control capacity may initiate and persist in worry, at least initially, because they value it. However, why they nevertheless rate their worry as excessive and uncontrollable is an important question for future research.
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Affiliation(s)
- Grace M Fishback
- Department of Neurology, University of Colorado School of Medicine, Denver, CO, United States
| | | | - Julian F Thayer
- Department of Psychological Science, School of Social Ecology, University of California, Irvine, Irvine, CA, United States
| | - Michael W Vasey
- Department of Psychology, The Ohio State University, Columbus, OH, United States
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16
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Progressive brain structural alterations assessed via causal analysis in patients with generalized anxiety disorder. Neuropsychopharmacology 2020; 45:1689-1697. [PMID: 32396920 PMCID: PMC7419314 DOI: 10.1038/s41386-020-0704-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 04/13/2020] [Accepted: 05/04/2020] [Indexed: 12/17/2022]
Abstract
Accumulating neuroimaging studies implicate widespread brain structural alterations in patients with generalized anxiety disorder (GAD), but little is known regarding the temporal information of these changes and their causal relationships. In this study, a morphometric analysis was performed on T1-weighted structural images, and the progressive changes in the gray matter volume (GMV) in GAD were simulated by dividing the patients into different groups from low illness duration to high illness duration. The duration was defined as the interval between the onset of GAD and the time for magnetic resonance imaging collection. Then, a causal structural covariance network analysis was conducted to describe the causal relationships of the brain structural alterations in GAD. With increased illness duration, the GMV reduction in GAD originated from the subgenual anterior cingulate cortex (sgACC) and propagated to the bilateral ventromedial prefrontal cortex, right dorsomedial prefrontal cortex, left inferior temporal gyrus, and right insula. Intriguingly, the sgACC and the right insula had positive causal effects on each other. Moreover, both sgACC and right insula exhibited positive causal effects on the parietal cortex and negative effects on the posterior cingulate cortex, dorsolateral prefrontal cortex, visual cortex, and temporal lobe. The opposite causal effects were noted on the somatosensory and the ventrolateral prefrontal cortices. In conclusion, patients with GAD show gradual GMV reduction with increasing ilness duration. Furthermore, the causal effects of the sgACC and the right insula GMV reduction with shifts of duration may provide an important new avenue for understanding the pathological anomalies in GAD.
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17
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Disrupted dynamic local brain functional connectivity patterns in generalized anxiety disorder. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109833. [PMID: 31812780 DOI: 10.1016/j.pnpbp.2019.109833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 11/01/2019] [Accepted: 12/03/2019] [Indexed: 01/14/2023]
Abstract
Previous studies have reported abnormalities in static brain activity and connectivity in patients with generalized anxiety disorder (GAD). However, the dynamic patterns of brain connectivity in patients with GAD have not been fully explored. In this study, we aimed to investigate the dynamic local brain functional connectivity in patients with GAD using dynamic regional phase synchrony (DRePS), a newly developed method for assessing intrinsic dynamic local functional connectivity. Seventy-four patients with GAD and 74 healthy controls (HCs) were enrolled and underwent resting-state functional magnetic resonance imaging. Compared to the HCs, patients with GAD exhibited decreased DRePS values in the bilateral caudate, left hippocampus, left anterior insula, left inferior frontal gyrus, and right fusiform gyrus extending to inferior temporal gyrus. The DRePS value of the left hippocampus was negatively correlated with the Hamilton Anxiety Rating Scale scores. Moreover, these abnormal DRePS patterns could be used to distinguish patients with GAD from HCs in an independent sample (18 patients with GAD and 21 HCs). Our findings provide further evidence on brain dysfunction in GAD from the perspective of the dynamic behaviour of local connections, suggesting that patients with GAD may have an insufficient brain adaptation. This study provides new insights into the neurocognitive mechanism of GAD and could potentially inform the diagnosis and treatment of this disease. Future studies on GAD could benefit from combining the DRePS method with task-related functional magnetic resonance imaging and non-invasive brain stimulation.
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18
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Porta-Casteràs D, Fullana MA, Tinoco D, Martínez-Zalacaín I, Pujol J, Palao DJ, Soriano-Mas C, Harrison BJ, Via E, Cardoner N. Prefrontal-amygdala connectivity in trait anxiety and generalized anxiety disorder: Testing the boundaries between healthy and pathological worries. J Affect Disord 2020; 267:211-219. [PMID: 32217221 DOI: 10.1016/j.jad.2020.02.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 01/17/2020] [Accepted: 02/08/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Current brain-based theoretical models of generalized anxiety disorder (GAD) suggest a dysfunction of amygdala-ventromedial prefrontal cortex emotional regulatory mechanisms. These alterations might be reflected by an altered resting state functional connectivity between both areas and could extend to vulnerable non-clinical samples such as high worriers without a GAD diagnosis. However, there is a lack of information in this regard. METHODS We investigated differences in resting state functional connectivity between the basolateral amygdala and the ventromedial prefrontal cortex (amygdala-vmPFC) in 28 unmedicated participants with GAD, 28 high-worriers and 28 low-worriers. We additionally explored selected clinical variables as predictors of amygdala-vmPFC connectivity, including anxiety sensitivity. RESULTS GAD participants presented higher left amygdala-vmPFC connectivity compared to both groups of non-GAD participants, and there were no differences between the latter two groups. In our exploratory analyses, concerns about the cognitive consequences of anxiety (the cognitive dimension of anxiety sensitivity) were found to be a significant predictor of the left amygdala-vmPFC connectivity. LIMITATIONS The cross-sectional nature of our study preclude us from assessing if functional connectivity measures and anxiety sensitivity scores entail an increased risk of GAD. CONCLUSIONS These results suggest a neurobiological qualitative distinction at the level of the amygdala-vmPFC emotional-regulatory system in GAD compared to non-GAD participants, either high- or low-worriers. At this neural level, they question previous hypotheses of continuity between high worries and GAD development. Instead, other anxiety traits such as anxiety sensitivity might confer a greater proneness to the amygdala-vmPFC connectivity alterations observed in GAD.
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Affiliation(s)
- D Porta-Casteràs
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - M A Fullana
- Institute of Neurosciences, Hospital Clinic, CIBERSAM, Barcelona, Spain
| | - D Tinoco
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - I Martínez-Zalacaín
- Department of Psychiatry, Bellvitge University Hospital -IDIBELL, CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - J Pujol
- MRI Research Unit,Hospital del Mar, CIBERSAM G21, Barcelona,Spain
| | - D J Palao
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
| | - C Soriano-Mas
- Department of Psychiatry, Bellvitge University Hospital -IDIBELL, CIBERSAM, Carlos III Health Institute, Barcelona, Spain; Department of Psychobiology and Methodology of Health Sciences. Universitat Autònoma de Barcelona, Barcelona, Spain
| | - B J Harrison
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Victoria, Australia
| | - E Via
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu of Barcelona, Barcelona, Spain; Child and Adolescent Mental Health Research Group, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.
| | - N Cardoner
- Mental Health Department, Unitat de Neurociència Traslacional. Parc Taulí University Hospital, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, CIBERSAM, Carlos III Health Institute, Bellaterra, Spain; Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
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19
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Hallion LS, Kusmierski SN, Caulfield MK. Worry alters speed-accuracy tradeoffs but does not impair sustained attention. Behav Res Ther 2020; 128:103597. [PMID: 32217356 DOI: 10.1016/j.brat.2020.103597] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 02/06/2020] [Accepted: 02/26/2020] [Indexed: 10/24/2022]
Abstract
Worry has been experimentally linked to a range of cognitive consequences, including impairments in working memory, inhibition, and cognitive control. However, findings are mixed, and the effects of worry on other phenomenologically-relevant constructs, such as sustained attention, have received less attention. Potential confounds such as speed-accuracy tradeoffs have also received little attention, as have psychometric and related design considerations, and potential moderators beyond trait worry. The present study investigated the effects of experimentally-induced worry versus a neutral control condition on speed-accuracy tradeoff-corrected performance on a validated measure of sustained attention (88 participants; within-subjects). Moderation by trait worry and trait mindfulness was probed in confirmatory and exploratory analyses, respectively. Worry led to faster and less accurate responding relative to the neutral comparison condition. There was no main effect of condition or trait worry on sustained attention after accounting for speed-accuracy tradeoffs. In exploratory analyses, higher trait mindfulness was robustly related to better post-worry performance, including after controlling for trait worry, general distress, and post-neutral performance, and correction for multiple comparisons. Follow-up analyses exploring dissociable mindfulness facets found a robust relationship between present-moment attention and post-worry performance. Future research should experimentally manipulate mindfulness facets to probe causality and inform treatment development.
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Affiliation(s)
- Lauren S Hallion
- Department of Psychology, University of Pittsburgh, USA; Center for the Neural Basis of Cognition, University of Pittsburgh, USA.
| | | | - M Kathleen Caulfield
- Department of Psychology, University of Pittsburgh, USA; Center for the Neural Basis of Cognition, University of Pittsburgh, USA
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20
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Li H, Zhang B, Hu Q, Zhang L, Jin Y, Wang J, Cui H, Pang J, Li C. Altered heartbeat perception sensitivity associated with brain structural alterations in generalised anxiety disorder. Gen Psychiatr 2020; 33:e100057. [PMID: 32175522 PMCID: PMC7047474 DOI: 10.1136/gpsych-2019-100057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 10/08/2019] [Accepted: 11/28/2019] [Indexed: 11/05/2022] Open
Abstract
Background Palpitation is a common complaint in generalised anxiety disorder (GAD). Brain imaging studies have investigated the neural mechanism of heartbeat perception in healthy volunteers. This study explored the neuroanatomical differences of altered heartbeat perception in patients with GAD using structural MRI. Aims Based on the strong somatic-interoceptive symptoms in GAD, we explored the regional structural brain abnormalities involved in heartbeat perception in patients with GAD. Methods This study was applied to the a priori regions using neuroanatomical theories of heartbeat perception, including the insula, anterior cingulate cortex, supplementary motor area and prefrontal cortex. A total of 19 patients with GAD and 19 healthy control subjects were enrolled. We used the FMRIB Software Library voxel-based morphometry software for estimating the grey matter volume of these regions of interest and analysed the correlation between heartbeat perception sensitivity and the volume of abnormal grey matter. Results Patients with GAD showed a significantly decreased volume of grey matter in their left medial prefrontal cortex, right orbital frontal cortex and anterior cingulate cortex. The grey matter volume of the left medial prefrontal cortex negatively correlated with heartbeat perception sensitivity in patients with GAD. Conclusions It should be the first study that shows heartbeat perception is associated with brain structure in GAD. Our findings suggest that the frontal region may play an important role in aberrant heartbeat perception processing in patients with GAD, and this may be an underlying mechanism resulting in the abnormal cardiovascular complaints in GAD. This is hypothesised as a ‘top-down’ deficiency, especially in the medial prefrontal cortex. This will provide the foundation for a more targeted region for neuromodulation intervention in the future.
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Affiliation(s)
- Hui Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Zhang
- Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Qiang Hu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lanlan Zhang
- Department of Psychiatry, Suzhou Guangji Hospital, Suzhou, China
| | - Yi Jin
- Institute of Psychology, Chinese Academy of Sciences, Shanghai, China
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huiru Cui
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaoyan Pang
- Department of Psychology, Shanghai University of Political Science and Law, Shanghai, China.,Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunbo Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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21
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Personalized Clinical Approaches to Anxiety Disorders. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:489-521. [DOI: 10.1007/978-981-32-9705-0_25] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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22
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Northoff G. Anxiety Disorders and the Brain's Resting State Networks: From Altered Spatiotemporal Synchronization to Psychopathological Symptoms. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:71-90. [PMID: 32002923 DOI: 10.1007/978-981-32-9705-0_5] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Anxiety disorders include a variety of different disorders including panic disorder (PD), social anxiety disorder (SAD), generalized anxiety disorder (GAD), and phobias. We here focus our review on GAD, SAD, and PD and put a specific emphasis on resting state networks and the coupling between the brain and the heart as all anxiety disorders exhibit abnormal perception of their own heartbeat in some way or the other. Resting state functional connectivity (rsFC) studies demonstrate abnormalities in default-mode network (DMN) in all anxiety disorders, e.g., mostly decreases in rsFC of DMN. In contrast, resting state fMRI shows increased rsFC in salience network (SN) (SAD, GAD) and/or somato-motor/sensory network (SMN) (PD). Since rsFC is coherence- or phase-based operating in the infraslow frequency domain (0.01-0.1 Hz), these data suggest spatiotemporal hypo- or hyper-synchronization in DMN and SMN/SN, respectively. These abnormalities in the neural network's spatiotemporal synchronization may, in turn, impact phase-based temporal synchronization of neural and cardiac activities resulting in decreased (DMN) or increased (SMN/SN) neuro-cardiac coupling in anxiety disorders. That, in turn, may be related to the various psychopathological symptoms like unstable sense of self (as based on unstable DMN showing spatiotemporal hypo-synchronization), increased emotions and specifically anxiety (as related to increased SN showing spatiotemporal hyper-synchronization), and increased bodily awareness (mediated by increased SMN with spatiotemporal hyper-synchronization) in anxiety disorders. Taken together, we here suggest altered spatiotemporal synchronization of neural and cardiac activity within the brain's resting state to underlie various psychopathological symptoms in anxiety disorders. Such spatiotemporal basis of psychopathological symptoms is well compatible with the recently suggested "Spatiotemporal Psychopathology."
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Affiliation(s)
- Georg Northoff
- EJLB-Michael Smith Chair for Neuroscience and Mental Health, Royal Ottawa Healthcare Group, University of Ottawa Institute of Mental Health Research, Ottawa, ON, Canada.
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23
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The spontaneous activity and functional network of the occipital cortex is correlated with state anxiety in healthy adults. Neurosci Lett 2019; 715:134596. [PMID: 31711976 DOI: 10.1016/j.neulet.2019.134596] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/09/2019] [Accepted: 10/28/2019] [Indexed: 12/22/2022]
Abstract
The occipital lobe has been implicated in anxiety disorder, however, its contributions to anxiety in healthy adults remain less clear. We conducted a resting-state functional magnetic resonance imaging study to explore the relationship between the amplitude of low-frequency fluctuation (ALFF), functional connectivity (FC), and state anxiety level in the healthy population. First, the results showed that the ALFF of the left inferior occipital gyrus (IOG) was negatively correlated with state anxiety. Furthermore, state anxiety was positively correlated with the FC between the left IOG and the right medial superior frontal gyrus and right cerebellum 8 area and negatively correlated with the FC between the left IOG and the left superior parietal gyrus. These results indicate that the occipital lobe of healthy individuals is involved in processing of anxiety in part through a frontal-parietal network.
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24
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Kolesar TA, Bilevicius E, Wilson AD, Kornelsen J. Systematic review and meta-analyses of neural structural and functional differences in generalized anxiety disorder and healthy controls using magnetic resonance imaging. NEUROIMAGE-CLINICAL 2019; 24:102016. [PMID: 31835287 PMCID: PMC6879983 DOI: 10.1016/j.nicl.2019.102016] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 12/18/2022]
Abstract
PFC-amygdala FC is altered in GAD, indicating top-down processing deficits. GAD had reduced activity for emotion regulation and working memory in the culmen. Salience, default, and central executive nodes have altered structure and function.
Objective To compare structure, functional connectivity (FC) and task-based neural differences in subjects with generalized anxiety disorder (GAD) compared to healthy controls (HC). Methods The Embase, Ovid Medline, PsycINFO, Scopus, and Web of Science databases were searched from inception until March 12, 2018. Two reviewers independently screened titles, abstracts, and full-text articles. Data were extracted from records directly contrasting GAD and HC that included structure (connectivity and local indices such as volume, etc.), FC, or task-based magnetic resonance imaging data. Meta-analyses were conducted, as applicable, using AES-SDM software. Results The literature search produced 4,645 total records, of which 85 met the inclusion criteria for the systematic review. Records included structural (n = 35), FC (n = 33), and task-based (n = 42) findings. Meta-analyses were conducted on voxel-based morphometry and task-based results. Discussion The systematic review confirms and extends findings from previous reviews. Although few whole-brain resting state studies were conducted, key nodes of resting state networks have altered physiology: the hippocampus (default network), ACC and amygdala (salience network), have reduced volume, and the dlPFC (central executive network) and ACC have reduced FC with the amygdala in GAD. Nodes in the sensorimotor network are also altered with greater pre- and postcentral volume, reduced supplementary motor area volume, and reduced FC in anterior and increased FC in posterior cerebellum. Conclusions Despite limitations due to sample size, the meta-analyses highly agree with the systematic review and provide evidence of widely distributed neural differences in subjects with GAD, compared to HC. Further research optimized for meta-analyses would greatly improve large-scale comparisons.
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Affiliation(s)
- Tiffany A Kolesar
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Alyssia D Wilson
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer Kornelsen
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada; Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.
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25
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Madonna D, Delvecchio G, Soares JC, Brambilla P. Structural and functional neuroimaging studies in generalized anxiety disorder: a systematic review. ACTA ACUST UNITED AC 2019; 41:336-362. [PMID: 31116259 PMCID: PMC6804309 DOI: 10.1590/1516-4446-2018-0108] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 08/16/2018] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Brain imaging studies carried out in patients suffering from generalized anxiety disorder (GAD) have contributed to better characterize the pathophysiological mechanisms underlying this disorder. The present study reviews the available functional and structural brain imaging evidence on GAD, and suggests further strategies for investigations in this field. METHODS A systematic literature review was performed in PubMed, PsycINFO, and Google Scholar, aiming to identify original research evaluating GAD patients with the use of structural and functional magnetic resonance imaging as well as diffusion tensor imaging. RESULTS The available studies have shown impairments in ventrolateral and dorsolateral prefrontal cortex, anterior cingulate, posterior parietal regions, and amygdala in both pediatric and adult GAD patients, mostly in the right hemisphere. However, the literature is often tentative, given that most studies have employed small samples and included patients with comorbidities or in current use of various medications. Finally, different methodological aspects, such as the type of imaging equipment used, also complicate the generalizability of the findings. CONCLUSIONS Longitudinal neuroimaging studies with larger samples of both juvenile and adult GAD patients, as well as at risk individuals and unaffected relatives, should be carried out in order to shed light on the specific biological signature of GAD.
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Affiliation(s)
- Domenico Madonna
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universitá di Milano, Milano, Italy.,Dipartimento di Neuroscienze e Salute Mentale, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giuseppe Delvecchio
- Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Universitá di Milano, Milano, Italy
| | - Jair C Soares
- Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Paolo Brambilla
- Dipartimento di Neuroscienze e Salute Mentale, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Psychiatry and Behavioral Sciences, University of Texas Health Sciences Center at Houston, Houston, TX, USA
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26
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Wang W, Peng Z, Wang X, Wang P, Li Q, Wang G, Chen F, Chen X, Liu S. Disrupted interhemispheric resting-state functional connectivity and structural connectivity in first-episode, treatment-naïve generalized anxiety disorder. J Affect Disord 2019; 251:280-286. [PMID: 30953893 DOI: 10.1016/j.jad.2019.03.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Revised: 03/25/2019] [Accepted: 03/29/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Aberrant functional and structural connectivity are considered to be involved in the underlying neural mechanism of generalized anxiety disorder (GAD). However, alterations in functional and structural interactions between the bilateral hemispheres are rarely examined. The current study aimed to characterized interhemispheric resting-state functional connectivity and white matter microstructural integrity of the corpus callosum in patients with GAD. METHODS Resting-state Blood oxygen level-dependent and diffusion tensor image were acquired for patients with GAD and healthy subjects. The two groups were matched in age, gender, education years. The voxel-mirrored homotopic connectivity (VMHC) of whole brain and white matter integrity of the corpus callosum (CC) were compared between the two groups. Their correlations with clinical measures were further performed. RESULTS Compare to controls, decreased resting-state VMHC were found in the precentral gyrus, middle cingulate gyrus and insula/putamen in patients with GAD. No regions of increased VMHC were detected in GAD. Compared to controls, GAD patients showed decreased fractional anisotropy (FA) values in CC2. In GAD group, further Pearson's correlation analyses showed that VMHC of the midcingulate gyrus positively correlated with FA of CC2, FA of CC2 negatively correlated with anxiety severity. Further mediation analyses demonstrated that attenuated VMHC in bilateral midcingulate gyrus partly mediated the association between white matter integrity of CC2 sub-region and anxiety severity. CONCLUSION Our findings suggested impairment of interhemispheric coordination in GAD. Moreover, disrupted interhemispheric connectivity correlated with anxiety severity in GAD. Our findings provided a novel clue about the neural mechanism of GAD, and may contribute to further deep exploration and treatment of GAD. LIMITATIONS The study was lack of comparison with non-GAD anxiety disorders.
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Affiliation(s)
- Wei Wang
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China; 71282 Hospital, Baoding 071052, China
| | - Zhaohui Peng
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China; Department of Radilogy, The 960th Hospital of the PLA Joint Logistice Support Force, Jinan, Shandong Province 250031, China
| | - Xiang Wang
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Peng Wang
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Qingchu Li
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | - Gang Wang
- The Second Community Healthcare Service Center of Zhengzhou Road, Luoyang 471000, China
| | - Fangni Chen
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China
| | | | - Shiyuan Liu
- Department of Radilogy, Changzheng Hospital, The Navy Military Medical University, No.415 Fengyang Road, Huangpu District, Shanghai 200003, China.
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27
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Liddell BJ, Williams EN. Cultural Differences in Interpersonal Emotion Regulation. Front Psychol 2019; 10:999. [PMID: 31133934 PMCID: PMC6523987 DOI: 10.3389/fpsyg.2019.00999] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 04/15/2019] [Indexed: 01/10/2023] Open
Abstract
Cultural differences exist in the use of emotion regulation (ER) strategies, but the focus to date has been on intrapersonal ER strategies such as cognitive reappraisal. An emerging literature highlights the importance of interpersonal ER, which utilizes social cues to facilitate the regulation of emotional states. In cultures that place high value on social interconnectedness as integral to their collectivistic self-construal, including East Asian cultures, interpersonal ER strategies may be particularly effective in reducing negative affect but this has not been previously tested. In this study, two groups comprising East Asian (n = 48) and Western European (n = 38) participants were randomly assigned to receive a priming narration depicting the use of either interpersonal (e.g., social modeling, perspective taking) or intrapersonal (e.g., cognitive reappraisal) ER strategies during a stressful experience. They were then instructed to utilize similar ER strategies in an emotion reactivity task during which they viewed high arousing negative pictorial stimuli while their heart rate (HR), heart rate variability (high frequency power - HF-HRV) and subjective affective states were measured. First we found that the East Asian group reported higher use of interpersonal ER strategies of social modeling and perspective taking in daily life. During the experimental interpersonal prime exposure, the East Asian group showed elevated HF-HRV (relative to baseline) compared to the Western European group, indicating more adaptive ER, but this pattern was not sustained during the reactivity or recovery phases. Instead, the East Asian group demonstrated increased HF-HRV and decreased HR across both prime conditions. The East Asian group also showed greater decreases in positive affect across the course of the experiment. Furthermore, individual differences in social modeling and individualistic self-construal moderated the effect of the ER prime in the East Asian group at trend levels, and main effects for perspective taking and reappraisal were observed in the Western European group. The findings support the notion that engaging in interpersonal ER strategies may be more beneficial for East Asian groups when immediately exposed to a stressful situation, as these strategies are congruent with cultural context and preferences, but our priming methodology may have limited the longer-term benefits.
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Affiliation(s)
- Belinda J. Liddell
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
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28
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Makovac E, Fagioli S, Watson DR, Meeten F, Smallwood J, Critchley HD, Ottaviani C. Response time as a proxy of ongoing mental state: A combined fMRI and pupillometry study in Generalized Anxiety Disorder. Neuroimage 2019; 191:380-391. [DOI: 10.1016/j.neuroimage.2019.02.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 02/12/2019] [Accepted: 02/14/2019] [Indexed: 01/27/2023] Open
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Carnevali L, Mancini M, Koenig J, Makovac E, Watson DR, Meeten F, Critchley HD, Ottaviani C. Cortical morphometric predictors of autonomic dysfunction in generalized anxiety disorder. Auton Neurosci 2019; 217:41-48. [DOI: 10.1016/j.autneu.2019.01.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/03/2018] [Accepted: 01/03/2019] [Indexed: 12/16/2022]
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30
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Molent C, Maggioni E, Cecchetto F, Garzitto M, Piccin S, Bonivento C, Maieron M, D'Agostini S, Balestrieri M, Perna G, Altamura AC, Brambilla P. Reduced cortical thickness and increased gyrification in generalized anxiety disorder: a 3 T MRI study. Psychol Med 2018; 48:2001-2010. [PMID: 29239286 DOI: 10.1017/s003329171700352x] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Although the study of the neuroanatomical correlates of generalized anxiety disorder (GAD) is gaining increasing interest, up to now the cortical anatomy of GAD patients has been poorly investigated and still no data on cortical gyrification are available. The aim of the present study is to quantitatively examine the cortical morphology in patients with GAD compared with healthy controls (HC) using magnetic resonance imaging (MRI). To the best of our knowledge, this is the first study analyzing the gyrification patterns in GAD. METHODS A total of 31 GAD patients and 31 HC underwent 3 T structural MRI. For each subject, cortical surface area (CSA), cortical thickness (CT), gray matter volume (GMV), and local gyrification index (LGI) were estimated in 19 regions of interest using the Freesurfer software. These parameters were then compared between the two groups using General Linear Model designs. RESULTS Compared with HC, GAD patients showed: (1) reduced CT in right caudal middle frontal gyrus (p < 0.05, Bonferroni corrected), (2) hyper-gyrification in right fusiform, inferior temporal, superior parietal and supramarginal gyri and in left supramarginal and superior frontal gyri (p < 0.05, Bonferroni corrected). No significant alterations in CSA and GMV were observed. CONCLUSIONS Our findings support the hypothesis of a neuroanatomical basis for GAD, highlighting a possible key role of the right hemisphere. The alterations of CT and gyrification in GAD suggest a neurodevelopmental origin of the disorder. Further studies on GAD are needed to understand the evolution of the cerebral morphology with age and during the clinical course of the illness.
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Affiliation(s)
- Cinzia Molent
- Unit of Psychiatry, Department of Medicine (DAME),University of Udine,Udine,Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health,IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico,University of Milan,Milan,Italy
| | - Filippo Cecchetto
- Unit of Psychiatry, Department of Medicine (DAME),University of Udine,Udine,Italy
| | - Marco Garzitto
- Scientific Institute IRCCS 'Eugenio Medea',Polo FVG, San Vito al Tagliamento, Pordenone,Italy
| | - Sara Piccin
- Scientific Institute IRCCS 'Eugenio Medea',Polo FVG, San Vito al Tagliamento, Pordenone,Italy
| | - Carolina Bonivento
- Unit of Psychiatry, Department of Medicine (DAME),University of Udine,Udine,Italy
| | - Marta Maieron
- Department of Physics,Azienda Ospedaliero Universitaria 'S.Maria della Misericordia',Udine,Italy
| | - Serena D'Agostini
- Department of Neuroradiology,Azienda Ospedaliero Universitaria 'S.Maria della Misericordia',Udine,Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME),University of Udine,Udine,Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences,Villa San Benedetto Menni, Hermanas Hospitalarias,FoRiPsi, Albese con Cassano, Como,Italy
| | - A Carlo Altamura
- Department of Neurosciences and Mental Health,IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico,University of Milan,Milan,Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health,IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico,University of Milan,Milan,Italy
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31
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Ottaviani C. Brain-heart interaction in perseverative cognition. Psychophysiology 2018; 55:e13082. [PMID: 29607505 DOI: 10.1111/psyp.13082] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 03/08/2018] [Accepted: 03/09/2018] [Indexed: 12/28/2022]
Abstract
The move from the concept of homeostasis to that of allostasis has led reactivity stress research to widen the object of its investigation: from the brief physiological response that occurs when one is facing a stressor to what happens when one is anticipating or recovering from a stressor. A paradigmatic example is represented by perseverative cognition, during which human beings react "as if" they were constantly facing a concrete stressor. The core idea behind this review is that the cognitive inflexibility that characterizes perseverative cognition is reflected in both our body (by increased autonomic nervous system rigidity assessed by heart rate variability; HRV) and our brain (by reduced prefrontal-amygdala functional connectivity). This is a review of studies conducted in different settings (laboratory, daily life), populations (healthy, major depression, generalized anxiety), location (United States, Europe), and age groups (children, adults) that consistently replicated the association between autonomic, subjective, and behavioral measures of cognitive inflexibility during perseverative cognition. Moreover, compelling neuroimaging data suggest that HRV reduction from pre- to post-induction of perseverative cognition is associated with both structural and functional brain abnormalities reflecting impaired prefrontal inhibitory control over subcortical structures (e.g., diminished prefrontal-amygdala functional connectivity). The integration of neuroscience techniques with clinical autonomic research has advanced our understanding of the neurobiology of brain-heart interaction during perseverative cognition, potentially yielding to more effective treatment packages. This is clinically relevant if one considers that perseverative cognition is a pervasive transdiagnostic factor that carries prognostic risk for both psychological and somatic health.
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Affiliation(s)
- Cristina Ottaviani
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy
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32
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Intrinsic Functional Hypoconnectivity in Core Neurocognitive Networks Suggests Central Nervous System Pathology in Patients with Myalgic Encephalomyelitis: A Pilot Study. Appl Psychophysiol Biofeedback 2018; 41:283-300. [PMID: 26869373 DOI: 10.1007/s10484-016-9331-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Exact low resolution electromagnetic tomography (eLORETA) was recorded from nineteen EEG channels in nine patients with myalgic encephalomyelitis (ME) and 9 healthy controls to assess current source density and functional connectivity, a physiological measure of similarity between pairs of distributed regions of interest, between groups. Current source density and functional connectivity were measured using eLORETA software. We found significantly decreased eLORETA source analysis oscillations in the occipital, parietal, posterior cingulate, and posterior temporal lobes in Alpha and Alpha-2. For connectivity analysis, we assessed functional connectivity within Menon triple network model of neuropathology. We found support for all three networks of the triple network model, namely the central executive network (CEN), salience network (SN), and the default mode network (DMN) indicating hypo-connectivity in the Delta, Alpha, and Alpha-2 frequency bands in patients with ME compared to controls. In addition to the current source density resting state dysfunction in the occipital, parietal, posterior temporal and posterior cingulate, the disrupted connectivity of the CEN, SN, and DMN appears to be involved in cognitive impairment for patients with ME. This research suggests that disruptions in these regions and networks could be a neurobiological feature of the disorder, representing underlying neural dysfunction.
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Abstract
Generalized anxiety disorder (GAD) is a prevalent and highly disabling mental health condition; however, there is still much to learn with regard to pertinent biomarkers, as well as diagnosis, made more difficult by the marked and common overlap of GAD with affective and anxiety disorders. Recently, intensive research efforts have focused on GAD, applying neuroimaging, genetic, and blood-based approaches toward discovery of pathogenetic and treatment-related biomarkers. In this paper, we review the large amount of available data, and we focus in particular on evidence from neuroimaging, genetic, and neurochemical measurements in GAD in order to better understand potential biomarkers involved in its etiology and treatment. Overall, the majority of these studies have produced results that are solitary findings, sometimes inconsistent and not clearly replicable. For these reasons, they have not yet been translated into clinical practice. Therefore, further research efforts are needed to distinguish GAD from other mental disorders and to provide new biological insights into its pathogenesis and treatment.
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Affiliation(s)
- Eduard Maron
- Faculty of Medicine, Department of Medicine, Center for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK ; Department of Psychiatry, University of Tartu, Tartu, Estonia ; North Estonia Medical Center, Department of Psychiatry, Tallinn, Estonia
| | - David Nutt
- Faculty of Medicine, Department of Medicine, Center for Neuropsychopharmacology, Division of Brain Sciences, Imperial College London, London, UK
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Maron E, Lan CC, Nutt D. Imaging and Genetic Approaches to Inform Biomarkers for Anxiety Disorders, Obsessive-Compulsive Disorders, and PSTD. Curr Top Behav Neurosci 2018; 40:219-292. [PMID: 29796838 DOI: 10.1007/7854_2018_49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Anxiety disorders are the most common mental health problem in the world and also claim the highest health care cost among various neuropsychiatric disorders. Anxiety disorders have a chronic and recurrent course and cause significantly negative impacts on patients' social, personal, and occupational functioning as well as quality of life. Despite their high prevalence rates, anxiety disorders have often been under-diagnosed or misdiagnosed, and consequently under-treated. Even with the correct diagnosis, anxiety disorders are known to be difficult to treat successfully. In order to implement better strategies in diagnosis, prognosis, treatment decision, and early prevention for anxiety disorders, tremendous efforts have been put into studies using genetic and neuroimaging techniques to advance our understandings of the underlying biological mechanisms. In addition to anxiety disorders including panic disorder, generalised anxiety disorder (GAD), specific phobias, social anxiety disorders (SAD), due to overlapping symptom dimensions, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) (which were removed from the anxiety disorder category in DSM-5 to become separate categories) are also included for review of relevant genetic and neuroimaging findings. Although the number of genetic or neuroimaging studies focusing on anxiety disorders is relatively small compare to other psychiatric disorders such as psychotic disorders or mood disorders, various structural abnormalities in the grey or white matter, functional alterations of activity during resting-state or task conditions, molecular changes of neurotransmitter receptors or transporters, and genetic associations have all been reported. With continuing effort, further genetic and neuroimaging research may potentially lead to clinically useful biomarkers for the prevention, diagnosis, and management of these disorders.
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Affiliation(s)
- Eduard Maron
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK.
- Department of Psychiatry, University of Tartu, Tartu, Estonia.
- Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia.
| | - Chen-Chia Lan
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - David Nutt
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
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Makovac E, Smallwood J, Watson DR, Meeten F, Critchley HD, Ottaviani C. The verbal nature of worry in generalized anxiety: Insights from the brain. NEUROIMAGE-CLINICAL 2017. [PMID: 29527493 PMCID: PMC5842731 DOI: 10.1016/j.nicl.2017.12.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background The Cognitive Avoidance Theory of Worry argues that worry is a cognitive strategy adopted to control the physiological arousal associated with anxiety. According to this theory, pathological worry, as in Generalized Anxiety Disorder (GAD), is verbal in nature, negative and abstract, rather than concrete. Neuroimaging studies link the expression of worry to characteristic modes of brain functional connectivity, especially in relation to the amygdala. However, the distinctive features of worry (verbal, abstract, negative), and their relationship to physiological arousal, have not so far been mapped to brain function. Methods We addressed this omission by undertaking a resting-state functional magnetic resonance neuroimaging study of 19 patients with GAD and 21 controls, before and after induction of perseverative cognitions, while measuring emotional bodily arousal from heart rate (HR). Seed-based analyses quantified brain changes in whole brain functional connectivity from the amygdala. Results In GAD, the induction increased negative thoughts and their verbal content. In line with predictions, the verbal expression of worry in GAD was associated with higher HR at baseline and attenuated HR increases after induction of perseverative cognitions. Within brain, the increased use of words during worry, and the associated dampening of HR after induction were mediated by the strength of functional connectivity between the amygdala and default mode network ‘hubs’ and the opercular cortex. The negative content of worry was further related to functional communication between amygdala and cingulo-opercular and temporal cortices. Conclusions Findings provide a neurobiological basis for the impact of verbal worry on HR in GAD. More negative worrisome thoughts have more words in GAD and more images in controls. Thinking in words is associated with reduced cardiac reactivity during worry. Verbal, abstract, and negative features of worry have unique neural correlates. Amygdala functional connectivity mediates use of words and HR decrease during worry. A neurobiological basis for the impact of verbal worry on HR in GAD is provided.
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Key Words
- Amygdala
- BDI, Beck Depression Inventory
- BOLD, blood oxygenation level dependent
- DMN, default mode network
- EPI, echoplanar imaging
- Functional connectivity
- GAD, Generalized Anxiety Disorder
- Generalized anxiety disorder
- HC, Healthy Controls
- HR, heart rate
- Heart rate
- NYC-Q, New York Cognition Questionnaire
- New York Cognition Questionnaire
- PCC, posterior cingulate cortex
- PSWQ, Penn State Worry Questionnaire
- RRS, Ruminative Response Scale
- SCID, Structured Clinical Interview for DSM
- STAI, Spielberger State Trait Anxiety Inventory
- Worry
- rsfMRI, resting-state functional magnetic resonance neuroimaging
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Affiliation(s)
- Elena Makovac
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Psychiatry, BSMS, Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, UK; Centre for Neuroimaging Science, King's College London, London, UK
| | - Jonathan Smallwood
- Department of Psychology, York Neuroimaging Centre, University of York, York, UK
| | - David R Watson
- Psychiatry, BSMS, Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, UK
| | - Frances Meeten
- Psychiatry, BSMS, Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, UK; Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Hugo D Critchley
- Psychiatry, BSMS, Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Brighton, UK; Sackler Centre for Consciousness Science, University of Sussex, Brighton, UK; Sussex Partnership NHS Foundation Trust Sussex, Sussex, UK
| | - Cristina Ottaviani
- Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, Italy; Department of Psychology, Sapienza University of Rome, Rome, Italy.
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Averill LA, Abdallah CG, Pietrzak RH, Averill CL, Southwick SM, Krystal JH, Harpaz-Rotem I. Combat Exposure Severity is Associated with Reduced Cortical Thickness in Combat Veterans: A Preliminary Report. ACTA ACUST UNITED AC 2017; 1. [PMID: 28845475 PMCID: PMC5568834 DOI: 10.1177/2470547017724714] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Chronic stress and related physiological responses are known to have
deleterious effects on neural integrity. Combat exposure is a notoriously
pathogenic stressor, and with over 2 million U.S. troops deployed to active
combat zones since 2001, there is an urgent need to advance our
understanding of its potential neural impact. Previous evidence suggests
structural alterations in posttraumatic stress disorder (PTSD) and more
recent studies have explored cortical thinning specifically. This
preliminary study investigates the impact of combat exposure on cortical
thickness, controlling for history of early life stress and age. Methods Twenty-one combat-exposed Veterans with PTSD and 20 non-PTSD combat-exposed
controls (mean age 32.7) completed the Combat Exposure Scale, Childhood
Trauma Questionnaire, and structural magnetic resonance imaging in a Siemens
3T TIM trio system. General linear model was used to examine the effect of
combat exposure on cortical thickness, controlling for early life trauma
exposure and age using cluster-wise correction
(p < 0.05). Results This preliminary study found a negative correlation between combat exposure
severity (CES) and cortical thickness in the left superior temporal and left
rostral middle frontal regions, as well as an interaction between PTSD
diagnosis status and CES, in the superior temporal/insular region showing a
stronger negative correlation between CES and cortical thickness in the
non-PTSD group. Conclusions Though caution should be taken with interpretation given the preliminary
nature of the findings, the results indicate combat exposure may affect
cortical structure beyond possible alterations due to early life stress
exposure or PTSD psychopathology. Though replication in larger samples is
required, these results provide useful information regarding possible neural
biomarkers and treatment targets for combat-related psychopathology as well
as highlighting the pathogenic effects of combat.
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Affiliation(s)
- Lynnette A Averill
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Chadi G Abdallah
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Robert H Pietrzak
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Christopher L Averill
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Steven M Southwick
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - John H Krystal
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Ilan Harpaz-Rotem
- Clinical Neurosciences Division, U.S. Department of Veterans Affairs National Center for PTSD, VA Connecticut Healthcare System West Haven, CT, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Neurocardiology: Cardiovascular Changes and Specific Brain Region Infarcts. BIOMED RESEARCH INTERNATIONAL 2017; 2017:5646348. [PMID: 28758117 PMCID: PMC5512017 DOI: 10.1155/2017/5646348] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 05/15/2017] [Indexed: 11/18/2022]
Abstract
There are complex and dynamic reflex control networks between the heart and the brain, including cardiac and intrathoracic ganglia, spinal cord, brainstem, and central nucleus. Recent literature based on animal model and clinical trials indicates a close link between cardiac function and nervous systems. It is noteworthy that the autonomic nervous-based therapeutics has shown great potential in the management of atrial fibrillation, ventricular arrhythmia, and myocardial remodeling. However, the potential mechanisms of postoperative brain injury and cardiovascular changes, particularly heart rate variability and the presence of arrhythmias, are not understood. In this chapter, we will describe mechanisms of brain damage undergoing cardiac surgery and focus on the interaction between cardiovascular changes and damage to specific brain regions.
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Besteher B, Gaser C, Langbein K, Dietzek M, Sauer H, Nenadić I. Effects of subclinical depression, anxiety and somatization on brain structure in healthy subjects. J Affect Disord 2017; 215:111-117. [PMID: 28319687 DOI: 10.1016/j.jad.2017.03.039] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Dimensional approaches in highly prevalent psychiatric disorders like depression or anxiety could lead to a better understanding of pathogenesis and advantages in early detection and prevention. In an effort to better understand associations of brain structural variation across the depression/anxiety spectra, we investigated minor subclinical symptoms in a non-clinical healthy population. METHODS We studied 177 healthy subjects from the community, who underwent high-resolution T1-weighted 3T MRI and completed the symptom-checklist-90 (SCL-90-R). Using voxel-based morphometry (VBM) analysis with CAT12 software, we correlated SCL-90-R-subscales for depression, anxiety, and somatization with gray matter across the brain. RESULTS Significant positive gray matter correlations emerged across all three scales in different areas: the depression subscale correlated positively with gray matter in the Rolandic operculum, superior temporal gyrus (left) and postcentral gyrus (bilateral), the anxiety subscale correlated positively with middle temporal gyrus, Rolandic operculum, middle cingular gyrus and precuneus bilaterally, and the somatization subscale with left inferior prefrontal cortex. Somatization also showed negative correlations with cerebellar vermis and right supplementary motor area. LIMITATIONS Our study is limited to VBM and does not include surface-based measures. It also only contains subjects with very small psychological distress by partly overlapping symptoms. CONCLUSION Our findings are consistent with a non-linear relationship between symptom severity and cortical volume in several brain areas involved in both emotion regulation as well as altered in clinically manifest depressive/anxiety disorders.
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Affiliation(s)
- Bianca Besteher
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany.
| | - Christian Gaser
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Neurology, Jena University Hospital, Jena, Germany
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Maren Dietzek
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Heinrich Sauer
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany; Department of Psychiatry and Psychotherapy, Philipps-University Marburg/Marburg University Hospital - UKGM, Marburg, Germany
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Transcranial direct current stimulation enhances soothing positive affect and vagal tone. Neuropsychologia 2017; 96:256-261. [DOI: 10.1016/j.neuropsychologia.2017.01.028] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 12/22/2016] [Accepted: 01/23/2017] [Indexed: 01/18/2023]
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Gazzellini S, Dettori M, Amadori F, Paoli B, Napolitano A, Mancini F, Ottaviani C. Association between Attention and Heart Rate Fluctuations in Pathological Worriers. Front Hum Neurosci 2016; 10:648. [PMID: 28082881 PMCID: PMC5187380 DOI: 10.3389/fnhum.2016.00648] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 12/08/2016] [Indexed: 11/13/2022] Open
Abstract
Recent data suggests that several psychopathological conditions are associated with alterations in the variability of behavioral and physiological responses. Pathological worry, defined as the cognitive representation of a potential threat, has been associated with reduced variability of heart beat oscillations (i.e., decreased heart rate variability; HRV) and lapses of attention indexed by reaction times (RTs). Clinical populations with attention deficit show RTs oscillation around 0.05 and 0.01 Hz when performing a sustained attention task. We tested the hypothesis that people who are prone to worry do it in a predictable oscillating pattern revealed through recurrent lapses in attention and concomitant oscillating HRV. Sixty healthy young adults (50% women) were recruited: 30 exceeded the clinical cut-off on the Penn State Worry Questionnaire (PSWQ; High-Worry, HW); the remaining 30 constituted the Low-Worry (LW) group. After a diagnostic assessment, participants performed two 15-min sustained attention tasks, interspersed by a standardized worry-induction procedure. RTs, HRV and moods were assessed. The analyses of the frequency spectrum showed that the HW group presents a significant higher and constant peak of RTs oscillation around 0.01 Hz (period 100 s) after the induction of worry, in comparison with their baseline and with the LW group that was not responsive to the induction procedure. Physiologically, the induction significantly reduced high-frequency HRV and such reduction was associated with levels of self-reported worry. Results are coherent with the oscillatory nature of the default mode network (DMN) and further confirm an association between cognitive rigidity and autonomic nervous system inflexibility.
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Affiliation(s)
| | | | | | | | | | | | - Cristina Ottaviani
- IRCCS Santa Lucia FoundationRome, Italy; Department of Psychology, Sapienza University of RomeRome, Italy
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Ottaviani C, Watson DR, Meeten F, Makovac E, Garfinkel SN, Critchley HD. Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder. Biol Psychol 2016; 119:31-41. [DOI: 10.1016/j.biopsycho.2016.06.009] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 06/20/2016] [Accepted: 06/22/2016] [Indexed: 12/30/2022]
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Neural activity during object perception in schizophrenia patients is associated with illness duration and affective symptoms. Schizophr Res 2016; 175:27-34. [PMID: 27130563 DOI: 10.1016/j.schres.2016.04.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Revised: 04/05/2016] [Accepted: 04/14/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND Abnormalities in visual processes have been observed in schizophrenia patients and have been associated with alteration of the lateral occipital complex and visual cortex. However, the relationship of these abnormalities with clinical symptomatology is largely unknown. METHODS We investigated the brain activity associated with object perception in schizophrenia. Pictures of common objects were presented to 26 healthy participants (age=36.9; 11 females) and 20 schizophrenia patients (age=39.9; 8 females) in an fMRI study. RESULTS In the healthy sample the presentation of pictures yielded significant activation (pFWE (cluster)<0.001) of the bilateral fusiform gyrus, bilateral lingual gyrus, and bilateral middle occipital gyrus. In patients, the bilateral fusiform gyrus and bilateral lingual gyrus were significantly activated (pFWE (cluster)<0.001), but not so the middle occipital gyrus. However, significant bilateral activation of the middle occipital gyrus (pFWE (cluster)<0.05) was revealed when illness duration was controlled for. Depression was significantly associated with increased activation, and anxiety with decreased activation, of the right middle occipital gyrus and several other brain areas in the patient group. No association with positive or negative symptoms was revealed. CONCLUSIONS Illness duration accounts for the weak activation of the middle occipital gyrus in patients during picture presentation. Affective symptoms, but not positive or negative symptoms, influence the activation of the right middle occipital gyrus and other brain areas.
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