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Sheynin J, Lokshina Y, Ahrari S, Nickelsen T, Duval ER, Ben-Zion Z, Shalev AY, Hendler T, Liberzon I. Greater Early Posttrauma Activation in the Right Inferior Frontal Gyrus Predicts Recovery From Posttraumatic Stress Disorder Symptoms. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:91-100. [PMID: 37451548 PMCID: PMC10787040 DOI: 10.1016/j.bpsc.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been associated with altered emotion processing and modulation in specific brain regions, i.e., the amygdala, insula, and medial prefrontal and anterior cingulate cortices. Functional alterations in these regions, recorded shortly after trauma exposure, may predict changes in PTSD symptoms. METHODS Survivors (N = 104) of a traumatic event, predominantly a motor vehicle accident, were included. Functional magnetic resonance imaging was used to assess brain activation 1, 6, and 14 months after trauma exposure (T1, T2, and T3, respectively). Participants performed the Shifted-attention Emotional Appraisal Task, which probes 3 affective processes: implicit emotional processing (of emotional faces), emotion modulation by attention shifting (away from these faces), and emotion modulation by appraisal (of the participants' own emotional response to these faces). We defined regions of interest based on task-related activations, extracted beta weights from these regions of interest, and submitted them to a series of analyses to examine relationships between neural activation and PTSD severity over the 3 time points. RESULTS At T1, a regression model containing activations in the left dorsolateral prefrontal cortex, bilateral inferior frontal gyrus (IFG), and medial prefrontal cortex during emotion modulation by appraisal significantly predicted change in PTSD symptoms. More specifically, greater right IFG activation at T1 was associated with greater reduction in symptom severity (T1-T3). Exploratory analysis also found that activation of the right IFG increased from T1 to T3. CONCLUSIONS The results suggest that greater early posttrauma activation during emotion appraisal in the right IFG, a region previously linked to cognitive control in PTSD, predicts recovery from PTSD symptoms.
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Affiliation(s)
- Jony Sheynin
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Yana Lokshina
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas; Department of Psychological & Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas
| | - Samira Ahrari
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Tetiana Nickelsen
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Ziv Ben-Zion
- Departments of Comparative Medicine and Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut; Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; United States Department of Veterans Affairs National Center for PTSD Clinical Neuroscience Division, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Arieh Y Shalev
- Department of Psychiatry, New York University Grossman School of Medicine, New York, New York
| | - Talma Hendler
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas; Department of Psychological & Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas.
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Mussini E, Di Russo F. Reduction of anticipatory brain activity in anxious people and regulatory effect of response-related feedback. Psychophysiology 2023; 60:e14166. [PMID: 35975745 DOI: 10.1111/psyp.14166] [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: 01/16/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 01/04/2023]
Abstract
Elevated anxiety levels degrade task performance, likely because of cognitive function reduction in the frontoparietal brain network. This study aimed to test whether anxiety could impact the frontal cortex anticipatory brain functions and to investigate the possible beneficial effect of response-related feedback on task performance. The electroencephalographic activity was recorded while participants performed two Go/No-go tasks: one with response-related feedback on errors (feedback task) and one task without feedback (standard task). We first tested whether anxiety levels could be associated with pre-stimulus ERP components such as the prefrontal negativity (pN), linked with top-down attentional control, and the Bereitschaftspotential (BP), related to motor preparation. Then, we assessed whether feedback could affect anxious people's brain preparation, reducing the state of uncertainty and improving performance. Results showed that the pN was almost absent and the BP was lower during a standard task in the high anxiety than in the low anxiety group. In the feedback task, these components increased in the high anxious, becoming comparable to the low anxious. Behavioral results showed that false alarms in the high anxiety group were larger than in the low anxiety group during the standard task but became comparable in the feedback task. Similarly, response time in the high anxiety group was slower in the standard task than in the feedback task, and high anxious people were faster in the feedback task than in the standard one. This study contributes to clarifying neural correlates of anxiety, showing brain activity reductions related to action preparation in frontal areas. In addition, response-related feedback tasks could be used to normalize task performance in high anxious people.
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Affiliation(s)
- Elena Mussini
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,Department of Neuroscience, Imaging, and Clinical Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Francesco Di Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, 00179
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Decreased Prosaposin and Progranulin in the Cingulate Cortex Are Associated with Schizophrenia Pathophysiology. Int J Mol Sci 2022; 23:ijms231912056. [PMID: 36233357 PMCID: PMC9570388 DOI: 10.3390/ijms231912056] [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: 08/29/2022] [Revised: 10/02/2022] [Accepted: 10/05/2022] [Indexed: 11/17/2022] Open
Abstract
Prosaposin (PSAP) and progranulin (PGRN) are two lysosomal proteins that interact and modulate the metabolism of lipids, particularly sphingolipids. Alterations in sphingolipid metabolism have been found in schizophrenia. Genetic associations of PSAP and PGRN with schizophrenia have been reported. To further clarify the role of PSAP and PGRN in schizophrenia, we examined PSAP and PGRN levels in postmortem cingulate cortex tissue from healthy controls along with patients who had suffered from schizophrenia, bipolar disorder, or major depressive disorder. We found that PSAP and PGRN levels are reduced specifically in schizophrenia patients. To understand the role of PSAP in the cingulate cortex, we used an AAV strategy to knock down PSAP in neurons located in this region. Neuronal PSAP knockdown led to the downregulation of neuronal PGRN levels and behavioral abnormalities. Cingulate-PSAP-deficient mice exhibited increased anxiety-like behavior and impaired prepulse inhibition, as well as intact locomotion, working memory, and a depression-like state. The behavioral changes were accompanied by increased early growth response protein 1 (EGR-1) and activity-dependent cytoskeleton-associated protein (ARC) levels in the sensorimotor cortex and hippocampus, regions implicated in circuitry dysfunction in schizophrenia. In conclusion, PSAP and PGRN downregulation in the cingulate cortex is associated with schizophrenia pathophysiology.
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Carmela M, Clara L, Maria Rosaria Anna M, Ivan F, Clemente C, Gianluca P, Antonio ZR, Antonio B. Which role for trait-anxiety in paternal perinatal depression? Preliminary results on healthy subjects. J Matern Fetal Neonatal Med 2020; 35:2445-2449. [PMID: 32646268 DOI: 10.1080/14767058.2020.1786514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Paternal Perinatal Depression (PPND) is a clinical condition, referred to emergence of depressive mood, i.e. sadness, hopelessness, despair and melancholy, but also loss of interest, and impairment in concentration and work performance, in fathers during the pregnancy in first postpartum year. Recently, the overlap with anxiety disorders is frequently observed. The study was aimed at evaluating a relationship between trait-anxiety and symptoms of PPND, in order to highlight trait-anxiety in onset of depressive syndrome. STUDY DESIGN A total number 79 participants have been recruited by convenience sampling method. Partners of pregnant women at the second trimester of pregnancy (17 ÷ 21 weeks of gestation) were consecutively recruited. At baseline, in 2nd trimester of pregnancy, and at 2nd months after childbirth, the psychiatric interview and socio-demographic data collection, were carried out and all subjects completed a self-administered STAI questionnaire. In postpartum period, the subjects completed the screening for postpartum depressive symptoms with PDSS scale. RESULTS Severity of "Anxiety proneness," assessed by STAI-Y, was "moderate in total sample (mean 58.7 ± 4.2). All fathers reported scores in clinical range, with one subject (1.3%) described as "mild," 56 "moderate" (70.9%), and 22 "severe" (27.8%). For symptoms of PPND, considering total sample, severity of depressive symptoms, was at the upper normal limit (mean score ± S.D. = 59.2 ± 33.1) and according to cutoff, in 35 subjects "normal adjustment" (44.3%), "significant symptoms" (13.9%) and "positive" in 33 (41.8%). We find a positive correlation among total score of STAI-Y and PDSS subscales, in particular section of Anxiety/Insecurity (p = .011), Emotional Liability (p = .007), Cognitive Impairment (p = .023), and Loss of Self (p = .012). CONCLUSIONS Trait-anxiety, as a personality dimension, is included in neuroticism, that is one of the risk factors of the clinical condition of prenatal depression. In our study, we found a level of pathological trait anxiety, assessed in the post-partum phase. This confirms the stability of the trait anxiety construct, as a dimensional component of the personality and the findings, may be useful for promote early intervention programs for psychological support of parents, focused on individual differences in anxiety vulnerability.
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Affiliation(s)
- Mento Carmela
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging Psychiatric, Psychiatric Unit Policlinico Hospital Messina, University of Messina, Messina, Italy
| | | | | | - Formica Ivan
- Dynamic Psychology, Cospecs Department, University of Messina, Messina, Italy
| | - Cedro Clemente
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Pandolfo Gianluca
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Zoccali Rocco Antonio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Bruno Antonio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Saviola F, Pappaianni E, Monti A, Grecucci A, Jovicich J, De Pisapia N. Trait and state anxiety are mapped differently in the human brain. Sci Rep 2020; 10:11112. [PMID: 32632158 PMCID: PMC7338355 DOI: 10.1038/s41598-020-68008-z] [Citation(s) in RCA: 79] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/12/2020] [Indexed: 12/20/2022] Open
Abstract
Anxiety is a mental state characterized by an intense sense of tension, worry or apprehension, relative to something adverse that might happen in the future. Researchers differentiate aspects of anxiety into state and trait, respectively defined as a more transient reaction to an adverse situation, and as a more stable personality attribute in experiencing events. It is yet unclear whether brain structural and functional features may distinguish these aspects of anxiety. To study this, we assessed 42 healthy participants with the State-Trait Anxiety Inventory and then investigated with MRI to characterize structural grey matter covariance and resting-state functional connectivity (rs-FC). We found several differences in the structural-functional patterns across anxiety types: (1) trait anxiety was associated to both structural covariance of Default Mode Network (DMN), with an increase in dorsal nodes and a decrease in its ventral part, and to rs-FC of DMN within frontal regions; (2) state anxiety, instead, was widely related to rs-FC of Salience Network and of DMN, specifically in its ventral nodes, but not associated with any structural pattern. In conclusion, our study provides evidence of a neuroanatomical and functional distinction between state and trait anxiety. These neural features may be additional markers in future studies evaluating early diagnosis or treatment effects.
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Affiliation(s)
- Francesca Saviola
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, TN, Italy
| | - Edoardo Pappaianni
- Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Alessia Monti
- Department of Neurorehabilitation Sciences, Casa Di Cura Privata del Policlinico, Milan, Italy
| | - Alessandro Grecucci
- Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy
| | - Jorge Jovicich
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Rovereto, TN, Italy
| | - Nicola De Pisapia
- Department of Psychology and Cognitive Sciences (DiPSCo), University of Trento, Corso Bettini 31, 38068, Rovereto, TN, Italy.
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Duval ER, Sheynin J, King AP, Phan KL, Simon NM, Martis B, Porter KE, Norman SB, Liberzon I, Rauch SAM. Neural function during emotion processing and modulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder. Depress Anxiety 2020; 37:670-681. [PMID: 32306485 PMCID: PMC8010611 DOI: 10.1002/da.23022] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 02/19/2020] [Accepted: 03/27/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been associated with exaggerated threat processing and deficits in emotion modulation circuitry. It remains unknown how neural circuits are associated with response to evidence-based treatments for PTSD. METHOD We examined associations between PTSD symptoms and indicators of neural response in key emotion processing and modulation regions. Fifty-six military Veterans with PTSD were randomly assigned to one of three evidence-based treatments (prolonged exposure, sertraline, and PE plus sertraline) in a randomized clinical trial ("PROGrESS"; 2018, Contemp Clin Trials, 64, 128-138). Twenty-seven combat-exposed controls (CCs) served as a comparison group at pretreatment. Before and after PTSD treatment, functional magnetic resonance imaging was used to assess brain activation and connectivity during the validated Shifted Attention Emotion Appraisal Task (2003, J Neurosci, 23, 5627-5633; 2013, Biol Psychiatry, 73, 1045-1053). RESULTS Greater activation in emotion processing (anterior insula) and modulation (prefrontal cortex) regions and increased connectivity between attentional control (dorsolateral prefrontal cortex and superior parietal cortex) and emotion processing (amygdala) regions, at pretreatment, were associated with subsequent PTSD symptom improvement. CONCLUSIONS This study is one of the first to examine task-based activation and functional connectivity in a PTSD treatment trial, and provides evidence to suggest that activation in and connectivity between emotion processing and modulation regions are important predictors of treatment response.
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Affiliation(s)
- Elizabeth R. Duval
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Jony Sheynin
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Anthony P. King
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - K. Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Naomi M. Simon
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts,Department of Psychiatry, New York University School of Medicine, New York, New York
| | - Brian Martis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Research Service, VA San Diego Healthcare System, San Diego, California,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, California
| | - Katherine E. Porter
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Sonya B. Norman
- Research Service, VA San Diego Healthcare System, San Diego, California,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, California,Executive Division, National Center for PTSD, White River Junction, Vermont
| | - Israel Liberzon
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Sheila A. M. Rauch
- Mental Health Service Line, VA Atlanta Healthcare System, Decatur, Georgia,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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The effects of induced and trait anxiety on the sequential modulation of emotional conflict. PSYCHOLOGICAL RESEARCH 2020; 85:618-633. [PMID: 32016501 DOI: 10.1007/s00426-020-01289-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/11/2020] [Indexed: 10/25/2022]
Abstract
The current study aimed to investigate whether induced anxiety, as well as trait anxiety, would lead to the failure of the regulation of emotional conflict. To measure the regulation of emotional conflict, the congruency sequence effect (CSE), which is a reduced effect of task-irrelevant distractor after incongruent trials compared to congruent trials, was observed while participants performed an emotional conflict task. In Experiment 1, participants performed the task in a safe context and a threatening context where a couple of electric shocks were given randomly on two consecutive days. In Experiment 2, participants performed the same task in either a safe or threatening context to avoid a potential carryover effect of the threat. The CSE observed in the safe context disappeared in the threatening context as well as in participants with high-trait anxiety level even without the threat. The findings imply that induced anxiety causes a failure of cognitive control that engenders the CSE in emotional congruency tasks. Moreover, such failure driven by participants' trait anxiety level might be a potential predisposing factor leading to anxiety disorders. Overall, these results suggest that induced anxiety, as well as trait anxiety, has an adverse impact on the sequential modulation of emotional conflict.
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Sah A, Sotnikov S, Kharitonova M, Schmuckermair C, Diepold RP, Landgraf R, Whittle N, Singewald N. Epigenetic Mechanisms Within the Cingulate Cortex Regulate Innate Anxiety-Like Behavior. Int J Neuropsychopharmacol 2019; 22:317-328. [PMID: 30668714 PMCID: PMC6441131 DOI: 10.1093/ijnp/pyz004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 01/11/2019] [Accepted: 01/14/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Pathological anxiety originates from a complex interplay of genetic predisposition and environmental factors, acting via epigenetic mechanisms. Epigenetic processes that can counteract detrimental genetic risk towards innate high anxiety are not well characterized. METHODS We used female mouse lines of selectively bred high (HAB)- vs low (LAB)-innate anxiety-related behavior and performed select environmental and pharmacological manipulations to alter anxiety levels as well as brain-specific manipulations and immunohistochemistry to investigate neuronal mechanisms associated with alterations in anxiety-related behavior. RESULTS Inborn hyperanxiety of high anxiety-like phenotypes was effectively reduced by environmental enrichment exposure. c-Fos mapping revealed that hyperanxiety in high anxiety-like phenotypes was associated with blunted challenge-induced neuronal activation in the cingulate-cortex, which was normalized by environmental enrichment. Relating this finding with epigenetic modifications, we found that high anxiety-like phenotypes (compared with low-innate anxiety phenotypes) showed reduced acetylation in the hypoactivated cingulate-cortex neurons following a mild emotional challenge, which again was normalized by environmental enrichment. Paralleling the findings using environmental enrichment, systemic administration of histone-deacetylase-inhibitor MS-275 elicited an anxiolytic-like effect, which was correlated with increased acetylated-histone-3 levels within cingulate-cortex. Finally, as a proof-of-principle, local MS-275 injection into cingulate-cortex rescued enhanced innate anxiety and increased acetylated-histone-3 within the cingulate-cortex, suggesting this epigenetic mark as a biomarker for treatment success. CONCLUSIONS Taken together, the present findings provide the first causal evidence that the attenuation of high innate anxiety-like behavior via environmental/pharmacological manipulations is epigenetically mediated via acetylation changes within the cingulate-cortex. Finally, histone-3 specific histone-deacetylase-inhibitor could be of therapeutic importance in anxiety disorders.
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Affiliation(s)
- Anupam Sah
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | | | - Maria Kharitonova
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | - Claudia Schmuckermair
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | | | | | - Nigel Whittle
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria
| | - Nicolas Singewald
- Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck, University of Innsbruck, Innsbruck, Austria,Correspondence: Nicolas Singewald, PhD, Department of Pharmacology and Toxicology, Institute of Pharmacy and Center for Molecular Biosciences Innsbruck (CMBI), University of Innsbruck, Innrain 80–82/III, A-6020 Innsbruck, Austria ()
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Ben-Zion Z, Fine NB, Keynan NJ, Admon R, Halpern P, Liberzon I, Hendler T, Shalev AY. Neurobehavioral moderators of post-traumatic stress disorder (PTSD) trajectories: study protocol of a prospective MRI study of recent trauma survivors. Eur J Psychotraumatol 2019; 10:1683941. [PMID: 31762950 PMCID: PMC6853209 DOI: 10.1080/20008198.2019.1683941] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/03/2019] [Accepted: 10/08/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Post-traumatic stress disorder (PTSD) is triggered by distinct events and is therefore amenable to studies of its early pathogenesis. Longitudinal studies during the year that follows trauma exposure revealed typical symptom trajectories leading to either recovery or protracted PTSD. Thezneurobehavioral correlates of early PTSD symptoms' trajectories have not been longitudinally explored. Objective: To present the rationale and design of a longitudinal study exploring the relationship between evolving PTSD symptoms and co-occurring cognitive functioning and structural and functional brain imaging parameters. Method: Adult civilians consecutively admitted to a general hospital emergency room (ER) for traumatic injury will be screened for early PTSD symptoms suggestive of chronic PTSD risk, and consecutively evaluated 1, 6 and 14 months following the traumatic event. Consecutive assessments will include structured clinical interviews for PTSD and comorbid disorders, self-reported depression and anxiety symptoms, a web-based assessment of cognitive domains previously linked with PTSD (e.g., memory, executive functions, cognitive flexibility), high-resolution structural MRI of both grey and white matter, functional resting-state connectivity, and fMRI tasks examining emotional reactivity and regulation, as well as motivation processing and sensitivity to risk and reward. Data analyses will explore putative cognitive predictors of non-remitting PTSD, and brain structural and functional correlates of PTSD persistence or recovery. Conclusion: This work will longitudinally document patterns of brain structures, connectivity, and functioning, predictive of (or associated with) emerging PTSD during the critical first year of after the traumatic event. It will thereby inform our understanding of the disorder's pathogenesis and underlying neuropathology. Challenges to longitudinal MRI studies of recent survivors, and methodological choices used to optimize the study's design are discussed.
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Affiliation(s)
- Ziv Ben-Zion
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Naomi B Fine
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.,School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Nimrod Jackob Keynan
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.,School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Roee Admon
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Pinchas Halpern
- Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Israel Liberzon
- Department of Psychiatry, Texas A&M Health Science Center, Austin, TX, USA
| | - Talma Hendler
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.,School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Arieh Y Shalev
- Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
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Barker H, Munro J, Orlov N, Morgenroth E, Moser J, Eysenck MW, Allen P. Worry is associated with inefficient functional activity and connectivity in prefrontal and cingulate cortices during emotional interference. Brain Behav 2018; 8:e01137. [PMID: 30378289 PMCID: PMC6305912 DOI: 10.1002/brb3.1137] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 09/06/2018] [Accepted: 09/17/2018] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Anxiety is known to impair attentional control particularly when Task demands are high. Neuroimaging studies generally support these behavioral findings, reporting that anxiety is associated with increased (inefficient) activity in dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) during attentional control Tasks. However, less is known about the relationship between worry (part of the cognitive dimension of trait anxiety) and DLPFC/ACC function and connectivity during attentional control. In the present study, we sought to clarify this relationship. METHODS Forty-one participants underwent functional magnetic resonance imaging (fMRI) during a composite Faces and Scenes Task with high and low emotional interference conditions. Individual worry levels were assessed using the Penn State Worry Questionnaire. RESULTS During high but not low emotional interference, worry was associated with increased activity in ACC, DLPFC, insula, and inferior parietal cortex. During high emotional interference, worry was also associated with reduced functional connectivity between ACC and DLPFC. Trait anxiety was not associated with changes in DLPFC/ACC activity or connectivity during either Task condition. CONCLUSIONS The results are consistent with cognitive models that propose worry competes for limited processing resources resulting in inefficient DLPFC and ACC activity when Tasks demands are high. Limitations of the present study and directions for future work are discussed.
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Affiliation(s)
- Holly Barker
- Department of Psychology, University of Roehampton, London, UK
| | - James Munro
- Department of Psychology, University of Roehampton, London, UK.,Department of Psychology, Edinburgh Napier University, Edinburgh, UK
| | - Natasza Orlov
- Department of Psychology, University of Roehampton, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Jason Moser
- Department of Psychology, Michigan State University, East Lansing, Michigan
| | - Michael W Eysenck
- Department of Psychology, University of Roehampton, London, UK.,Department of Psychology, Royal Holloway University of London, London, UK
| | - Paul Allen
- Department of Psychology, University of Roehampton, London, UK.,Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.,Combined Universities Brain Imaging Centre, London, UK
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Javanbakht A, Tompson S, Kitayama S, King A, Yoon C, Liberzon I. Gene by Culture Effects on Emotional Processing of Social Cues among East Asians and European Americans. Behav Sci (Basel) 2018; 8:bs8070062. [PMID: 29997310 PMCID: PMC6070862 DOI: 10.3390/bs8070062] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 07/04/2018] [Accepted: 07/07/2018] [Indexed: 11/19/2022] Open
Abstract
While Western cultures are more focused on individualization and self-expression, East Asian cultures promote interrelatedness. Largely unknown is how gene by culture interactions influence the degree to which individuals acquire culture, and the neurocircuitry underlying how social cues are processed. We sought to examine the interaction between DRD4 polymorphism and culture in the neural processing of social emotional cues. 19 Asian-born East Asian (AA) and 20 European American (EA) participants performed a shifted attention emotion appraisal functional magnetic resonance imaging (fMRI) task, which probes implicit emotional processing and regulation in response to social emotional cues. Half of the participants in each group were DRD4 2- or 7-repeat allele (2R/7R) carriers. AA participants showed larger left and right amygdala, and left hippocampal activation during implicit processing of fearful faces. There was a gene by culture interaction in the left insula during implicit processing of facial cues, while activation in EA DRD4 2R/7R carriers was larger than EA non-carriers and AA carriers. Our findings suggest that emotional facial cues are more salient to AA participants and elicit a larger amygdala reaction. Gene by culture interaction finding in insula suggests that DRD4 2R/7R carriers in each culture are more prone to adopting their cultural norm.
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Affiliation(s)
- Arash Javanbakht
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, 3901 Chrysler Service Drive, 3rd Floor, Detroit, MI 48201, USA.
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA.
| | - Steve Tompson
- Department of Psychology, University of Michigan, 3217 East Hall, Ann Arbor, MI 48109, USA.
| | - Shinobu Kitayama
- Department of Psychology, University of Michigan, 3217 East Hall, Ann Arbor, MI 48109, USA.
| | - Anthony King
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA.
| | - Carolyn Yoon
- Stephen M. Ross School of Business, University of Michigan, 701 Tappan Ave, Ann Arbor, MI 48109, USA.
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109, USA.
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12
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Burkhouse KL, Kujawa A, Hosseini B, Klumpp H, Fitzgerald KD, Langenecker SA, Monk CS, Phan KL. Anterior cingulate activation to implicit threat before and after treatment for pediatric anxiety disorders. Prog Neuropsychopharmacol Biol Psychiatry 2018; 84. [PMID: 29535037 PMCID: PMC5912209 DOI: 10.1016/j.pnpbp.2018.03.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Research suggests that individuals with anxiety have difficulty ignoring threat distractors when completing tasks with competing stimuli. Studies examining the neural correlates of these emotional processing difficulties in youth anxiety highlight reduced recruitment of regions associated with goal-directed attention, such as the anterior cingulate cortex (ACC). In the current study, we examined neural activation during an emotional conflict task in youth with anxiety disorders before and after treatment. METHODS Twenty-five youth (ages 9-19 years) with generalized, separation, and/or social anxiety disorder and 25 healthy controls underwent 2 functional magnetic resonance imaging scans approximately 13 weeks apart. At each scan, participants completed a task in which they matched shapes in the context of emotional distractors (happy and threatening faces). Between scans, anxious youth were treated with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT). RESULTS Prior to treatment, anxious youth exhibited reduced activation of the medial prefrontal cortex, encompassing the rostral ACC, when matching shapes in the context of threat distractors relative to healthy controls. Activation in this region increased in anxious youth after treatment, but remained unchanged in the healthy control group. Increases in rostral ACC activation were related to greater reductions in social anxiety and avoidance symptoms following treatment. CONCLUSIONS Effective treatments for pediatric anxiety may enhance rostral ACC response during attempts to filter out threat-relevant stimuli. Enhanced recruitment of this region may constitute one manner in which CBT and SSRI treatment reduce youth anxiety symptoms, particularly social anxiety and avoidance.
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Affiliation(s)
- Katie L. Burkhouse
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Bobby Hosseini
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois,Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | | | - Scott A. Langenecker
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois,Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - Christopher S. Monk
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois,Department of Psychology, University of Illinois at Chicago, Chicago, Illinois,Department of Anatomy and Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, Illinois
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13
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Duval ER, Joshi SA, Block SR, Abelson JL, Liberzon I. Insula activation is modulated by attention shifting in social anxiety disorder. J Anxiety Disord 2018; 56:56-62. [PMID: 29729828 PMCID: PMC5985215 DOI: 10.1016/j.janxdis.2018.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/22/2022]
Abstract
Social anxiety disorder (SAD) is characterized by exaggerated reactivity to social threat, often documented by biased attention to threatening information, and increased activation in brain regions involved in salience/threat processing. Attention training has been developed to ameliorate the attention bias documented in individuals with SAD, with mixed results. We investigated patterns of brain activation underlying acute attention modulation in 41 participants (29 with SAD and 12 health controls). We then investigated how brain activation changed over time in both groups in response to a 4-session attention training protocol (toward threat, away from threat, no-training control). Results revealed diminished pre-training deactivation in the insula in SAD participants during attention modulation. SAD participants also demonstrated an increase in insula deactivation over time, suggestive of an improvement in attention modulation of emotion, and this was associated with a decrease in symptom severity. Attention training did not, itself, lead to clinical improvement, though there was a trend level effect of training toward threat on increased insula deactivation over time. While deficits in attentional control and emotion modulation are documented in individuals with SAD, current attention training protocols are not robustly effective in ameliorating aberrant functioning. Pursuit of training protocols that have more robust impacts on the relevant neural circuitry may have some value.
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Affiliation(s)
- Elizabeth R. Duval
- Corresponding Author: Elizabeth Duval, University of Michigan, Department of Psychiatry 4250 Plymouth Rd, Ann Arbor, MI 48109, USA, Telephone: 734-936-4397,
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14
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Weger M, Sandi C. High anxiety trait: A vulnerable phenotype for stress-induced depression. Neurosci Biobehav Rev 2018; 87:27-37. [DOI: 10.1016/j.neubiorev.2018.01.012] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 01/14/2018] [Accepted: 01/21/2018] [Indexed: 11/25/2022]
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15
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Abstract
Anxiety disorders are among the most prevalent psychological issues worldwide, displaying the youngest age of onset and greatest chronicity of any mood or substance abuse disorder. Given the high social and economic cost imposed by these disorders, developing effective treatments is of the utmost importance. Anxiety disorders manifest in a variety of symptomatic phenotypes and are highly comorbid with other psychological diseases such as depression. These facts have made unraveling the complex underlying neural circuity an ever-present challenge for researchers. We offer a brief review on the neuroanatomy of anxiety disorders and discuss several currently available therapeutic options.
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Affiliation(s)
| | - Shehzad Khalid
- Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies
| | - Marios Loukas
- Department of Anatomical Sciences, St. George's University School of Medicine, Grenada, West Indies
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16
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Fronto-Striatal Glutamate in Autism Spectrum Disorder and Obsessive Compulsive Disorder. Neuropsychopharmacology 2017; 42:2456-2465. [PMID: 27869141 PMCID: PMC5645732 DOI: 10.1038/npp.2016.260] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2016] [Revised: 11/11/2016] [Accepted: 11/14/2016] [Indexed: 01/31/2023]
Abstract
Autism spectrum disorders (ASDs) and obsessive compulsive disorder (OCD) are often comorbid with the overlap based on compulsive behaviors. Although previous studies suggest glutamatergic deficits in fronto-striatal brain areas in both disorders, this is the first study to directly compare the glutamate concentrations across the two disorders with those in healthy control participants using both categorical and dimensional approaches. In the current multi-center study (four centers), we used proton magnetic resonance spectroscopy in 51 children with ASD, 29 with OCD, and 53 healthy controls (aged 8-13 years) to investigate glutamate (Glu) concentrations in two regions of the fronto-striatal circuit: midline anterior cingulate cortex (ACC) and left dorsal striatum. Spectra were processed with Linear Combination Model. Group comparisons were performed with one-way analyses of variance including sex, medication use, and scanner site as covariates. In addition, a dimensional analysis was performed, linking glutamate with a continuous measure of compulsivity across disorders. There was a main group effect for ACC glutamate (p=0.019). Contrast analyses showed increased glutamate both in children with ASD and OCD compared with controls (p=0.007), but no differences between the two disorders (p=0.770). Dimensional analyses revealed a positive correlation between compulsive behavior (measured with the Repetitive Behavior Scale) and ACC glutamate (rho=0.24, p=0.03). These findings were robust across sites. No differences were found in the striatum. The current findings confirm overlap between ASD and OCD in terms of glutamate involvement. Glutamate concentration in ACC seems to be associated with the severity of compulsive behavior.
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17
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Villemonteix T, Marx I, Septier M, Berger C, Hacker T, Bahadori S, Acquaviva E, Massat I. Attentional control of emotional interference in children with ADHD and typically developing children: An emotional N-back study. Psychiatry Res 2017; 254:1-7. [PMID: 28437666 DOI: 10.1016/j.psychres.2017.04.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 02/28/2017] [Accepted: 04/15/2017] [Indexed: 10/19/2022]
Abstract
Emotional interference control refers to the ability to remain focused on goal-oriented processes when confronted with disrupting but irrelevant emotional stimuli, a process that may be impaired in children and adults with attention deficit/hyperactivity disorder (ADHD). However, emotional interference levels are known to be associated with trait anxiety, and patients with ADHD often display elevated levels of trait anxiety, such as these may have confounded previous findings of decreased emotional interference control in this population. In the present study, male and female 8-13 years old (mean =11.0 years) children with ADHD (n=33) and typically developing (TD) children (n=24) performed a visual emotional working memory (n-back) task with 2 memory loads and three different background pictures (neutral/positive/negative), and trait anxiety measures were obtained. Children with ADHD performed less well, and displayed increased emotional interference in the presence of aversive distractors when compared with TD children. Contrary to our expectations, trait anxiety did not mediate the association between diagnostic group membership and the degree of emotional interference control; however, co-morbid ODD was associated with decreased levels of emotional interference in ADHD. Future research should aim at characterizing the mechanisms subtending decreased emotional interference control in the ADHD population.
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Affiliation(s)
- Thomas Villemonteix
- EA 2007, Psychopathology and Neuropsychology Lab., Université Paris 8, Saint-Denis, France; UR2NF - Neuropsychology and Functional Neuroimaging Research Unit, Centre de Recherche Cognition et Neurosciences, Université Libre de Bruxelles (ULB), Bruxelles, Belgium.
| | - Ivo Marx
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Mathilde Septier
- Assistance Publique-Hôpitaux de Paris, Department of Child and Adolescent Psychiatry, Robert-Debré Hospital, Paris, France; Inserm, U894, Psychiatry and NeurosciXence Center, Paris, France
| | - Christoph Berger
- Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Thomas Hacker
- Department of Psychiatry and Psychotherapy, University Medicine Rostock, Rostock, Germany
| | - Sara Bahadori
- Assistance Publique-Hôpitaux de Paris, Department of Child and Adolescent Psychiatry, Robert-Debré Hospital, Paris, France; Inserm, U894, Psychiatry and NeurosciXence Center, Paris, France
| | - Eric Acquaviva
- Assistance Publique-Hôpitaux de Paris, Department of Child and Adolescent Psychiatry, Robert-Debré Hospital, Paris, France
| | - Isabelle Massat
- UR2NF - Neuropsychology and Functional Neuroimaging Research Unit, Centre de Recherche Cognition et Neurosciences, Université Libre de Bruxelles (ULB), Bruxelles, Belgium; Laboratory of Experimental Neurology, ULB, Bruxelles, Belgium; National Fund of Scientific Research (FNRS) Belgium
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18
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Bunford N, Kinney KL, Michael J, Klumpp H. Threat distractor and perceptual load modulate test-retest reliability of anterior cingulate cortex response. Prog Neuropsychopharmacol Biol Psychiatry 2017; 77:120-127. [PMID: 28408292 PMCID: PMC9278877 DOI: 10.1016/j.pnpbp.2017.04.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 02/28/2017] [Accepted: 04/06/2017] [Indexed: 11/27/2022]
Abstract
Accumulating data from fMRI studies implicate the rostral anterior cingulate cortex (rACC) in inhibition of attention to threat distractors that compete with task-relevant goals for processing resources. However, little data is available on the reliability of rACC activation. Our aim in the current study was to examine test-retest reliability of rACC activation over a 12-week period, in the context of a validated emotional interference paradigm that varied in perceptual load. During functional MRI, 23 healthy volunteers completed a task involving a target letter in a string of identical letters (low load) or in a string of mixed letters (high load) superimposed on angry, fearful, and neutral face distractors. Intraclass correlation coefficients (ICCs) indicated that under low, but not high perceptual load, rACC activation to fearful vs. neutral distractors was moderately reliable. Conversely, regardless of perceptual load, rACC activation to angry vs. neutral distractors was not reliable. Regarding behavioral performance, ICCs indicated that accuracy was not reliable regardless of distractor type or perceptual load. Although reaction time (RT) was similarly not reliable regardless of distractor type under low perceptual load, RT to angry vs. neutral distractors and to fearful vs. neutral distractors was reliable under high perceptual load. Together, results indicate the test-retest reliability of rACC activation and corresponding behavioral performance are context dependent; reliability of the former varies as a function of distractor type and level of cognitive demand, whereas reliability of the latter depends on behavioral index (accuracy vs. RT) and level of cognitive demand but not distractor type.
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Affiliation(s)
- Nora Bunford
- Mood and Anxiety Disorders Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60608, USA.
| | - Kerry L. Kinney
- Department of Psychology, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Jamie Michael
- Mood and Anxiety Disorders Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60608, USA
| | - Heide Klumpp
- Mood and Anxiety Disorders Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60608, USA,Department of Psychology, University of Illinois at Chicago, Chicago, IL 60607, USA
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19
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Bunford N, Roberts J, Kennedy AE, Klumpp H. Neurofunctional correlates of behavioral inhibition system sensitivity during attentional control are modulated by perceptual load. Biol Psychol 2017; 127:10-17. [PMID: 28478139 DOI: 10.1016/j.biopsycho.2017.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 03/01/2017] [Accepted: 04/28/2017] [Indexed: 11/18/2022]
Abstract
Although the Behavioral Inhibition System (BIS) is associated with threat-sensitivity, little is known about its neurofunctional correlates during cognitive control over task-irrelevant threat distractors. Thirty non-clinical participants, who ranged in BIS sensitivity, completed an attentional control paradigm during fMRI. The paradigm varied in cognitive demand with low perceptual load comprising identical target letters and high perceptual load comprising a target letter in a mixed letter string; each superimposed on threatening and neutral face distractors. Whole-brain results indicated that individuals with higher, relative to lower BIS sensitivity, exhibited enhanced dorsolateral prefrontal cortex activation to angry (vs. neutral) and enhanced dorsal anterior cingulate cortex activation to fearful (vs. neutral) face distractors under low load whereas no differences in activation were observed under high load. These findings are consistent with literature indicating that the BIS is involved in conflict processing, including between cognitive and emotional or motivational goals.
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Affiliation(s)
- Nora Bunford
- Mood and Anxiety Disorders Research Program (MADRP), Psychiatry, University of Illinois at Chicago, Chicago, IL, United States.
| | - Julia Roberts
- Mood and Anxiety Disorders Research Program (MADRP), Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Amy E Kennedy
- Mood and Anxiety Disorders Research Program (MADRP), Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
| | - Heide Klumpp
- Mood and Anxiety Disorders Research Program (MADRP), Psychiatry, University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States
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20
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Burkhouse KL, Kujawa A, Klumpp H, Fitzgerald KD, Monk CS, Phan KL. Neural correlates of explicit and implicit emotion processing in relation to treatment response in pediatric anxiety. J Child Psychol Psychiatry 2017; 58:546-554. [PMID: 27861879 PMCID: PMC5393919 DOI: 10.1111/jcpp.12658] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Approximately 40%-45% of youth with anxiety disorders do not achieve remission (or a substantial reduction in symptoms) following treatment, highlighting the need to identify predictors of treatment response. Given the well-established link between attentional biases and anxiety disorders in youth and adults, this study examined the neural correlates of directing attention toward and away from emotional faces in relation to pediatric anxiety treatment response. METHOD Prior to beginning treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT), 37 youth (age 7-19 years) with generalized and/or social anxiety disorder completed a task with conditions that manipulated whether participants were instructed to match emotional faces (explicit emotion processing) or match shapes in the context of emotional face distractors (implicit emotion processing) during functional magnetic resonance imaging. RESULTS Results revealed that reduced activation in superior frontal gyrus (SFG), encompassing the dorsal anterior cingulate cortex (ACC) and dorsomedial prefrontal cortex (PFC), during implicit processing of emotional faces predicted a greater reduction in anxiety severity pre-to-post treatment. Post hoc analyses indicated that effects were not significantly moderated by the type of treatment or anxiety type. CONCLUSIONS Findings suggest that less recruitment of SFG, including the dorsal ACC and dorsomedial PFC, during implicit emotion processing predicts a greater reduction in youth anxiety symptoms pre-to-post treatment. Youth who exhibit reduced activation in these areas while matching shapes in the context of emotional face distractors may have more to gain from CBT and SSRI treatment due to preexisting deficits in attentional control. These findings suggest that neuroimaging may be a useful tool for predicting which youth are most likely to benefit from anxiety treatment.
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Affiliation(s)
| | - Autumn Kujawa
- Department of Psychiatry, University of Illinois at Chicago, IL
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, IL
,Department of Psychology, University of Illinois at Chicago, Chicago, IL
| | | | - Christopher S. Monk
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
,Department of Psychology, University of Michigan, Ann Arbor, MI
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, IL
,Department of Psychology, University of Illinois at Chicago, Chicago, IL
,Department of Anatomy and Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, USA
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21
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Fresco DM, Roy AK, Adelsberg S, Seeley S, García-Lesy E, Liston C, Mennin DS. Distinct Functional Connectivities Predict Clinical Response with Emotion Regulation Therapy. Front Hum Neurosci 2017; 11:86. [PMID: 28316567 PMCID: PMC5334508 DOI: 10.3389/fnhum.2017.00086] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/13/2017] [Indexed: 12/13/2022] Open
Abstract
Despite the success of available medical and psychosocial treatments, a sizable subgroup of individuals with commonly co-occurring disorders, generalized anxiety disorder (GAD) and major depressive disorder (MDD), fail to make sufficient treatment gains thereby prolonging their deficits in life functioning and satisfaction. Clinically, these patients often display temperamental features reflecting heightened sensitivity to underlying motivational systems related to threat/safety and reward/loss (e.g., somatic anxiety) as well as inordinate negative self-referential processing (e.g., worry, rumination). This profile may reflect disruption in two important neural networks associated with emotional/motivational salience (e.g., salience network) and self-referentiality (e.g., default network, DN). Emotion Regulation Therapy (ERT) was developed to target this hypothesized profile and its neurobehavioral markers. In the present study, 22 GAD patients (with and without MDD) completed resting state MRI scans before receiving 16 sessions of ERT. To test study these hypotheses, we examined the associations between baseline patterns of intrinsic functional connectivity (iFC) of the insula and of hubs within the DN (anterior and dorsal medial prefrontal cortex [MPFC] and posterior cingulate cortex [PCC]) and treatment-related changes in worry, somatic anxiety symptoms and decentering. Results suggest that greater treatment linked reductions in worry were associated with iFC clusters in both the insular and parietal cortices. Greater treatment linked gains in decentering, a metacognitive process that involves the capacity to observe items that arise in the mind with healthy psychological distance that is targeted by ERT, was associated with iFC clusters in the anterior and posterior DN. The current study adds to the growing body of research implicating disruptions in the default and salience networks as promising targets of treatment for GAD with and without co-occurring MDD.
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Affiliation(s)
- David M. Fresco
- Department of Psychological Sciences, Kent State UniversityKent, OH, USA
- Department of Psychiatry, Case Western Reserve University School of MedicineCleveland, OH, USA
| | - Amy K. Roy
- Department of Psychology, Fordham UniversityBronx, NY, USA
| | | | - Saren Seeley
- Department of Psychology, University of ArizonaTucson, AZ, USA
| | - Emmanuel García-Lesy
- The Graduate Center, City University of New YorkNew York, NY, USA
- Hunter College, City University of New YorkNew York, NY, USA
| | - Conor Liston
- Department of Psychiatry, Weill Cornell Medical CollegeNew York, NY, USA
| | - Douglas S. Mennin
- The Graduate Center, City University of New YorkNew York, NY, USA
- Hunter College, City University of New YorkNew York, NY, USA
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22
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Wang X, Xie H, Cotton AS, Duval ER, Tamburrino MB, Brickman KR, Elhai JD, Ho SS, McLean SA, Ferguson EJ, Liberzon I. Preliminary Study of Acute Changes in Emotion Processing in Trauma Survivors with PTSD Symptoms. PLoS One 2016; 11:e0159065. [PMID: 27415431 PMCID: PMC4944986 DOI: 10.1371/journal.pone.0159065] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 06/27/2016] [Indexed: 01/17/2023] Open
Abstract
Accumulating evidence suggests traumatic experience can rapidly alter brain activation associated with emotion processing. However, little is known about acute changes in emotion neurocircuits that underlie PTSD symptom development. To examine acute alterations in emotion circuit activation and structure that may be linked to PTSD symptoms, thirty-eight subjects performed a task of appraisal of emotional faces as their brains were functionally and structurally studied with MRI at both two weeks and three months after motor vehicle collision (MVC). As determined by symptoms reported in the PTSD Checklist at three months, sixteen survivors developed probable PTSD, whereas the remaining 22 did not meet criteria for PTSD diagnosis (non-PTSD). The probable PTSD group had greater activation than the non-PTSD group in dorsal and ventral medial prefrontal cortex (dmPFC and vmPFC) while appraising fearful faces within two weeks after MVC and in left insular cortex (IC) three months after MVC. dmPFC activation at two weeks significantly positively correlated with PTSD symptom severity at two weeks (R = 0.462, P = 0.006) and three months (R = 0.418, p = 0.012). Changes over time in dmPFC activation and in PTSD symptom severity were also significantly positively correlated in the probable PTSD group (R = 0.641, P = 0.018). A significant time by group interaction was found for volume changes in left superior frontal gyrus (SFG, F = 6.048, p = 0.019) that partially overlapped dmPFC active region. Between two weeks and three months, left SFG volume decreased in probable PTSD survivors. These findings identify alterations in frontal cortical activity and structure during the early post-trauma period that appear to be associated with development of PTSD symptoms.
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Affiliation(s)
- Xin Wang
- Department of Psychiatry, University of Toledo, Toledo, Ohio, United States of America
| | - Hong Xie
- Department of Neurosciences, University of Toledo, Toledo, Ohio, United States of America
| | - Andrew S Cotton
- Department of Psychiatry, University of Toledo, Toledo, Ohio, United States of America
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Marijo B Tamburrino
- Department of Psychiatry, University of Toledo, Toledo, Ohio, United States of America
| | - Kristopher R Brickman
- Department of Emergency Medicine, University of Toledo, Toledo, Ohio, United States of America
| | - Jon D Elhai
- Department of Psychology, University of Toledo, Toledo, Ohio, United States of America
| | - S Shaun Ho
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States of America
| | - Samuel A McLean
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Eric J Ferguson
- Department of Trauma service, ProMedica Toledo Hospital, Toledo, Ohio, United States of America
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, United States of America
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23
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Thoresen JC, Francelet R, Coltekin A, Richter KF, Fabrikant SI, Sandi C. Not all anxious individuals get lost: Trait anxiety and mental rotation ability interact to explain performance in map-based route learning in men. Neurobiol Learn Mem 2016; 132:1-8. [DOI: 10.1016/j.nlm.2016.04.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 04/06/2016] [Accepted: 04/20/2016] [Indexed: 12/21/2022]
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24
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Disrupted prefrontal activity during emotion processing in complicated grief: An fMRI investigation. Neuroimage 2015; 124:968-976. [PMID: 26434802 DOI: 10.1016/j.neuroimage.2015.09.054] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 08/27/2015] [Accepted: 09/26/2015] [Indexed: 11/20/2022] Open
Abstract
Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O'Connor and Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=-10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief.
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Harnett NG, Wheelock MD, Wood KH, Ladnier JC, Mrug S, Knight DC. Affective state and locus of control modulate the neural response to threat. Neuroimage 2015. [PMID: 26196669 DOI: 10.1016/j.neuroimage.2015.07.034] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The ability to regulate the emotional response to threat is critical to healthy emotional function. However, the response to threat varies considerably from person-to-person. This variability may be partially explained by differences in emotional processes, such as locus of control and affective state, which vary across individuals. Although the basic neural circuitry that mediates the response to threat has been described, the impact individual differences in affective state and locus of control have on that response is not well characterized. Understanding how these factors influence the neural response to threat would provide new insight into processes that mediate emotional function. Therefore, the present study used a Pavlovian conditioning procedure to investigate the influence individual differences in locus of control, positive affect, and negative affect have on the brain and behavioral responses to predictable and unpredictable threats. Thirty-two healthy volunteers participated in a fear conditioning study in which predictable and unpredictable threats (i.e., unconditioned stimulus) were presented during functional magnetic resonance imaging (fMRI). Locus of control showed a linear relationship with learning-related ventromedial prefrontal cortex (PFC) activity such that the more external an individual's locus of control, the greater their differential response to predictable versus unpredictable threat. In addition, positive and negative affectivity showed a curvilinear relationship with dorsolateral PFC, dorsomedial PFC, and insula activity, such that those with high or low affectivity showed reduced regional activity compared to those with an intermediate level of affectivity. Further, activity within the PFC, as well as other regions including the amygdala, were linked with the peripheral emotional response as indexed by skin conductance and electromyography. The current findings demonstrate that the neural response to threat within brain regions that mediate the peripheral emotional response is modulated by an individual's affective state as well as their perceptions of an event's causality.
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Affiliation(s)
| | | | - Kimberly H Wood
- Department of Psychology, University of Alabama at Birmingham, USA
| | - Jordan C Ladnier
- Department of Psychology, University of Alabama at Birmingham, USA
| | - Sylvie Mrug
- Department of Psychology, University of Alabama at Birmingham, USA
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, USA.
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26
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Liberzon I, Ma ST, Okada G, Ho SS, Swain JE, Evans GW. Childhood poverty and recruitment of adult emotion regulatory neurocircuitry. Soc Cogn Affect Neurosci 2015; 10:1596-606. [PMID: 25939653 DOI: 10.1093/scan/nsv045] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 04/24/2015] [Indexed: 01/18/2023] Open
Abstract
One in five American children grows up in poverty. Childhood poverty has far-reaching adverse impacts on cognitive, social and emotional development. Altered development of neurocircuits, subserving emotion regulation, is one possible pathway for childhood poverty's ill effects. Children exposed to poverty were followed into young adulthood and then studied using functional brain imaging with an implicit emotion regulation task focused. Implicit emotion regulation involved attention shifting and appraisal components. Early poverty reduced left dorsolateral prefrontal cortex recruitment in the context of emotional regulation. Furthermore, this emotion regulation associated brain activation mediated the effects of poverty on adult task performance. Moreover, childhood poverty also predicted enhanced insula and reduced hippocampal activation, following exposure to acute stress. These results demonstrate that childhood poverty can alter adult emotion regulation neurocircuitry, revealing specific brain mechanisms that may underlie long-term effects of social inequalities on health. The role of poverty-related emotion regulatory neurocircuitry appears to be particularly salient during stressful conditions.
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Affiliation(s)
- Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA, Ann Arbor Veterans Administration Medical Center, Ann Arbor, MI, USA,
| | - Sean T Ma
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Go Okada
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA, Department of Psychiatry, Hiroshima University, Hiroshima, Japan
| | - S Shaun Ho
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - James E Swain
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA, Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA, Child Study Center, Yale University, New Haven, CT, USA and
| | - Gary W Evans
- Department of Design and Environmental Analysis, and Departmentof Human Development, Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, USA
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27
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Lin T, Vaisvaser S, Fruchter E, Admon R, Wald I, Pine DS, Bar-Haim Y, Hendler T. A neurobehavioral account for individual differences in resilience to chronic military stress. Psychol Med 2015; 45:1011-1023. [PMID: 25192244 DOI: 10.1017/s0033291714002013] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND Military training is a chronic stressful period that often induces stress-related psychopathology. Stress vulnerability and resilience depend on personality trait anxiety, attentional threat bias and prefrontal-limbic dysfunction. However, how these neurobehavioral elements interact with regard to the development of symptoms following stress remains unclear. METHOD Fifty-five healthy combat soldiers undergoing intensive military training completed functional magnetic resonance imaging (fMRI) testing while performing the dot-probe task (DPT) composed of angry (threat) and neutral faces. Participants were then stratified according to their bias tendency to avoidance (n = 25) or vigilance (n = 30) groups, categorized as high or low trait anxiety and assessed for post-stress symptom severity. RESULTS Avoidance compared to vigilance tendency was associated with fewer post-trauma symptoms and increased hippocampal response to threat among high anxious but not low anxious individuals. Importantly, mediation analysis revealed that only among high anxious individuals did hippocampal activity lead to lower levels of symptoms through avoidance bias tendency. However, in the whole group, avoidance bias was modulated by the interplay between the hippocampus and the dorsal anterior cingulate cortex (dACC). CONCLUSIONS Our results provide a neurobehavioral model to explain the resilience to post-trauma symptoms following chronic exposure. The model points to the importance of considering threat bias tendency in addition to personality traits when investigating the brain response and symptoms of trauma. Such a multi-parametric approach that accounts for individual behavioral sensitivities may also improve brain-driven treatments of anxiety, possibly by targeting the interplay between the hippocampus and the dACC.
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Affiliation(s)
- T Lin
- Functional Brain Center,Wohl Institute for Advanced Imaging,Tel Aviv Sourasky Medical Center,Israel
| | - S Vaisvaser
- Functional Brain Center,Wohl Institute for Advanced Imaging,Tel Aviv Sourasky Medical Center,Israel
| | - E Fruchter
- Division of Mental Health,Medical Corps, IDF,Tel Hashomer,Military Mail,Israel
| | - R Admon
- Functional Brain Center,Wohl Institute for Advanced Imaging,Tel Aviv Sourasky Medical Center,Israel
| | - I Wald
- School of Psychological Sciences,Tel-Aviv University,Israel
| | - D S Pine
- Mood and Anxiety Disorders Program,Intramural Research Program,The Institute of Mental Health,Bethesda,MD,USA
| | - Y Bar-Haim
- School of Psychological Sciences,Tel-Aviv University,Israel
| | - T Hendler
- Functional Brain Center,Wohl Institute for Advanced Imaging,Tel Aviv Sourasky Medical Center,Israel
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28
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Swartz JR, Phan KL, Angstadt M, Klumpp H, Fitzgerald KD, Monk CS. Altered activation of the rostral anterior cingulate cortex in the context of emotional face distractors in children and adolescents with anxiety disorders. Depress Anxiety 2014; 31:870-9. [PMID: 24995682 PMCID: PMC4205191 DOI: 10.1002/da.22289] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Pediatric and adult anxiety disorder patients exhibit attention bias to threat and difficulty disengaging attention away from threat. Cognitive frameworks suggest that these patterns are associated with hyperactivation of regions associated with detecting threat, such as the amygdala, and hypoactivation of regions associated with regulating attention, including the lateral prefrontal cortex and rostral anterior cingulate cortex (rACC). The aim of the present study was to examine the neural correlates of these processes in children and adolescents with anxiety disorders. METHODS Participants with an anxiety disorder 7 to 19 years old (n = 34) and typically developing controls (n = 35) underwent fMRI scanning. During scanning, they completed a task with conditions that manipulated whether participants were instructed to match emotional faces (direct emotion processing) or match shapes in the context of emotional face distractors (attentional control). RESULTS Results revealed a significant difference in rACC activation during shape versus face matching, with controls evidencing greater rACC activation relative to patients. CONCLUSIONS This study identifies abnormalities in rACC activation as a potential neural mediator associated with pediatric anxiety disorders, which can inform frameworks for understanding their development and treatment.
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Affiliation(s)
- Johnna R. Swartz
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60607, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60607, USA
| | - Kate D. Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Christopher S. Monk
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA,Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA,Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI 48109, USA
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29
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Wheelock MD, Sreenivasan KR, Wood KH, Ver Hoef LW, Deshpande G, Knight DC. Threat-related learning relies on distinct dorsal prefrontal cortex network connectivity. Neuroimage 2014; 102 Pt 2:904-12. [PMID: 25111474 DOI: 10.1016/j.neuroimage.2014.08.005] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 07/23/2014] [Accepted: 08/02/2014] [Indexed: 10/24/2022] Open
Abstract
Conditioned changes in the emotional response to threat (e.g. aversive unconditioned stimulus; UCS) are mediated in part by the prefrontal cortex (PFC). Unpredictable threats elicit large emotional responses, while the response is diminished when the threat is predictable. A better understanding of how PFC connectivity to other brain regions varies with threat predictability would provide important insights into the neural processes that mediate conditioned diminution of the emotional response to threat. The present study examined brain connectivity during predictable and unpredictable threat exposure using a fear conditioning paradigm (previously published in Wood et al., 2012) in which unconditioned functional magnetic resonance imaging data were reanalyzed to assess effective connectivity. Granger causality analysis was performed using the time series data from 15 activated regions of interest after hemodynamic deconvolution, to determine regional effective connectivity. In addition, connectivity path weights were correlated with trait anxiety measures to assess the relationship between negative affect and brain connectivity. Results indicate the dorsomedial PFC (dmPFC) serves as a neural hub that influences activity in other brain regions when threats are unpredictable. In contrast, the dorsolateral PFC (dlPFC) serves as a neural hub that influences the activity of other brain regions when threats are predictable. These findings are consistent with the view that the dmPFC coordinates brain activity to take action, perhaps in a reactive manner, when an unpredicted threat is encountered, while the dlPFC coordinates brain regions to take action, in what may be a more proactive manner, to respond to predictable threats. Further, dlPFC connectivity to other brain regions (e.g. ventromedial PFC, amygdala, and insula) varied with negative affect (i.e. trait anxiety) when the UCS was predictable, suggesting that stronger connectivity may be required for emotion regulation in individuals with higher levels of negative affect.
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Affiliation(s)
- M D Wheelock
- Department of Psychology, University of Alabama at Birmingham, USA
| | - K R Sreenivasan
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA
| | - K H Wood
- Department of Psychology, University of Alabama at Birmingham, USA
| | - L W Ver Hoef
- Department of Neurology, University of Alabama at Birmingham, School of Medicine, Birmingham VA Medical Center, USA
| | - Gopikrishna Deshpande
- AU MRI Research Center, Department of Electrical and Computer Engineering, Auburn University, Auburn, AL, USA; Department of Psychology, Auburn University, Auburn, AL, USA
| | - D C Knight
- Department of Psychology, University of Alabama at Birmingham, USA.
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30
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Wood KH, Ver Hoef LW, Knight DC. The amygdala mediates the emotional modulation of threat-elicited skin conductance response. Emotion 2014; 14:693-700. [PMID: 24866521 PMCID: PMC4115032 DOI: 10.1037/a0036636] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The ability to respond adaptively to threats in a changing environment is an important emotional function. The amygdala is a critical component of the neural circuit that mediates many emotion-related processes, and thus likely plays an important role in modulating the peripheral emotional response to threat. However, prior research has largely focused on the amygdala's response to stimuli that signal impending threat, giving less attention to the amygdala's response to the threat itself. From a functional perspective, however, it is the response to the threat itself that is most biologically relevant. Thus, understanding the factors that influence the amygdala's response to threat is critical for a complete understanding of adaptive emotional processes. Therefore, we used functional MRI to investigate factors (i.e., valence and arousal of co-occurring visual stimuli) that influence the amygdala's response to threat (loud white noise). We also assessed whether changes in amygdala activity varied with the peripheral expression of emotion (indexed via skin conductance response; SCR). The results showed that threat-elicited amygdala activation varied with the arousal, not valence, of emotional images. More specifically, threat-elicited amygdala activation was larger to the threat when presented during high-arousal (i.e., negative and positive) versus low-arousal (i.e., neutral) images. Further, the threat-elicited amygdala response was positively correlated with threat-elicited SCR. These findings indicate the amygdala's response to threat is modified by the nature (e.g., arousal) of other stimuli in the environment. In turn, the amygdala appears to mediate important aspects of the peripheral emotional response to threat.
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Affiliation(s)
- Kimberly H. Wood
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35233
| | - Lawrence W. Ver Hoef
- University of Alabama at Birmingham, School of Medicine; Birmingham VA Medical Center
| | - David C. Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35233
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31
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Van Schuerbeek P, Baeken C, Luypaert R, De Raedt R, De Mey J. Does the amygdala response correlate with the personality trait 'harm avoidance' while evaluating emotional stimuli explicitly? Behav Brain Funct 2014; 10:18. [PMID: 24884791 PMCID: PMC4100577 DOI: 10.1186/1744-9081-10-18] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2013] [Accepted: 04/25/2014] [Indexed: 11/17/2022] Open
Abstract
Background The affective personality trait ‘harm avoidance’ (HA) from
Cloninger’s psychobiological personality model determines how an
individual deals with emotional stimuli. Emotional stimuli are processed by
a neural network that include the left and right amygdalae as important key
nodes. Explicit, implicit and passive processing of affective stimuli are
known to activate the amygdalae differently reflecting differences in
attention, level of detailed analysis of the stimuli and the cognitive
control needed to perform the required task. Previous studies revealed that
implicit processing or passive viewing of affective stimuli, induce a left
amygdala response that correlates with HA. In this new study we have tried
to extend these findings to the situation in which the subjects were
required to explicitly process emotional stimuli. Methods A group of healthy female participants was asked to rate the valence of
positive and negative stimuli while undergoing fMRI. Afterwards the neural
responses of the participants to the positive and to the negative stimuli
were separately correlated to their HA scores and compared between the low
and high HA participants. Results Both analyses revealed increased neural activity in the left laterobasal (LB)
amygdala of the high HA participants while they were rating the positive and
the negative stimuli. Conclusions Our results indicate that the left amygdala response to explicit processing
of affective stimuli does correlate with HA.
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Affiliation(s)
- Peter Van Schuerbeek
- Departement of Radiology, UZ-Brussel, Vrije Universiteit (VUB), Laarbeeklaan 101, 1090, Brussels, Belgium.
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32
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Ball TM, Stein MB, Ramsawh HJ, Campbell-Sills L, Paulus MP. Single-subject anxiety treatment outcome prediction using functional neuroimaging. Neuropsychopharmacology 2014; 39:1254-61. [PMID: 24270731 PMCID: PMC3957121 DOI: 10.1038/npp.2013.328] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2013] [Revised: 10/24/2013] [Accepted: 11/12/2013] [Indexed: 11/09/2022]
Abstract
The possibility of individualized treatment prediction has profound implications for the development of personalized interventions for patients with anxiety disorders. Here we utilize random forest classification and pre-treatment functional magnetic resonance imaging (fMRI) data from individuals with generalized anxiety disorder (GAD) and panic disorder (PD) to generate individual subject treatment outcome predictions. Before cognitive behavioral therapy (CBT), 48 adults (25 GAD and 23 PD) reduced (via cognitive reappraisal) or maintained their emotional responses to negative images during fMRI scanning. CBT responder status was predicted using activations from 70 anatomically defined regions. The final random forest model included 10 predictors contributing most to classification accuracy. A similar analysis was conducted using the clinical and demographic variables. Activations in the hippocampus during maintenance and anterior insula, superior temporal, supramarginal, and superior frontal gyri during reappraisal were among the best predictors, with greater activation in responders than non-responders. The final fMRI-based model yielded 79% accuracy, with good sensitivity (0.86), specificity (0.68), and positive and negative likelihood ratios (2.73, 0.20). Clinical and demographic variables yielded poorer accuracy (69%), sensitivity (0.79), specificity (0.53), and likelihood ratios (1.67, 0.39). This is the first use of random forest models to predict treatment outcome from pre-treatment neuroimaging data in psychiatry. Together, random forest models and fMRI can provide single-subject predictions with good test characteristics. Moreover, activation patterns are consistent with the notion that greater activation in cortico-limbic circuitry predicts better CBT response in GAD and PD.
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Affiliation(s)
- Tali M Ball
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
- Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA, USA
| | - Holly J Ramsawh
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Martin P Paulus
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
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33
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Wood KH, Kuykendall D, Ver Hoef LW, Knight DC. Neural substrates underlying learning-related changes of the unconditioned fear response. Open Neuroimag J 2013; 7:41-52. [PMID: 24478811 PMCID: PMC3905352 DOI: 10.2174/1874440001307010041] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Revised: 10/14/2013] [Accepted: 10/30/2013] [Indexed: 01/10/2023] Open
Abstract
The ability to predict an impending threat during Pavlovian conditioning diminishes the emotional response
that is produced once the threat is encountered. Diminution of the threat response appears to be mediated by somewhat
independent associative learning and expectancy-related processes. Therefore, the present study was designed to better
understand the neural mechanisms that support associative learning processes, independent of expectancy, that influence
the emotional response to a threat. Healthy volunteers took part in a Pavlovian conditioning procedure during which trait
anxiety, expectation of the unconditioned stimulus (UCS), skin conductance response (SCR), and functional magnetic
resonance imaging (fMRI) signal were assessed. The results showed no evidence for associative learning that was
independent of expectation. Threat-related SCR expression was diminished on predictable trials vs. unpredictable trials of
the UCS (i.e. conditioned UCR diminution). Similar to SCR, conditioned UCR diminution was observed within the left
dorsolateral PFC, dorsomedial PFC, ventromedial PFC, and left anterior insula. In contrast, potentiation of the threat-related
fMRI signal response was observed within left dorsolateral PFC, inferior parietal lobule (IPL), and posterior
insula. A negative relationship was observed between UCS expectancy and UCR expression within the dorsomedial PFC,
ventromedial PFC, and anterior insula. Finally, the anticipatory fMRI signal responses within the PFC, posterior
cingulate, and amygdala showed an inverse relationship with threat-related activation within the brain regions that showed
UCR diminution. The current findings suggest that the PFC and amygdala support learning-related processes that impact
the magnitude of the emotional response to a threat.
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Affiliation(s)
- Kimberly H Wood
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, UK
| | - Dystany Kuykendall
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, UK
| | - Lawrence W Ver Hoef
- University of Alabama at Birmingham, School of Medicine; Birmingham VA Medical Center, UK
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL 35294, UK
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Nees F, Witt SH, Lourdusamy A, Vollstädt-Klein S, Steiner S, Poustka L, Banaschewski T, Barker GJ, Büchel C, Conrod PJ, Frank J, Gallinat J, Garavan H, Heinz A, Ittermann B, Loth E, Mann K, Artiges E, Paus T, Pausova Z, Smolka MN, Struve M, Schumann G, Rietschel M, Flor H. Genetic risk for nicotine dependence in the cholinergic system and activation of the brain reward system in healthy adolescents. Neuropsychopharmacology 2013; 38:2081-9. [PMID: 23689675 PMCID: PMC3773681 DOI: 10.1038/npp.2013.131] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 04/23/2013] [Accepted: 04/25/2013] [Indexed: 01/30/2023]
Abstract
Genetic variation in a genomic region on chromosome 15q25.1, which encodes the alpha5, alpha3, and beta4 subunits of the cholinergic nicotinic receptor genes, confers risk to smoking and nicotine dependence (ND). Neural reward-related responses have previously been identified as important factors in the development of drug dependence involving ND. Applying an imaging genetics approach in two cohorts (N=487; N=478) of healthy non-smoking adolescents, we aimed to elucidate the impact of genome-wide significant smoking-associated variants in the CHRNA5-CHRNA3-CHRNB4 gene cluster on reward-related neural responses in central regions such as the striatum, orbitofrontal and anterior cingulate cortex (ACC), and personality traits related to addiction. In both samples, carriers of the rs578776 GG compared with AG/AA genotype showed a significantly lower neural response to reward outcomes in the right ventral and dorsal ACC but not the striatum or the orbitofrontal cortex. Rs578776 was unrelated to neural reward anticipation or reward magnitude. Significantly higher scores of anxiety sensitivity in GG compared with AG/AA carriers were found only in sample 1. Associations with other personality traits were not observed. Our findings suggest that the rs578776 risk variant influences susceptibility to ND by dampening the response of the ACC to reward feedback, without recruiting the striatum or orbitofrontal cortex during feedback or anticipation. Thus, it seems to have a major role in the processing of and behavioral adaptation to changing reward outcomes.
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Affiliation(s)
- F Nees
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany,Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, J 5, D-68159 Mannheim, Germany, Tel: +49 621 1703 6306, Fax: +49 621 1703 6305, E-mail:
| | - S H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - A Lourdusamy
- Institute of Psychiatry, King's College, London, UK
| | - S Vollstädt-Klein
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - S Steiner
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Heidelberg University, Mannheim, Germany
| | - L Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Heidelberg University, Mannheim, Germany
| | - T Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty, Heidelberg University, Mannheim, Germany
| | - G J Barker
- Institute of Psychiatry, King's College, London, UK
| | - C Büchel
- NeuroImage Nord, Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P J Conrod
- Institute of Psychiatry, King's College, London, UK,Department of Psychiatry, Université de Montreal, CHU Ste Justine Hospital, Montréal, QC, Canada
| | - J Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J Gallinat
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - H Garavan
- Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland,Departments of Psychiatry and Psychology, University of Vermont, Burlington, VT, USA
| | - A Heinz
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité—Universitätsmedizin Berlin, Berlin, Germany
| | - B Ittermann
- Physikalisch-Technische Bundesanstalt, Berlin, Germany
| | - E Loth
- Institute of Psychiatry, King's College, London, UK
| | - K Mann
- Department of Addictive Behaviour and Addiction Medicine, Central Institute of Mental Health, Mannheim, Germany
| | - E Artiges
- INSERM CEA Unit 1000 ‘Imaging & Psychiatry', Institut National de la Santé et de la Recherche Médicale, University Paris Sud, Orsay, and AP-HP Department of Adolescent Psychopathology and Medicine, Maison de Solenn, University Paris Descartes, Paris, France
| | - T Paus
- Rotman Research Institute, University of Toronto, Toronto, ON, Canada,School of Psychology, University of Nottingham, Nottingham, UK,Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Z Pausova
- The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - M N Smolka
- Neuroimaging Center and Department of Psychiatry, Technische Universität Dresden, Dresden, Germany
| | - M Struve
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - G Schumann
- Institute of Psychiatry, King's College, London, UK
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - H Flor
- Department of Cognitive and Clinical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Witthöft M, Mier D, Ofer J, Müller T, Rist F, Kirsch P, Bailer J, Diener C. Neuronal and behavioral correlates of health anxiety: results of an illness-related emotional Stroop task. Neuropsychobiology 2013; 67:93-102. [PMID: 23296017 DOI: 10.1159/000345545] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Accepted: 10/24/2012] [Indexed: 11/19/2022]
Abstract
BACKGROUND Health anxiety (HA) is defined as the objectively unfounded fear or conviction of suffering from a severe illness. Predominant attention allocation to illness-related information is regarded as a central process in the development and maintenance of HA, yet little is known about the neuronal correlates of this attentional bias. METHODS An emotional Stroop task with body symptom, illness, and neutral words was employed to elicit emotional interference in healthy participants with high (HA+, n = 12) and low (HA-, n = 12) HA during functional magnetic resonance imaging. RESULTS Prolonged reaction times for indicating the color of symptom words and a decrease in rostral anterior cingulate cortex (rACC) activation were seen in HA+ participants. Emotional interference effects on the behavioral level were negatively related to rACC activity over the whole group. Groups did not differ during the processing of threatening illness words. CONCLUSION The results indicate stronger attention allocation toward body symptom words already in subclinical HA. This attentional bias appears to be linked to hypoactivity of the rACC which impedes effective emotional interference reduction, leading instead to a ruminative processing of the stimulus content.
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Affiliation(s)
- Michael Witthöft
- Department of Clinical Psychology and Psychotherapy, Johannes Gutenberg University, Mainz, Germany.
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36
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Hardee JE, Benson BE, Bar-Haim Y, Mogg K, Bradley BP, Chen G, Britton JC, Ernst M, Fox NA, Pine DS, Pérez-Edgar K. Patterns of neural connectivity during an attention bias task moderate associations between early childhood temperament and internalizing symptoms in young adulthood. Biol Psychiatry 2013; 74:273-9. [PMID: 23489415 PMCID: PMC3725217 DOI: 10.1016/j.biopsych.2013.01.036] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Revised: 01/02/2013] [Accepted: 01/25/2013] [Indexed: 11/24/2022]
Abstract
BACKGROUND Biased attention to threat is found in both individuals with anxiety symptoms and children with the childhood temperament of behavioral inhibition (BI). Although perturbed fronto-amygdala function is implicated in biased attention among anxious individuals, no work has examined the neural correlates of attention biases in BI. Work in this area might clarify underlying mechanisms for anxiety in a sample at risk for internalizing disorders. We examined the relations among early childhood BI, fronto-amygdala connectivity during an attention bias task in young adulthood, and internalizing symptoms, assessed in young adulthood. METHODS Children were assessed for BI at multiple age points from infancy through age seven. On the basis of a composite of observational and maternal report data, we selected 21 young adults classified as having a history of BI and 23 classified as non-BI for this study (n = 44). Participants completed an event-related functional magnetic resonance imaging attention-bias task involving threat (angry faces) and neutral trials. Internalizing symptoms were assessed by self-report and diagnostic interviews. RESULTS The young adults characterized in childhood with BI exhibited greater strength in threat-related connectivity than non-behaviorally inhibited young adults. Between-group differences manifested in connections between the amygdala and two frontal regions: dorsolateral prefrontal cortex and anterior insula. Amygdala-insula connectivity also interacted with childhood BI to predict young adult internalizing symptoms. CONCLUSIONS Behavioral inhibition during early childhood predicts differences as young adults in threat and attention-related fronto-amygdala connectivity. Connectivity strength, in turn, moderated the relations between early BI and later psychopathology.
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Affiliation(s)
- Jillian E. Hardee
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Brenda E. Benson
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Yair Bar-Haim
- School of Psychological Science, Tel Aviv University, Tel Aviv, Israel
| | - Karin Mogg
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Brendan P Bradley
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Gang Chen
- Scientific and Statistical Computing Core, National Institute of Mental Health, Bethesda, MD, USA
| | | | - Monique Ernst
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Nathan A. Fox
- Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA
| | - Daniel S. Pine
- Section on Development and Affective Neuroscience, National Institute of Mental Health, Bethesda, MD, USA
| | - Koraly Pérez-Edgar
- Department of Psychology and Child Study Center, The Pennsylvania State University, University Park, PA, USA,Corresponding author and reprint requests: Koraly Pérez-Edgar, Department of Psychology, The Pennsylvania State University, 111 Moore Building, University Park, PA, 16802-3106;
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Rive MM, van Rooijen G, Veltman DJ, Phillips ML, Schene AH, Ruhé HG. Neural correlates of dysfunctional emotion regulation in major depressive disorder. A systematic review of neuroimaging studies. Neurosci Biobehav Rev 2013; 37:2529-53. [PMID: 23928089 DOI: 10.1016/j.neubiorev.2013.07.018] [Citation(s) in RCA: 317] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2013] [Revised: 06/25/2013] [Accepted: 07/27/2013] [Indexed: 11/16/2022]
Abstract
Abnormal emotion processing is a core feature of major depressive disorder (MDD). Since the emergence of functional neuroimaging techniques, many studies have been conducted in MDD subjects to elucidate the underlying abnormalities in the neural systems involved in emotion regulation. In this systematic review, we discuss this research in the context of the neural model of emotion regulation previously described by Phillips et al. (2008). This model differentiates between automatic and voluntary emotion regulation subprocesses. Automatic regulation subprocesses were shown to involve predominantly medial prefrontal cortical structures, in addition to the hippocampus and parahippocampus, while voluntary regulation processes additionally recruited lateral prefrontal cortical regions. In conclusion, although the available data is limited, findings suggest that MDD subjects demonstrate abnormally reduced activity in lateral prefrontal cortices during explicit voluntary control of emotional experience. During early, automatic stages of emotion regulation, on the other hand, MDD subjects appear to achieve successful emotion regulation by recruiting additional lateral prefrontal neural regions, that may be mediated by medial prefrontal, especially rostral/dorsal anterior cingulate gyrus (ACG) functioning. Dysfunctional automatic regulation may impair successful voluntary emotion regulation, and may present a target for novel therapeutic approaches in MDD.
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Affiliation(s)
- Maria M Rive
- Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
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Sripada RK, Marx CE, King AP, Rajaram N, Garfinkel SN, Abelson JL, Liberzon I. DHEA enhances emotion regulation neurocircuits and modulates memory for emotional stimuli. Neuropsychopharmacology 2013; 38:1798-807. [PMID: 23552182 PMCID: PMC3717538 DOI: 10.1038/npp.2013.79] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2012] [Revised: 02/17/2013] [Accepted: 03/27/2013] [Indexed: 12/31/2022]
Abstract
Dehydroepiandrosterone (DHEA) is a neurosteroid with anxiolytic, antidepressant, and antiglucocorticoid properties. It is endogenously released in response to stress, and may reduce negative affect when administered exogenously. Although there have been multiple reports of DHEA's antidepressant and anxiolytic effects, no research to date has examined the neural pathways involved. In particular, brain imaging has not been used to link neurosteroid effects to emotion neurocircuitry. To investigate the brain basis of DHEA's impact on emotion modulation, patients were administered 400 mg of DHEA (N=14) or placebo (N=15) and underwent 3T fMRI while performing the shifted-attention emotion appraisal task (SEAT), a test of emotional processing and regulation. Compared with placebo, DHEA reduced activity in the amygdala and hippocampus, enhanced connectivity between the amygdala and hippocampus, and enhanced activity in the rACC. These activation changes were associated with reduced negative affect. DHEA reduced memory accuracy for emotional stimuli, and also reduced activity in regions associated with conjunctive memory encoding. These results demonstrate that DHEA reduces activity in regions associated with generation of negative emotion and enhances activity in regions linked to regulatory processes. Considering that activity in these regions is altered in mood and anxiety disorders, our results provide initial neuroimaging evidence that DHEA may be useful as a pharmacological intervention for these conditions and invite further investigation into the brain basis of neurosteroid emotion regulatory effects.
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Affiliation(s)
- Rebecca K Sripada
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109, USA.
| | - Christine E Marx
- Department of Psychiatry, Duke University, Durham, NC, USA,Durham VA Medical Center, Durham, NC, USA
| | - Anthony P King
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Ann Arbor VA Medical Center, Ann Arbor, MI, USA
| | - Nirmala Rajaram
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Ann Arbor VA Medical Center, Ann Arbor, MI, USA
| | - Sarah N Garfinkel
- Department of Psychiatry, Brighton and Sussex Medical School, University of Sussex, Falmer, UK
| | - James L Abelson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychology, University of Michigan, Ann Arbor, MI, USA,Ann Arbor VA Medical Center, Ann Arbor, MI, USA
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39
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Killgore WDS, Schwab ZJ, Tkachenko O, Webb CA, DelDonno SR, Kipman M, Rauch SL, Weber M. Emotional intelligence correlates with functional responses to dynamic changes in facial trustworthiness. Soc Neurosci 2013; 8:334-46. [DOI: 10.1080/17470919.2013.807300] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Sripada RK, Marx CE, King AP, Rampton JC, Ho S, Liberzon I. Allopregnanolone elevations following pregnenolone administration are associated with enhanced activation of emotion regulation neurocircuits. Biol Psychiatry 2013; 73:1045-53. [PMID: 23348009 PMCID: PMC3648625 DOI: 10.1016/j.biopsych.2012.12.008] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2012] [Revised: 11/16/2012] [Accepted: 12/09/2012] [Indexed: 02/08/2023]
Abstract
BACKGROUND The neurosteroid allopregnanolone is a potent allosteric modulator of the gamma-aminobutyric acid type A receptor with anxiolytic properties. Exogenous administration of allopregnanolone reduces anxiety, and allopregnanolone blockade impairs social and affective functioning. However, the neural mechanism whereby allopregnanolone improves mood and reduces anxiety is unknown. In particular, brain imaging has not been used to link neurosteroid effects to emotion regulation neurocircuitry. METHODS To investigate the brain basis of allopregnanolone's impact on emotion regulation, participants were administered 400 mg of pregnenolone (n=16) or placebo (n=15) and underwent 3T functional magnetic resonance imaging while performing the shifted-attention emotion appraisal task, which probes emotional processing and regulation. RESULTS Compared with placebo, allopregnanolone was associated with reduced activity in the amygdala and insula across all conditions. During the appraisal condition, allopregnanolone increased activity in the dorsal medial prefrontal cortex and enhanced connectivity between the amygdala and dorsal medial prefrontal cortex, an effect that was associated with reduced self-reported anxiety. CONCLUSIONS These results demonstrate that in response to emotional stimuli, allopregnanolone reduces activity in regions associated with generation of negative emotion. Furthermore, allopregnanolone may enhance activity in regions linked to regulatory processes. Aberrant activity in these regions has been linked to anxiety psychopathology. These results thus provide initial neuroimaging evidence that allopregnanolone may be a target for pharmacologic intervention in the treatment of anxiety disorders and suggest potential future directions for research into neurosteroid effects on emotion regulation neurocircuitry.
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Affiliation(s)
- Rebecca K. Sripada
- Psychiatry, University of Michigan, Ann Arbor, MI,Psychology, University of Michigan, Ann Arbor, MI,Corresponding author: Rebecca K. Sripada, 4250 Plymouth Road, 2702 Rachel Upjohn Building, Ann Arbor, MI 48109, , Tel : (734) 232-0190, Fax : (734) 936-7868
| | - Christine E. Marx
- Psychiatry, Duke University, Durham, NC,Durham VA Medical Center, Durham, NC
| | - Anthony P. King
- Psychiatry, University of Michigan, Ann Arbor, MI,Ann Arbor VA Medical Center, Ann Arbor, MI
| | | | - Shaun Ho
- Psychiatry, University of Michigan, Ann Arbor, MI
| | - Israel Liberzon
- Psychiatry, University of Michigan, Ann Arbor, MI,Psychology, University of Michigan, Ann Arbor, MI,Ann Arbor VA Medical Center, Ann Arbor, MI
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Lindgren L, Lehtipalo S, Winsö O, Karlsson M, Wiklund U, Brulin C. Touch massage: a pilot study of a complex intervention. Nurs Crit Care 2013; 18:269-77. [DOI: 10.1111/nicc.12017] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Klumpp H, Post D, Angstadt M, Fitzgerald DA, Phan KL. Anterior cingulate cortex and insula response during indirect and direct processing of emotional faces in generalized social anxiety disorder. BIOLOGY OF MOOD & ANXIETY DISORDERS 2013; 3:7. [PMID: 23547713 PMCID: PMC3632493 DOI: 10.1186/2045-5380-3-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 02/07/2013] [Indexed: 06/01/2023]
Abstract
BACKGROUND Generalized social anxiety disorder (gSAD) is associated with a heightened neural sensitivity to signals that convey threat, as evidenced by exaggerated amygdala and/or insula activation when processing face stimuli that express negative emotions. Less clear in the brain pathophysiology of gSAD are cortical top down control mechanisms that moderate reactivity in these subcortical emotion processing regions. This study evaluated amygdala, insula, and anterior cingulate cortex (ACC) activity in gSAD with a novel "Emotional Faces Shifting Attention Task" (EFSAT), an adaptation of perceptual assessment tasks well-known to elicit amygdala response. In healthy volunteers, the task has been shown to engage the amygdala when attention is directed to emotional faces and the ACC when attention is directed to shapes, away from emotional faces. METHODS During functional MRI, 29 participants with gSAD and 27 healthy controls viewed images comprising a trio of faces (angry, fear, or happy) alongside a trio of geometric shapes (circles, rectangles, or triangles) within the same field of view. Participants were instructed to match faces or match shapes, effectively directing attention towards or away from emotional information, respectively. RESULTS Participants with gSAD exhibited greater insula, but not amygdala, activation compared to controls when attending to emotional faces. In contrast, when attention was directed away from faces, controls exhibited ACC recruitment, which was not evident in gSAD. Across participants, greater ACC activation was associated with less insula activation. CONCLUSIONS Evidence that individuals with gSAD exhibited exaggerated insula reactivity when attending to emotional faces in EFSAT is consistent with other studies suggesting that the neural basis of gSAD may involve insula hyper-reactivity. Furthermore, greater ACC response in controls than gSAD when sustained goal-directed attention is required to shift attention away from social signals, together with a negative relationship between ACC and bilateral insula activity, indicate the ACC may have served a regulatory role when the focus of attention was directed to shapes amidst emotional faces.
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Affiliation(s)
- Heide Klumpp
- Mood and Anxiety Disorders Research Program, Department of Psychiatry (HK, DP, DAF, KLP), University of Illinois at Chicago, 1747 W. Roosevelt Rd, Chicago, IL, 60608, USA
| | - David Post
- Mood and Anxiety Disorders Research Program, Department of Psychiatry (HK, DP, DAF, KLP), University of Illinois at Chicago, 1747 W. Roosevelt Rd, Chicago, IL, 60608, USA
| | - Mike Angstadt
- Department of Psychiatry (MA, KLP), University of Michigan, Ann Arbor, MI, USA
| | - Daniel A Fitzgerald
- Mood and Anxiety Disorders Research Program, Department of Psychiatry (HK, DP, DAF, KLP), University of Illinois at Chicago, 1747 W. Roosevelt Rd, Chicago, IL, 60608, USA
| | - K Luan Phan
- Mood and Anxiety Disorders Research Program, Department of Psychiatry (HK, DP, DAF, KLP), University of Illinois at Chicago, 1747 W. Roosevelt Rd, Chicago, IL, 60608, USA
- Department of Psychiatry (MA, KLP), University of Michigan, Ann Arbor, MI, USA
- Neuropsychiatric Research Program (KLP), Mental Health Service, Jesse Brown VA Medical Center, Chicago, IL, USA
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Holtmann J, Herbort MC, Wüstenberg T, Soch J, Richter S, Walter H, Roepke S, Schott BH. Trait anxiety modulates fronto-limbic processing of emotional interference in borderline personality disorder. Front Hum Neurosci 2013; 7:54. [PMID: 23459637 PMCID: PMC3585713 DOI: 10.3389/fnhum.2013.00054] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Accepted: 02/08/2013] [Indexed: 01/17/2023] Open
Abstract
Previous studies of cognitive alterations in borderline personality disorder (BPD) have yielded conflicting results. Given that a core feature of BPD is affective instability, which is characterized by emotional hyperreactivity and deficits in emotion regulation, it seems conceivable that short-lasting emotional distress might exert temporary detrimental effects on cognitive performance. Here we used functional magnetic resonance imaging (fMRI) to investigate how task-irrelevant emotional stimuli (fearful faces) affect performance and fronto-limbic neural activity patterns during attention-demanding cognitive processing in 16 female, unmedicated BPD patients relative to 24 age-matched healthy controls. In a modified flanker task, emotionally negative, socially salient pictures (fearful vs. neutral faces) were presented as distracters in the background. Patients, but not controls, showed an atypical response pattern of the right amygdala with increased activation during emotional interference in the (difficult) incongruent flanker condition, but emotion-related amygdala deactivation in the congruent condition. A direct comparison of the emotional conditions between the two groups revealed that the strongest diagnosis-related differences could be observed in the dorsal and, to a lesser extent, also in the rostral anterior cingulate cortex (dACC, rACC) where patients exhibited an increased neural response to emotional relative to neutral distracters. Moreover, in the incongruent condition, both the dACC and rACC fMRI responses during emotional interference were negatively correlated with trait anxiety in the patients, but not in the healthy controls. As higher trait anxiety was also associated with longer reaction times (RTs) in the BPD patients, we suggest that in BPD patients the ACC might mediate compensatory cognitive processes during emotional interference and that such neurocognitive compensation that can be adversely affected by high levels of anxiety.
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Affiliation(s)
- Jana Holtmann
- Department of Psychiatry, Campus Mitte, Charité Universitätsmedizin BerlinBerlin, Germany
- Campus Benjamin Franklin, Charité Universitätsmedizin BerlinBerlin, Germany
- Department of Education and Psychology, Freie Universität BerlinBerlin, Germany
| | - Maike C. Herbort
- Department of Psychiatry, Campus Mitte, Charité Universitätsmedizin BerlinBerlin, Germany
- Campus Benjamin Franklin, Charité Universitätsmedizin BerlinBerlin, Germany
- Department of Education and Psychology, Freie Universität BerlinBerlin, Germany
- Department of Behavioral Neurology, Leibniz Institute for NeurobiologyMagdeburg, Germany
| | - Torsten Wüstenberg
- Department of Psychiatry, Campus Mitte, Charité Universitätsmedizin BerlinBerlin, Germany
| | - Joram Soch
- Department of Behavioral Neurology, Leibniz Institute for NeurobiologyMagdeburg, Germany
- Department of Neurology, Otto von Guericke UniversityMagdeburg, Germany
| | - Sylvia Richter
- Department of Behavioral Neurology, Leibniz Institute for NeurobiologyMagdeburg, Germany
- Department of Clinical Psychology, University of SalzburgSalzburg, Austria
| | - Henrik Walter
- Department of Psychiatry, Campus Mitte, Charité Universitätsmedizin BerlinBerlin, Germany
| | - Stefan Roepke
- Campus Benjamin Franklin, Charité Universitätsmedizin BerlinBerlin, Germany
| | - Björn H. Schott
- Department of Psychiatry, Campus Mitte, Charité Universitätsmedizin BerlinBerlin, Germany
- Department of Behavioral Neurology, Leibniz Institute for NeurobiologyMagdeburg, Germany
- Department of Neurology, Otto von Guericke UniversityMagdeburg, Germany
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Sylvester CM, Corbetta M, Raichle ME, Rodebaugh TL, Schlaggar BL, Sheline YI, Zorumski CF, Lenze EJ. Functional network dysfunction in anxiety and anxiety disorders. Trends Neurosci 2012; 35:527-35. [PMID: 22658924 DOI: 10.1016/j.tins.2012.04.012] [Citation(s) in RCA: 379] [Impact Index Per Article: 31.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Revised: 03/28/2012] [Accepted: 04/27/2012] [Indexed: 01/22/2023]
Abstract
A recent paradigm shift in systems neuroscience is the division of the human brain into functional networks. Functional networks are collections of brain regions with strongly correlated activity both at rest and during cognitive tasks, and each network is believed to implement a different aspect of cognition. We propose here that anxiety disorders and high trait anxiety are associated with a particular pattern of functional network dysfunction: increased functioning of the cingulo-opercular and ventral attention networks as well as decreased functioning of the fronto-parietal and default mode networks. This functional network model can be used to differentiate the pathology of anxiety disorders from other psychiatric illnesses such as major depression and provides targets for novel treatment strategies.
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Affiliation(s)
- C M Sylvester
- Department of Psychiatry, Washington University, Saint Louis, MO, USA.
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Wood KH, Ver Hoef LW, Knight DC. Neural mechanisms underlying the conditioned diminution of the unconditioned fear response. Neuroimage 2012; 60:787-99. [DOI: 10.1016/j.neuroimage.2011.12.048] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2011] [Revised: 12/15/2011] [Accepted: 12/17/2011] [Indexed: 10/14/2022] Open
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46
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Trait anxiety and the dynamics of attentional control. Biol Psychol 2012; 89:252-9. [DOI: 10.1016/j.biopsycho.2011.10.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2011] [Revised: 10/17/2011] [Accepted: 10/19/2011] [Indexed: 01/09/2023]
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