Disorder- and emotional context-specific neurofunctional alterations during inhibitory control in generalized anxiety and major depressive disorder

Treating anxiety comorbidity: Lessons from exposure generalization studies

Comorbidity is a characteristic hallmark of anxiety disorders. Presence of comorbid anxiety and depression is challenging to the diagnosis and treatment. Conventional and transdiagnostic treatment options for anxiety disorders strongly depend on the use of exposure. Recent compelling evidence suggests that the beneficial effects of exposure therapy are transferable across different fear- and anxiety provoking situations and might even affect depressive symptomatology. We provide an overview of findings on existing studies on generalization of exposure effects to untreated stimuli and depression. Potential mechanisms which contribute to generalization of beneficial exposure therapy effects, such as extinction generalization, mastery-related increases in self-efficacy and underlying neural changes are presented and discussed. Understanding and promoting mechanisms related to exposure therapy efficacy and generalization can expedite and enhance the development of more effective transdiagnostic therapy approaches for comorbid anxiety disorders.

Effects of open-skill exercise on executive functions in children and adolescents: a systematic review and meta-analysis

Background

The research on the intervention of open-skill exercise on the executive functions of children and adolescents still requires quantitative synthesis, and there is inconsistency in the effects of intervention by strategic and interceptive skills, which are sub-divided from open-skill exercise. Therefore, this study systematically explores the aforementioned issues and examines the potential moderating factors in the effects of open-skill exercise intervention on executive functions.

Methods

Computer searches of the CNKI, WOS, PubMed, ScienceDirect and SPORTDiscus databases were conducted. Two researchers independently screened the articles and extracted data, and used the bias risk assessment tool recommended by the Cochrane Collaboration Network and the Methodological Index for Non- Randomized Studies (MINORS) scale to assess included randomized controlled trials (RCTs) and quasi-experimental designs (QEDs). Statistical analyses were performed using Stata 16.0 software.

Results

A total of 16 articles and 17 studies were included, comprising 11 RCTs and 6 QEDs. The participants were 1,298 children and adolescents aged 5 to 16. Open skill exercises have significant intervention effects (p < 0.01) on inhibitory control (SMD = -0.627, 95%CI = -0.890 to -0.363), working memory (SMD = -0.517, 95%CI = -0.768 to -0.266), and cognitive flexibility (SMD = -0.652, 95%CI = -1.085 to -0.219). The effects of strategic skill exercises are higher than those of interceptive skills, particularly in the dimension of inhibitory control (SMD = -0.707, 95%CI = -0.819 to -0.594, p < 0.05). In addition, moderate-intensity and higher-frequency exercises overall have a more positive effect on promoting executive functions (p < 0.05); interventions of 6 to 10 weeks are more effective for working memory (p < 0.05), while 30-min sessions are the most effective for working memory (p < 0.05), and sessions lasting 75 to 120 min are the most effective for cognitive flexibility (p < 0.05). Open-skill exercise has a more positive impact on inhibitory control in the 5-9 age group and on working memory in the 10-16 age group (p < 0.05); open-skill exercise, especially, has a more positive intervention effect on inhibitory control in the Eastern group (p < 0.05). Both Egger linear regression analyses and literature sensitivity analyses suggested that the Meta-analysis results were stable and reliable.

Conclusion

Open-skill exercise has a positive intervention effect on executive functioning in children and adolescents, and strategic skill exercise interventions are more effective. In addition, the quantitative elements of exercise (intensity, frequency, and duration per session) and demographic factors (age and ethnicity) play a potential moderating role in this context. Based on this, it is recommended that children and adolescents choose more strategic open-skill exercises according to their actual situation and select appropriate quantitative exercise factors to maximize the enhancement of their executive functions.

Systematic review registration

https://www.crd.york.ac.uk/prospero/#myprospero, CRD42025636714.

Pupillary response to cognitive control in depression-prone individuals

Revealing the pupillary correlates of depression-prone individuals is conducive to the early intervention and treatment of depression. This study recruited 31 depression-prone and 31 healthy individuals. They completed an emotional task-switching task combined with a go/no-go task, and task-evoked pupillary responses (TEPR) were recorded. Behavioral results showed no significant differences in behavioral performance in terms of cognitive flexibility and inhibition between the depression-prone group and the healthy control group. The pupillary results revealed that (1) the depression-prone group showed slightly lower TEPRs to positive stimuli than the healthy controls during cue presentation; (2) during target presentation, the depression-prone group did not show an effect of emotional valence on the pupillary response in the task-repeat trials; and (3) compared to the healthy controls, the depression-prone group showed significantly smaller TEPRs to negative no-go stimuli and had a longer latency of the second peak of pupil dilation in no-go trials. These results imply that depression-prone individuals may have slower neural responses in cognitive control tasks and emotion-specific weakened cognitive control than healthy individuals.

Executive functions in older adults with generalised anxiety disorder and healthy controls: Associations with heart rate variability, brain-derived neurotrophic factor, and physical fitness

Executive functions (EF) decline with age and this decline in older adults with generalised anxiety disorder (GAD) may be influenced by heart rate variability (HRV), brain-derived neurotrophic factor (BDNF), and physical fitness. Understanding these relationships is important for tailored treatments in this population. In this study, 51 adults with GAD (M age = 66.46, SD = 4.08) and 51 healthy controls (M age = 67.67, SD = 4.04) were assessed on cognitive inhibition (Stroop task), shifting (Trails part 4), flexibility (Wisconsin Card Sorting Test - Perseverative errors), working memory (Digit Span Backwards), IQ (Wechsler Abbreviated Scale of Intelligence), high frequency HRV, serum mature BDNF levels, and VO2 max. Results indicated that participants with GAD exhibited better cognitive inhibition compared to controls, with no general reduction in EF. Cognitive inhibition was predicted by gender, HRV, and BDNF levels, while cognitive shifting was predicted by gender and IQ, and cognitive flexibility and working memory by IQ. The enhanced cognitive inhibition in GAD participants might stem from maladaptive use of this function, characteristic of GAD, or protection from EF decline due to normal HRV. Increased BDNF levels, possibly due to good fitness, or compensatory mechanisms related to the disorder, might also play a role. These findings highlight the complexity of EF and related mechanisms in GAD, highlighting the need for interventions that consider both cognitive and physiological factors for optimal outcomes.

Dynamic brain functional states associated with inhibition control under different altitudes

Chronic exposure to the hypobaric hypoxia environment of plateau could influence human cognitive behaviours which are supported by dynamic brain connectivity states. Until now, how functional connectivity (FC) of the brain network changes with altitudes is still unclear. In this article, we used EEG data of the Go/NoGo paradigm from Weinan (347 m) and Nyingchi (2950 m). A combination of dynamic FC (dFC) and the K-means cluster was employed to extract dynamic FC states which were later distinguished by graph metrics. Besides, temporal properties of networks such as fractional windows (FW), transition numbers (TN) and mean dwell time (MDT) were calculated. Finally, we successfully extracted two different states from dFC matrices where State 1 was verified to have higher functional integration and segregation. The dFC states dynamically switched during the Go/NoGo tasks and the FW of State 1 showed a rise in the high-altitude participants. Also, in the regional analysis, we found higher state deviation in the fronto-parietal cortices and enhanced FC strength in the occipital lobe. These results demonstrated that long-term exposure to the high-altitude environment could lead brain networks to reorganize as networks with higher inter- and intra-networks information transfer efficiency, which could be attributed to a compensatory mechanism to the compromised brain function due to the plateau environment. This study provides a new perspective in considering how the plateau impacted cognitive impairment.

Effects of open and closed skill exercise interventions on executive function in typical children: a meta-analysis

BACKGROUND

The effects of open and closed skill exercise interventions for executive function in children and adolescents have received widespread attention. Open skill refers to the skill of performing motor tasks in an unpredictable environment; closed skill refers to the skill of performing motor tasks in a stable environment. However, the results of related studies are currently controversial and Meta-analysis is urgently needed.

METHODS

After computer searches of CNKI, Wan-Fang, VIP, WOS, PubMed, and EBSCO databases, two researchers independently screened articles, extracted information, and evaluated the quality of the articles. This study was statistical analyzed using Stata 16.0 software.

RESULTS

A total of 31 articles were included, including 2988 typical children. Open, closed, continuous and sequential skills all improved executive function in typical children to varying degrees, but open and sequential skills were more effective in improving executive function, particularly in the former in the working memory (SMD=-0.833, P < 0.001) and in the latter in the inhibitory control (SMD=-0.834, P < 0.001) and cognitive flexibility (SMD=-0.903, P < 0.001). Long-term, moderate- intensity interventions were better than acute, vigorous-intensity interventions for executive function, with long-term interventions reflected in working memory (SMD=-0.579, P < 0.001) and moderate-intensity interventions reflected in all three dimensions of executive function (P < 0.01). Intervention periods, intervention intensity and continuous and sequential skills classified by action structure play a significant moderating role. Better results for long-term, sequential structural action interventions based on open skills (P < 0.001); better results for acute, moderate intensity, sequential structural action interventions based on closed (P < 0.05). Whereas intervention intensity had a non-significant moderating effect in the open skills intervention, both moderate and vigorous intensity had a significant effect on executive function (P < 0.001).

CONCLUSION

Open and closed skills have different levels of facilitation effects on executive function in typical children, but open skills are more effective. The facilitation effects of open and closed skills were moderated by the qualitative characteristics and action structure of the intervention.

Abnormal multi-layered dynamic cortico-subcortical functional connectivity in major depressive disorder and generalized anxiety disorder

Comorbidity has been frequently observed between generalized anxiety disorder (GAD) and major depressive disorder (MDD), however, common and distinguishable alterations in the topological organization of functional brain networks remain poorly understood. We sought to determine a robust and sensitive functional connectivity marker for diagnostic classification and symptom severity prediction. Multi-layered dynamic functional connectivity including whole brain, network-node and node-node layers via graph theory and gradient analyses were applied to functional MRI resting-state data obtained from 31 unmedicated GAD and 34 unmedicated MDD patients as well as 33 age and education matched healthy controls (HC). GAD and MDD symptoms were assessed using Penn State Worry Questionnaire and Beck Depression Inventory II, respectively. Three network measures including global properties (i.e., global efficiency, characteristic path length), regional nodal property (i.e., degree) and connectivity gradients were computed. Results showed that both patient groups exhibited abnormal dynamic cortico-subcortical topological organization compared to healthy controls, with MDD > GAD > HC in degree of randomization. Furthermore, our multi-layered dynamic functional connectivity network model reached 77% diagnostic accuracy between GAD and MDD and was highly predictive of symptom severity, respectively. Gradients of functional connectivity for superior frontal cortex-subcortical regions, middle temporal gyrus-subcortical regions and amygdala-cortical regions contributed more in this model compared to other gradients. We found shared and distinct cortico-subcortical connectivity features in dynamic functional brain networks between GAD and MDD, which together can promote the understanding of common and disorder-specific topological organization dysregulations and facilitate early neuroimaging-based diagnosis.

Opposing and emotion-specific associations between frontal activation with depression and anxiety symptoms during facial emotion processing in generalized anxiety and depression

Major depression (MDD) and generalized anxiety disorder (GAD) have become one of the leading global causes of disability and both are characterized by marked interpersonal and social impairments. However, despite high comorbidity and overlapping social-emotional deficits, it remains unclear whether MDD and GAD share a common neural basis during interpersonal processing. In the present study, we combined an emotional face processing paradigm with fMRI and dimensional and categorical analyses in a sample of unmedicated MDD and GAD patients (N = 72) as well as healthy controls (N = 35). No group differences were found in categorical analyses. However, the dimensional analyses revealed that dorsolateral prefrontal cortex (dlPFC) reactivity to sad facial expressions was positively associated with depression symptom load, yet negatively associated with anxiety symptom load in the entire sample. On the network level depression symptom load was positively associated with functional connectivity between the bilateral amygdala and a widespread network including the anterior cingulate and insular cortex. Together, these findings suggest that the dlPFC - engaged in cognitive and emotional processing - exhibits symptom- and emotion-specific alteration during interpersonal processing. Dysregulated communication between the amygdala and core regions of the salience network may represent depression-specific neural dysregulations.

Effect of Physical Exercise in Real-World Settings on Executive Function of Typical Children and Adolescents: A Systematic Review

OBJECTIVE

The aim of this paper is to provide a systematic review of research on physical exercise in real-world settings on executive function of typical children and adolescents.

METHODS

The CNKI, WOS, PubMed, ScienceDirect, and SPORTDiscus databases were searched by computer. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias in the included literature. Statistical analysis was performed using frequency and percentage and the χ² test.

RESULTS

A total of 49 articles was included. Acute (moderate intensity lasting 30-50 min) and long-term (interventions of moderate intensity of 30-50 min at least 3 times a week for 17 weeks or more) physical exercises in real-world settings have positive intervention effects on executive function. Furthermore, for acute interventions, closed skills are more efficient for inhibitory control, open skills are more efficient for working memory and cognitive flexibility, and open-continuous and closed-sequential skills are the most efficient; long-term interventions with open skills, sequential skills, and open-sequential skills are more effective.

CONCLUSION

Physical exercise in real-world settings has a good promotion effect on typical children and adolescents, and motor skills with open and/or sequential attributes are more helpful in improving executive function.

Disorder-specific impaired neurocognitive function in major depression and generalized anxiety disorder

BACKGROUND

Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are both highly prevalent and comorbid psychiatric disorders. Neurocognitive dysfunction has been commonly found in MDD, but the findings in GAD are inconsistent. Few studies have directly compared cognitive performance between GAD and MDD. Therefore, the present study aimed to reveal the similar and distinct cognitive impairments between both disorders.

METHODS

Three non-overlapping and non-comorbid groups were enrolled in the current study including patients with GAD (n = 37), MDD (n = 107) and healthy controls (n = 74). Levels of anxiety and depression were assessed using the Hamilton Anxiety Rating Scale (HAMA) and the Hamilton Depression Rating Scale (HAMD) respectively. The Cambridge Neuropsychological Test Automated Battery (CANTAB) was used to compare the cognitive performance, including sustained attention, visual memory, executive functions and learning.

RESULTS

Both MDD and GAD groups demonstrated common significant deficits in sustained attention, visual memory, working memory and learning when compared to healthy controls. Despite the similarities, the MDD group had significantly greater impairment in learning, particularly generalization, while the GAD group demonstrated more pronounced deficits in visual memory.

LIMITATIONS

Patients involved were medicated and the sample size for GAD was relatively small.

CONCLUSIONS

The significant differences in visual memory and learning between MDD and GAD groups might be indicators to distinguishing both disorders. These results confirm that cognitive function is of great importance as a future target for treatment in order to improve wellbeing, quality of life and functionality in both GAD and MDD.

Pathological fear, anxiety and negative affect exhibit distinct neurostructural signatures: evidence from psychiatric neuroimaging meta-analysis

Internalizing disorders encompass anxiety, fear and depressive disorders, which exhibit overlap at both conceptual and symptom levels. Given that a neurobiological evaluation is lacking, we conducted a Seed-based D-Mapping comparative meta-analysis including coordinates as well as original statistical maps to determine common and disorder-specific gray matter volume alterations in generalized anxiety disorder (GAD), fear-related anxiety disorders (FAD, i.e., social anxiety disorder, specific phobias, panic disorder) and major depressive disorder (MDD). Results showed that GAD exhibited disorder-specific altered volumes relative to FAD including decreased volumes in left insula and lateral/medial prefrontal cortex as well as increased right putamen volume. Both GAD and MDD showed decreased prefrontal volumes compared to controls and FAD. While FAD showed less robust alterations in lingual gyrus compared to controls, this group presented intact frontal integrity. No shared structural abnormalities were found. Our study is the first to provide meta-analytic evidence for distinct neuroanatomical abnormalities underlying the pathophysiology of anxiety-, fear-related and depressive disorders. These findings may have implications for determining promising target regions for disorder-specific neuromodulation interventions (e.g. transcranial magnetic stimulation or neurofeedback).

Disorder- and cognitive demand-specific neurofunctional alterations during social emotional working memory in generalized anxiety disorder and major depressive disorder

BACKGROUND

Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD) are both characterized by cognitive and social impairments. Determining disorder-specific neurobiological alterations in GAD and MDD by means of functional magnetic resonance imaging (fMRI) may promote determination of precise diagnostic markers.

METHODS

This study aimed to examine disorder-specific behavioral and neural alterations at the intersection of social and cognitive processing in treatment-naïve first-episode GAD (n = 35) and MDD (n = 37) patients compared to healthy controls (n = 35) by employing a social-emotional n-back fMRI paradigm.

RESULTS

No behavioral differences between patients and healthy controls were observed. However, GAD patients exhibited decreased bilateral dorsomedial prefrontal cortex (dmPFC) engagement during the 0-back condition yet increased dmPFC engagement during the 1-back condition compared to MDD and healthy participants. In contrast, MDD patients exhibited increased dmPFC-insula coupling during 0-back, yet decreased coupling during 1-back, compared to GAD and healthy participants. Dimensional symptom-load analysis confirmed that increased dmPFC-insula connectivity during 0-back was positively associated with depressive symptom load.

LIMITATIONS

The moderate sample size in the present study did not allow us to further explore gender differences. In addition, some patients exhibited GAD and MDD comorbidity according to the M.I.N.I. interview. Finally, the paradigm we used did not allow to further disentangle emotion-specific effects on working memory.

CONCLUSIONS

These findings suggest that the dmPFC engaged in integrating affective and cognitive components and self-other processing exhibits GAD-specific neurofunctional dysregulations whereas functional dmPFC communication with the insula, a region involved in salience processing, may represent an MDD-specific neurofunctional deficit.

The role of prepotent response inhibition and interference control in depression

INTRODUCTION

The ability to suppress inappropriate prepotent response and to overcome the interference of irrelevant information are two important components of inhibitory control. Little is known, however, about the relevant contributions in these two components of inhibitory control to depression. The aim of the present study was to assess the prepotent response inhibition and interference control simultaneously in a group of patients diagnosed with major depression disorder (MDD).

METHODS

A clinical group of patients with MDD (n = 41) and a control group of healthy volunteers (n = 39) were recruited and assessed using the stop-signal task and the Flanker task respectively.

RESULTS

The results showed longer stop-signal reaction time in patients with MDD in the stop-signal task. Regarding the interference control function, the analysis showed the response accuracy under the incongruent condition was significantly lower in patients with MDD than healthy individuals.

CONCLUSIONS

In conclusion, patients with MDD showed impairments both in prepotent response inhibition and interference control. The present findings provide a better understanding of the mechanism of depression-related deficits in inhibition and have great implications for the development of cognitive training programmes to remediate cognitive dysfunction in depression.

Proteomic Insights Into Susceptibility and Resistance to Chronic-Stress-Induced Depression or Anxiety in the Rat Striatum

Chronic stress is a key factor for the onset of anxiety and depression disorders. However, the stress-induced common and unique molecular basis of the two psychiatric disorders is not fully known and still needs to be explored. Previously, we employed a chronic mild stress (CMS) procedure to induce a rat model including depression-susceptible (Dep-Sus), anxiety-susceptible (Anx-Sus), and insusceptible (Insus) cohorts. In this work, we continuously analyze the striatal proteomes of the three stressed cohorts by the use of comparative proteomics and bioinformatics approaches. Through isobaric tags for relative and absolute quantitation (iTRAQ)-based analysis, 386 abnormally expressed proteins in total were identified. These deregulated proteins are involved in various biological functions and significant pathways that are potentially connected with resistance and susceptibility to CMS-caused anxious- or depressive-like behaviors and, hence, could act as suggestive protein targets. A further parallel reaction monitoring-based independent investigation shows that alterations in Pak5, Dgkg, Scn4b, Rb1cc1, and Acin1; Ggps1, Fntb, Nudt19, Ufd1, and Ndufab1; and Dnajb12, Hbb2, Ap2s1, Ip6k1, and Stk4 were specifically connected with Dep-Sus, Anx-Sus, or Insus groups, respectively, potentially indicating that identical CMS treatment results in the different changes in the striatal protein regulations. Overall, our current proteomics study of the striatum provides an important molecular foundation and comprehensive insights into common and specific deregulations correlated with pathophysiological mechanisms that underlie resistance and susceptibility to chronic stress-induced anxiety or depression.

Proteomic Response of Rat Pituitary Under Chronic Mild Stress Reveals Insights Into Vulnerability and Resistance to Anxiety or Depression

Chronic stress as one of the most significant risk factor can trigger overactivity of hypothalamic-pituitary-adrenal (HPA) axis in depression as well as anxiety. Yet, the shared and unique neurobiological underpinnings underlying the pituitary abnormality in these two disorders have not been made clear. We previously have established depression-susceptible, anxiety-susceptible and insusceptible groups using a valid chronic mild stress (CMS) model. In this work, the possible protein expression changes in the rat pituitary of these three groups were continuously investigated through the use of the comparative quantitative proteomics and bioinformatics approaches. The pituitary-proteome analysis identified totally 197 differential proteins as a CMS response. These deregulated proteins were involved in diverse biological functions and significant pathways potentially connected with the three different behavioral phenotypes, likely serving as new investigative protein targets. Afterwards, parallel reaction monitoring-based independent analysis found out that expression alterations in Oxct1, Sec24c, Ppp1cb, Dock1, and Coq3; Lama1, Glb1, Gapdh, Sccpdh, and Renbp; Sephs1, Nup188, Spp1, Prodh1, and Srm were specifically linked to depression-susceptible, anxiety-susceptible and insusceptible groups, respectively, suggesting that the same CMS had different impacts on the pituitary protein regulatory system. Collectively, the current proteomics research elucidated an important molecular basis and furnished new valuable insights into neurochemical commonalities and specificities of the pituitary dysfunctional mechanisms in HPA axis underlying vulnerability and resistance to stress-induced anxiety or depression.