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Ding J, Tang Z, Liu Y, Chen Q, Tong K, Yang M, Ding X. Altered Intrinsic Brain Activity in Ischemic Stroke Patients Assessed Using the Percent Amplitude of a Fluctuation Method. Brain Topogr 2024:10.1007/s10548-024-01063-1. [PMID: 38896171 DOI: 10.1007/s10548-024-01063-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 06/12/2024] [Indexed: 06/21/2024]
Abstract
Ischemic stroke is a vascular disease that may cause cognitive and behavioral abnormalities. This study aims to assess abnormal brain function in ischemic stroke patients using the percent amplitude of fluctuation (PerAF) method and further explore the feasibility of PerAF as an imaging biomarker for investigating ischemic stroke pathophysiology mechanisms. Sixteen ischemic stroke patients and 22 healthy controls (HCs) underwent resting state functional magnetic resonance imaging (rs-fMRI) scanning, and the resulting data were analyzed using PerAF. Then a correlation analysis was conducted between PerAF values and Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores. Finally, the abnormal PerAF values were extracted and defined as features for support vector machine (SVM) analysis. Compared with HCs, ischemic stroke patients showed decreased PerAF in the bilateral cuneus, left middle frontal gyrus, precuneus and right inferior temporal gyrus, and increased PerAF in the bilateral orbital part of middle frontal gyrus and right orbital part of superior frontal gyrus. Correlation analyses revealed that PerAF values in the left orbital part of middle frontal gyrus was negatively correlated with the MoCA scores. The SVM classification of the PerAF values achieved an area under the curve (AUC) of 0.98 and an accuracy of 94.74%. Abnormal brain function has been found among ischemic stroke patients, which may be correlated with visual impairment, attention deficits, and dysregulation of negative emotions following a stroke. Our findings may support the potential of PerAF as a sensitive biomarker for investigating the underlying mechanisms of ischemic stroke.
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Affiliation(s)
- Jurong Ding
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China.
- Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China.
| | - Zhiling Tang
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China
- Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Yihong Liu
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China
- Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Qiang Chen
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China
- Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Ke Tong
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China
- Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Mei Yang
- School of Automation and Information Engineering, Sichuan University of Science and Engineering, Zigong, PR China
- Artificial Intelligence Key Laboratory of Sichuan Province, Sichuan University of Science & Engineering, Zigong, PR China
| | - Xin Ding
- Department of Neurology, Chengdu Second People's Hospital, Chengdu, PR China
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2
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Han Y, Yan H, Shan X, Li H, Liu F, Li P, Zhao J, Guo W. Shared and distinctive neural substrates of generalized anxiety disorder with or without depressive symptoms and their roles in prognostic prediction. J Affect Disord 2024; 348:207-217. [PMID: 38160885 DOI: 10.1016/j.jad.2023.12.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 11/05/2023] [Accepted: 12/24/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The neurophysiological mechanisms underlying generalized anxiety disorder (GAD) with or without depressive symptoms are obscure. This study aimed to uncover them and assess their predictive value for treatment response. METHODS We enrolled 98 GAD patients [58 (age: 33.22 ± 10.23 years old, males/females: 25/33) with and 40 (age: 33.65 ± 10.49 years old, males/females: 14/26) without depressive symptoms] and 54 healthy controls (HCs, age: 32.28 ± 10.56 years old, males/females: 21/33). Patients underwent clinical assessments and resting-state functional MRI (rs-fMRI) at baseline and after 4-week treatment with paroxetine, while HCs underwent rs-fMRI at baseline only. Regional homogeneity (ReHo) was employed to measure intrinsic brain activity. We compared ReHo in patients to HCs and examined changes in ReHo within the patient groups after treatment. Support vector regression (SVR) analyses were conducted separately for each patient group to predict the patients' treatment response. RESULTS Both patient groups exhibited higher ReHo in the middle/superior frontal gyrus decreased ReHo in different brain regions compared to HCs. Furthermore, differences in ReHo were detected between the two patient groups. After treatment, the patient groups displayed distinct ReHo change patterns. By utilizing SVR based on baseline abnormal ReHo, we effectively predicted treatment response of patients (p-value for correlation < 0.05). LIMITATIONS The dropout rate was relatively high. CONCLUSIONS This study identified shared and unique neural substrates in GAD patients with or without depressive symptoms, potentially serving as biomarkers for treatment response prediction. Comorbid depressive symptoms were associated with differences in disease manifestation and treatment response compared to pure GAD cases.
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Affiliation(s)
- Yiding Han
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang 161006, China
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China.
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Gkintoni E, Ortiz PS. Neuropsychology of Generalized Anxiety Disorder in Clinical Setting: A Systematic Evaluation. Healthcare (Basel) 2023; 11:2446. [PMID: 37685479 PMCID: PMC10486954 DOI: 10.3390/healthcare11172446] [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: 07/14/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
This research paper provides a systematic review of the neuropsychology of generalized anxiety disorder (GAD), examining relevant articles' methodologies and subject matter and highlighting key findings. It suggests potential cognitive deficits in GAD patients, such as subtle attention, executive function, and working memory deficiencies. It also discusses neural correlates of GAD, particularly the hyperactivity in the amygdala and insula, and the additional impact of comorbidity with other psychiatric disorders. The paper uses the PRISMA methodology and draws data from the PsycINFO, Scopus, PubMed, and Elsevier databases. Although the reviewed research has contributed to understanding GAD's cognitive and neural mechanisms, further research is required. Additionally, the paper mentions the clinical neuropsychology of GAD, including strategies and treatments, such as cognitive behavioral therapy (CBT), mindfulness, and medication. Lastly, the review identifies the limitations of the existing research and recommends future directions to enhance the understanding of GAD's underlying cognitive and neural mechanisms. The neural underpinnings of GAD encompass heightened activity within the amygdala and insula, which are brain regions implicated in processing adverse emotional reactions. Co-occurring psychiatric disorders, such as major depressive disorder (MDD), can also impact neuropsychological functioning. Additional investigation is warranted to better understand the intricate interplay between GAD, cognitive performance, and underlying neural processes.
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Affiliation(s)
- Evgenia Gkintoni
- Department of Psychology, University of Ioannina, 45110 Ioannina, Greece
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Yan H, Han Y, Shan X, Li H, Liu F, Li P, Zhao J, Guo W. Breaking the Fear Barrier: Aberrant Activity of Fear Networks as a Prognostic Biomarker in Patients with Panic Disorder Normalized by Pharmacotherapy. Biomedicines 2023; 11:2420. [PMID: 37760861 PMCID: PMC10525800 DOI: 10.3390/biomedicines11092420] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/23/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Panic disorder (PD) is a prevalent type of anxiety disorder. Previous studies have reported abnormal brain activity in the fear network of patients with PD. Nonetheless, it remains uncertain whether pharmacotherapy can effectively normalize these abnormalities. This longitudinal resting-state functional magnetic resonance imaging study aimed to investigate the spontaneous neural activity in patients with PD and its changes after pharmacotherapy, with a focus on determining whether it could predict treatment response. The study included 54 drug-naive patients with PD and 54 healthy controls (HCs). Spontaneous neural activity was measured using regional homogeneity (ReHo). Additionally, support vector regression (SVR) was employed to predict treatment response from ReHo. At baseline, PD patients had aberrant ReHo in the fear network compared to HCs. After 4 weeks of paroxetine treatment (20 mg/day), a significant increase in ReHo was observed in the left fusiform gyrus, which had shown reduced ReHo before treatment. The SVR analysis showed significantly positive correlations (p < 0.0001) between the predicted and actual reduction rates of the severity of anxiety and depressive symptoms. Here, we show patients with PD had abnormal spontaneous neural activities in the fear networks. Furthermore, these abnormal spontaneous neural activities can be partially normalized by pharmacotherapy and serve as candidate predictors of treatment response. Gaining insight into the trajectories of brain activity normalization following treatment holds the potential to provide vital insights for managing PD.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Yiding Han
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, China;
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin 300052, China;
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar 161006, China;
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, China; (H.Y.); (Y.H.); (X.S.); (J.Z.)
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5
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Guo M, Zhong Y, Xu J, Zhang G, Xu A, Kong J, Wang Q, Hang Y, Xie Y, Wu Z, Lang N, Tang Y, Zhang N, Wang C. Altered brain function in patients with acrophobia: A voxel-wise degree centrality analysis. J Psychiatr Res 2023; 164:59-65. [PMID: 37315355 DOI: 10.1016/j.jpsychires.2023.05.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 04/25/2023] [Accepted: 05/16/2023] [Indexed: 06/16/2023]
Abstract
AIM To explore the local spontaneous neural activity and whole-brain functional connectivity patterns in the resting brain of acrophobia patients. METHODS 50 patients with acrophobia and 47 healthy controls were selected for this study. All participants underwent resting-state MRI scans after enrollment. The imaging data were then analyzed using a voxel-based degree centrality (DC) method, and seed-based functional connectivity (FC) correlation analysis was used to explore the correlation between abnormal functional connectivity and clinical symptom scales in acrophobia. The severity of symptoms was evaluated using self-report and behavioral measures. RESULTS Compared to controls, acrophobia patients showed higher DC in the right cuneus and left middle occipital gyrus and significantly lower DC in the right cerebellum and left orbitofrontal cortex (p < 0.01, GRF corrected). Additionally, there were negative correlations between the acrophobia questionnaire avoidance (AQ- Avoidance) scores and right cerebellum-left perirhinal cortex FC (r = -0.317, p = 0.025) and between scores of the 7-item generalized anxiety disorder scale and left middle occipital gyrus-right cuneus FC (r = -0.379, p = 0.007). In the acrophobia group, there was a positive correlation between behavioral avoidance scale and right cerebellum-right cuneus FC (r = 0.377, p = 0.007). CONCLUSIONS The findings indicated that there are local abnormalities in spontaneous neural activity and functional connectivity in the visual cortex, cerebellum, and orbitofrontal cortex in patients with acrophobia.
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Affiliation(s)
- Meilin Guo
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Jingren Xu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Guojia Zhang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Aoran Xu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Jingya Kong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Qiuyu Wang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Yaming Hang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Ya Xie
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China
| | - Zhou Wu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Nan Lang
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China
| | - Yibin Tang
- College of Internet of Things Engineering, Hohai University, Changzhou, Jiangsu, China
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, 210029, China; School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, 210097, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
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6
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White LK, Makhoul W, Teferi M, Sheline YI, Balderston NL. The role of dlPFC laterality in the expression and regulation of anxiety. Neuropharmacology 2023; 224:109355. [PMID: 36442650 PMCID: PMC9790039 DOI: 10.1016/j.neuropharm.2022.109355] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 11/07/2022] [Accepted: 11/23/2022] [Indexed: 11/27/2022]
Abstract
Anxiety disorders are the most common mental health disorder. Therefore, elucidating brain mechanisms implicated in anxiety disorders is important avenue for developing novel treatments and improving care. The dorsolateral prefrontal cortex (dlPFC) is thought to be critically involved in working memory processes (i.e. maintenance, manipulation, suppression, etc.). In addition, there is evidence that this region is involved in anxiety regulation. However, it is unclear how working memory related dlPFC processes contribute to anxiety regulation. Furthermore, we know that laterality plays an important role in working memory related dlPFC processing, however there is no current model of dlPFC mediated anxiety regulation that accounts for potential laterality effects. To address this gap, we propose a potential framework where the dlPFC contributes to emotion regulation via working memory processing. According to this framework, working memory is a fundamental process executed by the dlPFC. However, the domain of content differs across the left and right dlPFC, with the left dlPFC sensitive to primarily verbal content, and the right dlPFC sensitive to primarily non-verbal (affective content). Critically, working memory processes allow for both the retention and suppression of affective information in working memory and the overall net effect of processing on mood will depend on the balance of retention and suppression, the valence of the information being processed (positive vs. negative), and the domain of the information (verbal vs. non-verbal). If accurate, the proposed framework predicts that effects of neuromodulation targeting the dlPFC may be dependent upon the context during which the stimulation is presented. This article is part of the Special Issue on 'Fear, Anxiety and PTSD'.
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Affiliation(s)
- Lauren K White
- Lifespan Brain Institute Children's Hospital of Philadelphia and Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Walid Makhoul
- Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA
| | - Marta Teferi
- Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA
| | - Yvette I Sheline
- Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA
| | - Nicholas L Balderston
- Center for Neuromodulation in Depression and Stress Department of Psychiatry University of Pennsylvania, Philadelphia, PA, USA.
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7
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Fang CW, Chen WR, Chen MS, Yu YF. Role of stimulus types and valence on the affective memory performance of adults with anxiety. Heliyon 2022; 8:e12535. [PMID: 36619474 PMCID: PMC9812702 DOI: 10.1016/j.heliyon.2022.e12535] [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: 07/25/2022] [Revised: 10/25/2022] [Accepted: 12/14/2022] [Indexed: 12/25/2022] Open
Abstract
Previous studies have found that the emotion of anxiety in adults is easily influence by negative stimuli However, few studies have explored the effect of stimulus types on working memory performance and cognitive processing of adults with anxiety. This study aimed to explore the effects of anxiety on affective working memory and the role of stimulus types and valences on affective working memory performance. Forty adults were recruited for the experiment and were divided into two groups according to their anxiety levels. The valence and type of stimulus were manipulated in a memory recognition experiment. The results indicated that individuals with anxiety performed poorer when subjected to positive stimuli than for neutral and negative stimuli, whereas healthy adults exhibited the opposite. Furthermore, participants outperformed on affective pictures than affective words, but the effect size of the words was larger than that of the pictures for the difference between the valence and anxiety groups. This study highlights the differences in affective working performance across stimulus types and valences between healthy adults and adults with anxiety. The findings clarified the effect of positive valence and affective words on the affective working memory processing mechanism in adults with anxiety.
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Affiliation(s)
- Chen-Wen Fang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan,Department of Neurology, National Taiwan University Hospital (Yunlin Branch), Yunlin, Taiwan
| | - Wei-Ru Chen
- Department of Creative Product Design, Southern Taiwan University of Science and Technology, Tainan, Taiwan,Corresponding author.
| | - Min-Sheng Chen
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
| | - Ya-Fang Yu
- Department of Industrial Engineering and Management, National Yunlin University of Science and Technology, Yunlin, Taiwan
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8
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Zhang L, Zou Z, Yu S, Xiao X, Shi Y, Cao W, Liu Y, Zheng H, Zheng Q, Zhou S, Yao J, Deng Y, Yang Q, Chen S, Hao P, Li N, Li Y. Functional connectivity impairment of thalamus-cerebellum-scratching neural circuits in pruritus of chronic spontaneous urticaria. Front Neurosci 2022; 16:1026200. [PMID: 36340791 PMCID: PMC9630740 DOI: 10.3389/fnins.2022.1026200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 10/06/2022] [Indexed: 11/18/2022] Open
Abstract
Pruritus of chronic spontaneous urticaria (CSU) is one of the most common and irritating sensations that severely affects the quality of life. However, the changes in the functional connectivity (FC) between thalamic subregions and other brain regions have not been fully elucidated. This study aimed to explore the potential changes in brain neural circuits by focusing on various subregions of the thalamus in patients with CSU pruritus to contribute to the understanding of chronic pruritus from the perspective of central mechanisms. A total of 56 patients with CSU and 30 healthy controls (HCs) completed the data analysis. Urticaria Activity Score 7 (UAS7), pruritus visual analog score (VAS-P), Dermatological Life Quality Index (DLQI), and immunoglobulin E (IgE) values were collected to assess clinical symptoms. Seed-based resting-state functional connectivity (rs-FC) analysis was used to assess relevant changes in the neural circuits of the brain. Compared to HCs, seeds within the caudal temporal thalamus (cTtha) on the right side of patients with CSU showed increased rs-FC with the cerebellum anterior lobe (CAL). Seeds within the lateral prefrontal thalamus (lPFtha) on the right side showed increased rs-FC with both CAL and pons, while those within the medial prefrontal thalamus (mPFtha) on the right side showed increased rs-FC with both CAL and the dorsal lateral prefrontal cortex (dlPFC) on the right side. Seeds within the posterior parietal thalamus (PPtha) on the right side showed increased rs-FC with the cerebellum posterior lobe (CPL) on the left side. The UAS7 values and IgE levels were positively correlated with the rs-FC of the right dlPFC. Our results suggest that patients with CSU may exhibit stronger rs-FC alterations between certain thalamic subregions and other brain regions. These changes affect areas of the brain involved in sensorimotor and scratching. Trial registration number [http://www.chictr.org.cn], identifier [ChiCTR1900022994].
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Affiliation(s)
- Leixiao Zhang
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zihao Zou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Siyi Yu
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Xianjun Xiao
- College of Health Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yunzhou Shi
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Wei Cao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ying Liu
- Chinese Medicine Hospital, Chengdu, Sichuan, China
| | - Hui Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Qianhua Zheng
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Siyuan Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Junpeng Yao
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Yanli Deng
- Sichuan Second Chinese Medicine Hospital, Chengdu, Sichuan, China
| | - Qian Yang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Sijue Chen
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Pingsheng Hao
- Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Ning Li
- Department of Integrated Traditional and Western Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ying Li
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
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9
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Liu X, Zheng G, Wang X, Li Y, Ji S, Zhang Y, Yao C, Zhang Y, Hu B. The brain activation of anxiety disorders with emotional stimuli-an fMRI ALE meta-analysis. Neurocase 2022; 28:448-457. [PMID: 36548914 DOI: 10.1080/13554794.2022.2160262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Numerous studies have analyzed the state of brain activation about anxiety disorders under emotional stimuli. However, there is no meta-analysis to assess the commonality and specificity activation concerning different subtypes of anxiety. Here, we used ALE to assess this. 29 studies revealed increased bilateral amygdala, anterior cingulate gyrus, parahippocampal gyrus activation in anxiety disorders during emotional stimuli. Moreover, we observed decreased activations in the posterior cingulate, lingual gyrus, and precuneus. In sub-analysis, although different anxiety showed dissimilar activations, the principal activations were observed in limbic lobe, which might indicate the limbic circuit was the main neural reflection of anxiety symptoms.
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Affiliation(s)
- Xia Liu
- School of Computer Science, Qinghai Normal University, Xining, Qinghai Province, China
| | - Guowei Zheng
- Guangyuan Mental Health Center, Guangyuan, Sichuan Province, China
| | - Xiuzhen Wang
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Yongchao Li
- Guangyuan Mental Health Center, Guangyuan, Sichuan Province, China
| | - Shanling Ji
- Guangyuan Mental Health Center, Guangyuan, Sichuan Province, China
| | - Yu Zhang
- Guangyuan Mental Health Center, Guangyuan, Sichuan Province, China
| | - Chaofan Yao
- Guangyuan Mental Health Center, Guangyuan, Sichuan Province, China
| | - Yinghui Zhang
- Gansu Provincial Key Laboratory of Wearable Computing, School of Information Science and Engineering, Lanzhou University, Lanzhou, China
| | - Bin Hu
- School of Computer Science, Qinghai Normal University, Xining, Qinghai Province, China.,Guangyuan Mental Health Center, Guangyuan, Sichuan Province, China.,CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Beijing, China.,Chinese Academy of Sciences, Joint Research Center for Cognitive Neurosensor Technology of Lanzhou University & Institute of Semiconductors, Lanzhou, China.,School of Medical Technology, Beijing Institute of Technology Beijing, China
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10
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Xu X, Xin F, Liu C, Chen Y, Yao S, Zhou X, Zhou F, Huang Y, Dai J, Wang J, Zou Z, Kendrick KM, Zhou B, Becker B. Disorder- and cognitive demand-specific neurofunctional alterations during social emotional working memory in generalized anxiety disorder and major depressive disorder. J Affect Disord 2022; 308:98-105. [PMID: 35427713 DOI: 10.1016/j.jad.2022.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/03/2022] [Accepted: 04/08/2022] [Indexed: 02/06/2023]
Abstract
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.
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Affiliation(s)
- Xiaolei Xu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China; School of Psychology, Shandong Normal University, Jinan 250358, China
| | - Fei Xin
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China; School of Psychology, Shenzhen University, Shenzhen 518060, Guangdong, China
| | - Congcong Liu
- Department of Psychology, Xinxiang Medical University, Henan 453003, China
| | - Yuanshu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Shuxia Yao
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Xinqi Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Feng Zhou
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Yulan Huang
- Department of Psychosomatic Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, China
| | - Jing Dai
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China; Chengdu Mental Health Center, The Fourth People's Hospital of Chengdu, Chengdu, Sichuan 610036, China
| | - Jinyu Wang
- Department of Psychosomatic Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, China
| | - Zhili Zou
- Department of Psychosomatic Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, China
| | - Keith M Kendrick
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China
| | - Bo Zhou
- Department of Psychosomatic Medicine, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, China.
| | - Benjamin Becker
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054, China.
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11
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Cao J, Huang Y, Hodges SA, Meshberg N, Kong J. Identify potential neuroimaging-based scalp acupuncture and neuromodulation targets for anxiety. BRAIN SCIENCE ADVANCES 2021. [DOI: 10.26599/bsa.2021.9050011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Anxiety is a common psychiatric symptom with unsatisfactory treatment. Scalp acupuncture is a new type of acupuncture based on the functions of different brain regions. However, recent brain neuroimaging findings have not been well-integrated into scalp acupuncture practice and research since it was developed. In parallel, recently developed brain stimulation methods have also been applied to treat anxiety. In this study, we integrated meta-analysis (using Neurosynth), resting-state functional connectivity, and diffusion tensor imaging (using the amygdala as the region of interest) to identify potential locations of scalp acupuncture/neuromodulation for anxiety. We found that the superior/middle frontal gyrus, middle/superior temporal gyrus, precentral gyrus, supplementary motor area, supramarginal gyrus, angular gyrus, and superior/inferior occipital gyrus are involved in the pathophysiology of anxiety, and, thus, may be used as the target areas of scalp stimulation for alleviating anxiety. Integrating multidisciplinary brain methods to identify key surface cortical areas associated with a certain disorder may shed light on the development of scalp acupuncture/neuromodulation, particularly in the domain of identifying stimulation locations.
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Affiliation(s)
- Jin Cao
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
| | - Yiting Huang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
| | - Sierra A. Hodges
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
| | - Nathaniel Meshberg
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, MA, USA
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12
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Cao J, Chai-Zhang TC, Huang Y, Eshel MN, Kong J. Potential scalp stimulation targets for mental disorders: evidence from neuroimaging studies. J Transl Med 2021; 19:343. [PMID: 34376209 PMCID: PMC8353731 DOI: 10.1186/s12967-021-02993-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 07/17/2021] [Indexed: 11/16/2022] Open
Abstract
Mental disorders widely contribute to the modern global disease burden, creating a significant need for improvement of treatments. Scalp stimulation methods (such as scalp acupuncture and transcranial electrical stimulation) have shown promising results in relieving psychiatric symptoms. However, neuroimaging findings haven’t been well-integrated into scalp stimulation treatments. Identifying surface brain regions associated with mental disorders would expand target selection and the potential for these interventions as treatments for mental disorders. In this study, we performed large-scale meta-analyses separately on eight common mental disorders: attention deficit hyperactivity disorder, anxiety disorder, autism spectrum disorder, bipolar disorder, compulsive disorder, major depression, post-traumatic stress disorder and schizophrenia; utilizing modern neuroimaging literature to summarize disorder-associated surface brain regions, and proposed neuroimaging-based target protocols. We found that the medial frontal gyrus, the supplementary motor area, and the dorsal lateral prefrontal cortex are commonly involved in the pathophysiology of mental disorders. The target protocols we proposed may provide new brain targets for scalp stimulation in the treatment of mental disorders, and facilitate its clinical application.
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Affiliation(s)
- Jin Cao
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Thalia Celeste Chai-Zhang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Yiting Huang
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Maya Nicole Eshel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA.
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13
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Kim N, Kim MJ. Altered Task-Evoked Corticolimbic Responsivity in Generalized Anxiety Disorder. Int J Mol Sci 2021; 22:ijms22073630. [PMID: 33807276 PMCID: PMC8037355 DOI: 10.3390/ijms22073630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/23/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
Generalized anxiety disorder (GAD) is marked by uncontrollable, persistent worry and exaggerated response to uncertainty. Here, we review and summarize the findings from the GAD literature that employs functional neuroimaging methods. In particular, the present review focuses on task-based blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) studies. We find that select brain regions often regarded as a part of a corticolimbic circuit (e.g., amygdala, anterior cingulate cortex, prefrontal cortex) are consistently targeted for a priori hypothesis-driven analyses, which, in turn, shows varying degrees of abnormal BOLD responsivity in GAD. Data-driven whole-brain analyses show the insula and the hippocampus, among other regions, to be affected by GAD, depending on the task used in each individual study. Overall, while the heterogeneity of the tasks and sample size limits the generalizability of the findings thus far, some promising convergence can be observed in the form of the altered BOLD responsivity of the corticolimbic circuitry in GAD.
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Affiliation(s)
- Nayoung Kim
- Department of Psychology, Sungkyunkwan University, Seoul 03063, Korea;
| | - M. Justin Kim
- Department of Psychology, Sungkyunkwan University, Seoul 03063, Korea;
- Center for Neuroscience Imaging Research, Institute for Basic Science, Suwon 16060, Korea
- Correspondence:
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Balderston NL, Flook E, Hsiung A, Liu J, Thongarong A, Stahl S, Makhoul W, Sheline Y, Ernst M, Grillon C. Patients with anxiety disorders rely on bilateral dlPFC activation during verbal working memory. Soc Cogn Affect Neurosci 2020; 15:1288-1298. [PMID: 33150947 PMCID: PMC7759210 DOI: 10.1093/scan/nsaa146] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 10/01/2020] [Accepted: 10/22/2020] [Indexed: 01/06/2023] Open
Abstract
One of the hallmarks of anxiety disorders is impaired cognitive control, affecting working memory (WM). The dorsolateral prefrontal cortex (dlPFC) is critical for WM; however, it is still unclear how dlPFC activity relates to WM impairments in patients. Forty-one healthy volunteers and 32 anxiety (general and/or social anxiety disorder) patients completed the Sternberg WM paradigm during safety and unpredictable shock threat. On each trial, a series of letters was presented, followed by brief retention and response intervals. On low- and high-load trials, subjects retained the series (five and eight letters, respectively) in the original order, while on sort trials, subjects rearranged the series (five letters) in alphabetical order. We sampled the blood oxygenation level-dependent activity during retention using a bilateral anatomical dlPFC mask. Compared to controls, patients showed increased reaction time during high-load trials, greater right dlPFC activity and reduced dlPFC activity during threat. These results suggest that WM performance for patients and controls may rely on distinct patterns of dlPFC activity with patients requiring bilateral dlPFC activity. These results are consistent with reduced efficiency of WM in anxiety patients. This reduced efficiency may be due to an inefficient allocation of dlPFC resources across hemispheres or a decreased overall dlPFC capacity.
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Affiliation(s)
- Nicholas L Balderston
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
- Center for Neuromodulation in Depression and Stress Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Elizabeth Flook
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Abigail Hsiung
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Jeffrey Liu
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Amanda Thongarong
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Sara Stahl
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Walid Makhoul
- Center for Neuromodulation in Depression and Stress Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Yvette Sheline
- Center for Neuromodulation in Depression and Stress Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Monique Ernst
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
| | - Christian Grillon
- Section on Neurobiology of Fear and Anxiety, National Institute of Mental Health National Institutes of Health, Bethesda, MD 20892, USA
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15
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Lin X, Zhou RB, Huang J, Su YS, Mao RZ, Niu ZA, Cao L, Hu YY, Yang T, Wang X, Zhao GQ, Wang Y, Peng DH, Wu ZG, Wang ZW, Yuan CM, Chen J, Fang YR. Altered resting-state fMRI signals and network topological properties of bipolar depression patients with anxiety symptoms. J Affect Disord 2020; 277:358-367. [PMID: 32861836 DOI: 10.1016/j.jad.2020.08.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 06/13/2020] [Accepted: 08/09/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND This study aims to explore the changes in functional neuroimaging in bipolar depression patients with anxiety symptoms (BDP-A). METHODS Forty-five BDP-A patients, 22 bipolar depression patients without anxiety symptoms (BDP-NA), and 48 healthy controls (HC) were finally involved. The low-frequency oscillation characteristics, functional connectivity (FC), and network properties among the three groups of participants were analyzed. RESULTS Compared with the BDP-NA group, BDP-A patients exhibited significantly decreased amplitude of low-frequency fluctuation (ALFF) in the left middle frontal gyrus (MFG), superior occipital gyrus, and inferior parietal, but supramarginal and angular gyri (IPL). Enhanced FC from left IPL to middle temporal gyrus, from left precentral gyrus (PreCG) to bilateral angular gyri, medial superior frontal gyrus, and left superior frontal gyrus (SFG)/MFG were also revealed. Compared with HC, the BDP-A group showed remarkably increased ALFF in the left MFG/PreCG, right superior parietal gyrus, while decreased ALFF in the left inferior frontal gyrus, opercular part, and SFG. In addition, higher regional homogeneity in the left MFG/PreCG was found. LIMITATIONS The limitations are as follows: (1) relatively small sample size; (2) not all the patients were drug-naive; (3) lack of pure anxiety disorder patients as a controlled group; (4) mental health conditions of HC were not systemic evaluated. CONCLUSIONS BDP-A patients showed significant differences in resting-state fMRI properties when compared with BDP-NA or HC group. These results may infer the dysfunction of the dorsal attention network, the default network, and the fronto-limbic system as well as disrupted brain network efficiency in BDP-A patients.
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Affiliation(s)
- Xiao Lin
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Ru-Bai Zhou
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Jia Huang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - You-Song Su
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Rui-Zhi Mao
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Zhi-Ang Niu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Lan Cao
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Ying-Yan Hu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Tao Yang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Xing Wang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Guo-Qing Zhao
- Department of Psychology, Provincial Hospital Affiliated to Shandong University, Jinan 250021,China
| | - Yong Wang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Dai-Hui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Zhi-Guo Wu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Zuo-Wei Wang
- Shanghai Hongkou District Mental Health Center, Shanghai 200080, China
| | - Cheng-Mei Yuan
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China
| | - Jun Chen
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai 201108, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China.
| | - Yi-Ru Fang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, 600 South Wan Ping Rd, Shanghai 200030, China; CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai 200031, China; Shanghai Key Laboratory of Psychotic Disorders, Shanghai 201108, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, China.
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16
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Li K, Zhang H, Wang B, Yang Y, Zhang M, Li W, Li X, Lv L, Zhao J, Zhang H. Hippocampal functional network: The mediating role between obsession and anxiety in adult patients with obsessive-compulsive disorder. World J Biol Psychiatry 2020; 21:685-695. [PMID: 32174208 DOI: 10.1080/15622975.2020.1733082] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES Anxiety is a very common symptom and closely related to obsessive-compulsive symptoms in obsessive-compulsive disorder (OCD). However, the association between anxiety and obsessive-compulsive symptoms at the hippocampus network level remains unclear. METHODS This study enrolled 42 patients with OCD and 42 healthy controls (HCs), who underwent resting-state functional magnetic resonance imaging (fMRI) and clinical evaluation. Multiple linear regression analysis was performed to investigate the behavioural significance and interactive effects of obsessive-compulsive and anxiety symptoms on the hippocampus functional connectivity (HFC). The mediation analysis model was used to explore whether the hippocampus functional connectivity (FC) network indirectly mediated the relationship between obsessive-compulsive symptoms and anxiety. RESULTS Results showed that the FCs with the cerebellum, middle temporal gyrus (MTG) and anterior cingulate gyrus (ACG) were increased in the hippocampus FC network in patients with OCD compared with those in HCs. The regions of interactive effects between anxiety and obsession, which are mainly located in the prefrontal cortex and MTG, were positively correlated. The mediation effect is 0.018 between obsession and anxiety on the HFC networks in patients with OCD. CONCLUSIONS The FC between the hippocampus and MTG plays a key role in the relationship between anxiety and obsession.
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Affiliation(s)
- Kun Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Haisan Zhang
- Department of Radiology, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Bi Wang
- Department of Radiology, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China
| | - Yongfeng Yang
- Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Meng Zhang
- School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
| | - Wenqiang Li
- Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Xianrui Li
- School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China.,Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China
| | - Jingping Zhao
- Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, P. R. China
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, P. R. China.,Henan Key Lab of Biological Psychiatry, Xinxiang, P. R. China.,School of Psychology, Xinxiang Medical University, Xinxiang, P. R. China
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17
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Disrupted dynamic local brain functional connectivity patterns in generalized anxiety disorder. Prog Neuropsychopharmacol Biol Psychiatry 2020; 99:109833. [PMID: 31812780 DOI: 10.1016/j.pnpbp.2019.109833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 11/01/2019] [Accepted: 12/03/2019] [Indexed: 01/14/2023]
Abstract
Previous studies have reported abnormalities in static brain activity and connectivity in patients with generalized anxiety disorder (GAD). However, the dynamic patterns of brain connectivity in patients with GAD have not been fully explored. In this study, we aimed to investigate the dynamic local brain functional connectivity in patients with GAD using dynamic regional phase synchrony (DRePS), a newly developed method for assessing intrinsic dynamic local functional connectivity. Seventy-four patients with GAD and 74 healthy controls (HCs) were enrolled and underwent resting-state functional magnetic resonance imaging. Compared to the HCs, patients with GAD exhibited decreased DRePS values in the bilateral caudate, left hippocampus, left anterior insula, left inferior frontal gyrus, and right fusiform gyrus extending to inferior temporal gyrus. The DRePS value of the left hippocampus was negatively correlated with the Hamilton Anxiety Rating Scale scores. Moreover, these abnormal DRePS patterns could be used to distinguish patients with GAD from HCs in an independent sample (18 patients with GAD and 21 HCs). Our findings provide further evidence on brain dysfunction in GAD from the perspective of the dynamic behaviour of local connections, suggesting that patients with GAD may have an insufficient brain adaptation. This study provides new insights into the neurocognitive mechanism of GAD and could potentially inform the diagnosis and treatment of this disease. Future studies on GAD could benefit from combining the DRePS method with task-related functional magnetic resonance imaging and non-invasive brain stimulation.
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18
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Chen Y, Cui Q, Xie A, Pang Y, Sheng W, Tang Q, Li D, Huang J, He Z, Wang Y, Chen H. Abnormal dynamic functional connectivity density in patients with generalized anxiety disorder. J Affect Disord 2020; 261:49-57. [PMID: 31600587 DOI: 10.1016/j.jad.2019.09.084] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 09/03/2019] [Accepted: 09/30/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Numerous studies have revealed the abnormal static functional connectivity (FC) among different brain regions in patients with generalized anxiety disorder (GAD). However, little is known about the dynamic changes of FC in patients with GAD. METHODS This study investigated the whole-brain dynamic changes of FC in patients with GAD by combining global FC density (FCD) and sliding window correlation analyses. The standard deviation of dynamic FCD (dFCD) was calculated to evaluate its temporal variability along time. Support vector regression was then employed to predict the symptom severity of patients based on abnormal dynamic connectivity patterns. RESULTS The abnormal dFCD variability between 81 GAD patients and 80 healthy controls showed that the patients had higher dFCD variability in the bilateral dorsomedial prefrontal cortex (dmPFC) and left hippocampus while lower dFCD variability in the right postcentral gyrus. The abnormal dFCD variability of the left dmPFC is an important feature for anxiety prediction. LIMITATIONS The selection of sliding window length remains controversial, and most of our patients have been treated with medications. Future studies are expected to rule out the potential confounding effects from applying different parameters of the sliding window and recruiting large samples of medication-free patients. CONCLUSION The altered patterns of time-varying brain connectivity in the frontolimbic and sensorimotor areas may reflect abnormal dynamic neural communication between these regions and other regions of the brain, which may deepen our understanding of the disease.
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Affiliation(s)
- Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Cui
- School of Public Administration, University of Electronic Science and Technology of China, Chengdu, China.
| | - Ailing Xie
- School of Public Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajing Pang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Di Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Huang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yifeng Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.
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19
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Cui Q, Sheng W, Chen Y, Pang Y, Lu F, Tang Q, Han S, Shen Q, Wang Y, Xie A, Huang J, Li D, Lei T, He Z, Chen H. Dynamic changes of amplitude of low-frequency fluctuations in patients with generalized anxiety disorder. Hum Brain Mapp 2019; 41:1667-1676. [PMID: 31849148 PMCID: PMC7267950 DOI: 10.1002/hbm.24902] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/26/2019] [Accepted: 12/09/2019] [Indexed: 01/18/2023] Open
Abstract
Previous neuroimaging studies have mainly focused on alterations of static and dynamic functional connectivity in patients with generalized anxiety disorder (GAD). However, the characteristics of local brain activity over time in GAD are poorly understood. This study aimed to investigate the abnormal time‐varying local brain activity of GAD by using the amplitude of low‐frequency fluctuation (ALFF) method combined with sliding‐window approach. Group comparison results showed that compared with healthy controls (HCs), patients with GAD exhibited increased dynamic ALFF (dALFF) variability in widespread regions, including the bilateral dorsomedial prefrontal cortex, hippocampus, thalamus, striatum; and left orbital frontal gyrus, inferior parietal lobule, temporal pole, inferior temporal gyrus, and fusiform gyrus. The abnormal dALFF could be used to distinguish between patients with GAD and HCs. Increased dALFF variability values in the striatum were positively correlated with GAD symptom severity. These findings suggest that GAD patients are associated with abnormal temporal variability of local brain activity in regions implicated in executive, emotional, and social function. This study provides insight into the brain dysfunction of GAD from the perspective of dynamic local brain activity, highlighting the important role of dALFF variability in understanding neurophysiological mechanisms and potentially informing the diagnosis of GAD.
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Affiliation(s)
- Qian Cui
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Sheng
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yuyan Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Yajing Pang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Fengmei Lu
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qin Tang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Shaoqiang Han
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Qian Shen
- Education Center for Students Cultural Qualities, University of Electronic Science and Technology of China, Chengdu, China
| | - Yifeng Wang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ailing Xie
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Jing Huang
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Di Li
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Ting Lei
- School of Public Affairs and Administration, University of Electronic Science and Technology of China, Chengdu, China
| | - Zongling He
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Huafu Chen
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
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20
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The spontaneous activity and functional network of the occipital cortex is correlated with state anxiety in healthy adults. Neurosci Lett 2019; 715:134596. [PMID: 31711976 DOI: 10.1016/j.neulet.2019.134596] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Revised: 10/09/2019] [Accepted: 10/28/2019] [Indexed: 12/22/2022]
Abstract
The occipital lobe has been implicated in anxiety disorder, however, its contributions to anxiety in healthy adults remain less clear. We conducted a resting-state functional magnetic resonance imaging study to explore the relationship between the amplitude of low-frequency fluctuation (ALFF), functional connectivity (FC), and state anxiety level in the healthy population. First, the results showed that the ALFF of the left inferior occipital gyrus (IOG) was negatively correlated with state anxiety. Furthermore, state anxiety was positively correlated with the FC between the left IOG and the right medial superior frontal gyrus and right cerebellum 8 area and negatively correlated with the FC between the left IOG and the left superior parietal gyrus. These results indicate that the occipital lobe of healthy individuals is involved in processing of anxiety in part through a frontal-parietal network.
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21
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Kolesar TA, Bilevicius E, Wilson AD, Kornelsen J. Systematic review and meta-analyses of neural structural and functional differences in generalized anxiety disorder and healthy controls using magnetic resonance imaging. NEUROIMAGE-CLINICAL 2019; 24:102016. [PMID: 31835287 PMCID: PMC6879983 DOI: 10.1016/j.nicl.2019.102016] [Citation(s) in RCA: 77] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 08/22/2019] [Accepted: 09/27/2019] [Indexed: 12/18/2022]
Abstract
PFC-amygdala FC is altered in GAD, indicating top-down processing deficits. GAD had reduced activity for emotion regulation and working memory in the culmen. Salience, default, and central executive nodes have altered structure and function.
Objective To compare structure, functional connectivity (FC) and task-based neural differences in subjects with generalized anxiety disorder (GAD) compared to healthy controls (HC). Methods The Embase, Ovid Medline, PsycINFO, Scopus, and Web of Science databases were searched from inception until March 12, 2018. Two reviewers independently screened titles, abstracts, and full-text articles. Data were extracted from records directly contrasting GAD and HC that included structure (connectivity and local indices such as volume, etc.), FC, or task-based magnetic resonance imaging data. Meta-analyses were conducted, as applicable, using AES-SDM software. Results The literature search produced 4,645 total records, of which 85 met the inclusion criteria for the systematic review. Records included structural (n = 35), FC (n = 33), and task-based (n = 42) findings. Meta-analyses were conducted on voxel-based morphometry and task-based results. Discussion The systematic review confirms and extends findings from previous reviews. Although few whole-brain resting state studies were conducted, key nodes of resting state networks have altered physiology: the hippocampus (default network), ACC and amygdala (salience network), have reduced volume, and the dlPFC (central executive network) and ACC have reduced FC with the amygdala in GAD. Nodes in the sensorimotor network are also altered with greater pre- and postcentral volume, reduced supplementary motor area volume, and reduced FC in anterior and increased FC in posterior cerebellum. Conclusions Despite limitations due to sample size, the meta-analyses highly agree with the systematic review and provide evidence of widely distributed neural differences in subjects with GAD, compared to HC. Further research optimized for meta-analyses would greatly improve large-scale comparisons.
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Affiliation(s)
- Tiffany A Kolesar
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada
| | - Elena Bilevicius
- Department of Psychology, University of Manitoba, Winnipeg, MB, Canada
| | - Alyssia D Wilson
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Jennifer Kornelsen
- Department of Physiology and Pathophysiology, University of Manitoba, Winnipeg, MB, Canada; Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada; Department of Radiology, University of Manitoba, Winnipeg, MB, Canada.
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22
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Maggioni E, Delvecchio G, Grottaroli M, Garzitto M, Piccin S, Bonivento C, Maieron M, D'Agostini S, Perna G, Balestrieri M, Brambilla P. Common and different neural markers in major depression and anxiety disorders: A pilot structural magnetic resonance imaging study. Psychiatry Res Neuroimaging 2019; 290:42-50. [PMID: 31279954 DOI: 10.1016/j.pscychresns.2019.06.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 02/04/2023]
Abstract
Although anxiety and depression often co-occur and share some clinical features, it is still unclear if they are neurobiologically distinct or similar processes. In this study, we explored common and specific cortical morphology alterations in depression and anxiety disorders. Magnetic Resonance Imaging data were acquired from 13 Major Depressive Disorder (MDD), 11 Generalized Anxiety Disorder (GAD), 11 Panic Disorder (PD) patients and 21 healthy controls (HC). Regional cortical thickness, surface area (SA), volume and gyrification were measured and compared among groups. We found left orbitofrontal thinning in all patient groups, as well as disease-specific alterations. MDD showed volume deficits in left precentral gyrus compared to all groups, volume and area deficits in right fusiform gyrus compared to GAD and HC. GAD showed lower SA than MDD and PD in right superior parietal cortex, higher gyrification than HC in right frontal gyrus. PD showed higher gyrification in left superior parietal cortex when compared to MDD and higher SA in left postcentral gyrus compared to all groups. Our results suggest that clinical phenotypic similarities between major depression and anxiety disorders might rely on common prefrontal alterations. Frontotemporal and parietal abnormalities may represent unique biological signatures of depression and anxiety.
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Affiliation(s)
- Eleonora Maggioni
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuseppe Delvecchio
- Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, Milan, Italy
| | - Marika Grottaroli
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Garzitto
- Scientific Institute, IRCCS E. Medea, via della Bontà 7, San Vito al Tagliamento, Pordenone, Italy
| | - Sara Piccin
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, via Colugna 50, Udine, Italy
| | - Carolina Bonivento
- Scientific Institute, IRCCS E. Medea, via della Bontà 7, San Vito al Tagliamento, Pordenone, Italy
| | - Marta Maieron
- Department of Physics, Azienda Ospedaliero Universitaria 'S.Maria della Misericordia', P.za S. Maria della Misericordia, Udine, Italy
| | - Serena D'Agostini
- Department of Neuroradiology, Azienda Ospedaliero Universitaria 'S.Maria della Misericordia', P.za S. Maria della Misericordia, Udine, Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences, Villa San Benedetto Menni, Hermanas Hospitalarias, via Roma 16, Albese con Cassano, Como, Italy; Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME), University of Udine, via Colugna 50, Udine, Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Pathophysiology and Transplantation, University of Milan, via F. Sforza 35, Milan, Italy.
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23
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Goossen B, van der Starre J, van der Heiden C. A review of neuroimaging studies in generalized anxiety disorder: "So where do we stand?". J Neural Transm (Vienna) 2019; 126:1203-1216. [PMID: 31222605 DOI: 10.1007/s00702-019-02024-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 05/27/2019] [Indexed: 12/20/2022]
Abstract
Generalized anxiety disorder (GAD) is a prevalent anxiety disorder, but is still poorly recognized in clinical practice. The aim of this review is to provide a coherent understanding of the functional neuroanatomy of GAD; second, to discuss the current theoretical cognitive models surrounding GAD; and finally to discuss the discrepancy between fundamental research and clinical practice and highlight several potential directions for future research in this domain. A systematic review of original papers investigating the neural correlates of DSM-IV and DSM-5 defined GAD samples was undertaken in Ovid literature search, PubMed, Medline, EMbase, PsycINFO, Google Scholar, and TRIP databases. Articles published between 2007 and 2018 were included. First, GAD seems to be characterized by limbic and (pre)frontal abnormalities. More specifically, GAD patients show difficulties in engaging the prefrontal cortex (PFC) and anterior cingulate cortex (ACC) during emotional regulation tasks. Second, the involved brain areas appear to be characterized by heterogeneity possibly due to a variety of experimental designs and test subjects. Third, regarding the discrimination between GAD and other anxiety disorders via fMRI, results appear to be mixed. Studies report both GAD-specific activity and an inability to differentiate between GAD and other anxiety or mood disorders. The usage of different experimental tasks, test subjects, outcome measures and experimental designs limits the possibilities of generalizing results as well as conducting meta-analytical research. Certain theoretical models of GAD describe our understanding of this disorder and form the basis for treatment interventions. However, fMRI research thus far has failed to validate these models. To bridge the gap between fundamental research and clinical practice in GAD, we propose that fMRI researchers make an effort to validate the existing cognitive model of GAD. An alternative approach could be that new models would be based on current neuroimaging research as well as convergent research methods such as Heart Rate Variability (a bottom up approach).
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Affiliation(s)
- Bastiaan Goossen
- Outpatient Treatment Center GGZ Delfland, Sint Jorisweg 2, 2612 GA, Delft, The Netherlands.
| | | | - Colin van der Heiden
- Outpatient Treatment Center Indigo, Spijkenisse, The Netherlands.,Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
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24
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Li K, Zhang H, Yang Y, Zhu J, Wang B, Shi Y, Li X, Meng Z, Lv L, Zhang H. Abnormal functional network of the thalamic subregions in adult patients with obsessive-compulsive disorder. Behav Brain Res 2019; 371:111982. [PMID: 31141727 DOI: 10.1016/j.bbr.2019.111982] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/22/2019] [Accepted: 05/25/2019] [Indexed: 12/18/2022]
Abstract
The thalamus plays an important role in pathological mechanisms underlying obsessive-compulsive disorder (OCD). As the thalamus is a heterogeneous brain region, functional connectivity (FC) between thalamic subregions and other brain regions is worth investigating in OCD. In addition, the relationship between abnormal FC and clinical symptoms is still unclear. In this study, we used resting-state functional magnetic resonance imaging to scan 45 OCD patients and 43 well-matched healthy controls (HCs). Thalamic subregions were defined according to the Human Brainnetome Atlas. The fractional amplitude of low-frequency fluctuations (fALFF) and FC seeding-based connectivity were compared using a two-sample t-test. Correlations between abnormal FC and clinical symptoms were analyzed in OCD patients. Compared with HCs, increased fALFF was found in the bilateral thalamus, and increased FC was observed between the right posterior parietal thalamus (PPtha) and left middle occipital gyrus (LMOG) and between the right occipital thalamus (Otha) and right middle occipital gyrus (RMOG) in OCD patients. In addition, OCD patients had reduced FC between the left sensory thalamus (Stha) and left orbital inferior frontal gyrus, right PPtha and left prefrontal cortex, and between the right Otha and left inferior parietal gyrus (LIPG), respectively. Within the OCD group, the FC between right PPtha-LMOG was correlated with severity of clinical symptoms. These results revealed that the FC between the thalamus and occipital lobe is related to obsessive-compulsive symptoms in OCD patients. This finding provides more accurate information about the involvement of the thalamus in the pathophysiology of OCD.
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Affiliation(s)
- Kun Li
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453002, China
| | - Haisan Zhang
- Radiology department, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453002, China
| | - Yongfeng Yang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453002, China
| | - Jianli Zhu
- Department of Psychology, Xinxiang Medical University, Henan, 453003, China
| | - Bi Wang
- Radiology department, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453002, China
| | - Yanli Shi
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453002, China
| | - Xianrui Li
- Department of Psychology, Xinxiang Medical University, Henan, 453003, China
| | - Zhang Meng
- Department of Psychology, Xinxiang Medical University, Henan, 453003, China
| | - Luxian Lv
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453002, China.
| | - Hongxing Zhang
- Department of Psychiatry, Henan Mental Hospital, The Second Affiliated Hospital of Xinxiang Medical University, Xinxiang, Henan, 453002, China; Department of Psychology, Xinxiang Medical University, Henan, 453003, China.
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Weber-Goericke F, Muehlhan M. A quantitative meta-analysis of fMRI studies investigating emotional processing in excessive worriers: Application of activation likelihood estimation analysis. J Affect Disord 2019; 243:348-359. [PMID: 30266026 DOI: 10.1016/j.jad.2018.09.049] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 07/27/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Excessive worry is a highly impairing cognitive activity which features a range of psychological disorders. Investigations of its disturbed underlying neural mechanisms have presented largely heterogeneous results. This quantitative neuroimaging meta-analysis aims to identify consistent functional disturbances in emotional processing associated with excessive worry across previously published studies. METHODS We used the activation likelihood estimation (ALE) method to test for significant convergence across findings of 16 neuroimaging experiments reporting functional aberrations during emotional processing between individuals experiencing high versus normal levels of worry. RESULTS Results demonstrated convergent aberrations in high compared to normal worriers mainly in a left-hemispheric cluster comprising parts of the middle frontal gyrus, inferior frontal gyrus and anterior insula. Behavioral characterization indicated the identified cluster to be associated with language processing and memory, while meta-analytic connectivity mapping yielded strong functional connections between the observed convergent regions and parts of the salience network as well as the default mode network. LIMITATIONS The ALE method cannot consider findings based on regions of interest analyses and studies without significant group differences. CONCLUSION Our results indicate that in response to emotional contexts worry prone individuals exhibit disturbed functioning in brain areas which are possibly associated with deviant inner speech processes experienced by these individuals. The observed clusters may further constitute key nodes within interacting neural networks that support internally and externally oriented cognition and control the dynamic interplay among these processes.
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Affiliation(s)
- Fanny Weber-Goericke
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, School of Science, Technische Universität Dresden, Dresden Germany
| | - Markus Muehlhan
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany; Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, School of Science, Technische Universität Dresden, Dresden Germany.
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26
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Chen X, Chen Z, Dong Z, Liu M, Yu S. Morphometric changes over the whole brain in caffeine-containing combination-analgesic-overuse headache. Mol Pain 2018; 14:1744806918778641. [PMID: 29877133 PMCID: PMC5992799 DOI: 10.1177/1744806918778641] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective To investigate brain morphometric changes in medication-overuse headache with excessive intake of caffeine-containing combination analgesics. Materials and methods We recruited 32 medication-overuse headache patients overusing caffeine-containing combination analgesics and 26 normal controls with matched sex and age. Magnetic resonance T1-weighted images were processed by automatic volume algorithm of brain regions over the whole brain according to the neuromorphometrics template. We explored the volume differences between groups and correlation with clinical variables. Results Medication-overuse headache patients demonstrated decreased volume in cerebellum, optic chiasm, and increased volume in right lateral orbital gyrus, left calcarine, bilateral middle occipital gyrus, right superior parietal lobe, and right temporal transverse gyrus compared with normal controls. The increased volume was primarily contributed by patients of lower headache frequency (10–20 days/month) and with no psychological comorbidities. In regression analyses, the volume of bilateral middle occipital gyrus had negative association with migraine duration, and the volume of right lateral orbital gyrus and right superior parietal lobe was negatively correlated with number of medications per month. Conclusions Volume changes of brain regions involved in affective and cognitive processing, visual and auditory perception, and pain sensory/discrimination suggested a particular role of those regions in the pathogenesis of medication-overuse headache overusing caffeine-containing combination analgesics. Morphometric changes in multiple visual processing areas and volume gain in lower headache frequency and less anxiety and depression may be specific features related to overusing caffeine-containing combination analgesics.
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Affiliation(s)
- Xiaoyan Chen
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Zhiye Chen
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China.,2 Department of Radiology, Chinese PLA General Hospital, Beijing, China.,3 Department of Radiology, Hainan Branch of Chinese PLA General Hospital, Hainan, China
| | - Zhao Dong
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
| | - Mengqi Liu
- 2 Department of Radiology, Chinese PLA General Hospital, Beijing, China.,3 Department of Radiology, Hainan Branch of Chinese PLA General Hospital, Hainan, China
| | - Shengyuan Yu
- 1 Department of Neurology, Chinese PLA General Hospital, Beijing, China
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27
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Molent C, Maggioni E, Cecchetto F, Garzitto M, Piccin S, Bonivento C, Maieron M, D'Agostini S, Balestrieri M, Perna G, Altamura AC, Brambilla P. Reduced cortical thickness and increased gyrification in generalized anxiety disorder: a 3 T MRI study. Psychol Med 2018; 48:2001-2010. [PMID: 29239286 DOI: 10.1017/s003329171700352x] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Although the study of the neuroanatomical correlates of generalized anxiety disorder (GAD) is gaining increasing interest, up to now the cortical anatomy of GAD patients has been poorly investigated and still no data on cortical gyrification are available. The aim of the present study is to quantitatively examine the cortical morphology in patients with GAD compared with healthy controls (HC) using magnetic resonance imaging (MRI). To the best of our knowledge, this is the first study analyzing the gyrification patterns in GAD. METHODS A total of 31 GAD patients and 31 HC underwent 3 T structural MRI. For each subject, cortical surface area (CSA), cortical thickness (CT), gray matter volume (GMV), and local gyrification index (LGI) were estimated in 19 regions of interest using the Freesurfer software. These parameters were then compared between the two groups using General Linear Model designs. RESULTS Compared with HC, GAD patients showed: (1) reduced CT in right caudal middle frontal gyrus (p < 0.05, Bonferroni corrected), (2) hyper-gyrification in right fusiform, inferior temporal, superior parietal and supramarginal gyri and in left supramarginal and superior frontal gyri (p < 0.05, Bonferroni corrected). No significant alterations in CSA and GMV were observed. CONCLUSIONS Our findings support the hypothesis of a neuroanatomical basis for GAD, highlighting a possible key role of the right hemisphere. The alterations of CT and gyrification in GAD suggest a neurodevelopmental origin of the disorder. Further studies on GAD are needed to understand the evolution of the cerebral morphology with age and during the clinical course of the illness.
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Affiliation(s)
- Cinzia Molent
- Unit of Psychiatry, Department of Medicine (DAME),University of Udine,Udine,Italy
| | - Eleonora Maggioni
- Department of Neurosciences and Mental Health,IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico,University of Milan,Milan,Italy
| | - Filippo Cecchetto
- Unit of Psychiatry, Department of Medicine (DAME),University of Udine,Udine,Italy
| | - Marco Garzitto
- Scientific Institute IRCCS 'Eugenio Medea',Polo FVG, San Vito al Tagliamento, Pordenone,Italy
| | - Sara Piccin
- Scientific Institute IRCCS 'Eugenio Medea',Polo FVG, San Vito al Tagliamento, Pordenone,Italy
| | - Carolina Bonivento
- Unit of Psychiatry, Department of Medicine (DAME),University of Udine,Udine,Italy
| | - Marta Maieron
- Department of Physics,Azienda Ospedaliero Universitaria 'S.Maria della Misericordia',Udine,Italy
| | - Serena D'Agostini
- Department of Neuroradiology,Azienda Ospedaliero Universitaria 'S.Maria della Misericordia',Udine,Italy
| | - Matteo Balestrieri
- Unit of Psychiatry, Department of Medicine (DAME),University of Udine,Udine,Italy
| | - Giampaolo Perna
- Department of Clinical Neurosciences,Villa San Benedetto Menni, Hermanas Hospitalarias,FoRiPsi, Albese con Cassano, Como,Italy
| | - A Carlo Altamura
- Department of Neurosciences and Mental Health,IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico,University of Milan,Milan,Italy
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health,IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico,University of Milan,Milan,Italy
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28
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Zainal NH, Newman MG. Executive function and other cognitive deficits are distal risk factors of generalized anxiety disorder 9 years later. Psychol Med 2018; 48:2045-2053. [PMID: 29224581 PMCID: PMC6707521 DOI: 10.1017/s0033291717003579] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The cognitive model (Hirsch & Mathews, 2012) and attentional control theory (Eysenck & Derakshan, 2011) postulate that compromised executive function (EF) and other cognitive constructs are negatively linked to increased excessive and uncontrollable worry, the core symptom of generalized anxiety disorder (GAD). However, the prospective link between neuropsychological constructs and GAD are not well understood. METHODS A nationally representative sample of 2605 community-dwelling adults whose average age was 55.20 (s.d. = 11.41, range 33-84; 56.31% females) participated at baseline and 9-year follow-up. Baseline neuropsychological function and symptoms were measured using the Brief Test of Adult Cognition by Telephone and Composite International Diagnostic Interview - Short Form. Multivariate Poisson and negative binomial regression analyses were conducted with 11 baseline covariates entered simultaneously: age, gender, years of formal education, perceived control, hypertension/diabetes, body mass index, exercise status, as well as GAD severity, panic disorder severity, and depression severity. Those with baseline GAD were also removed. RESULTS Lower Time 1 composite global cognition z-score independently predicted higher Time 2 GAD severity and diagnosis [odds ratio (OR) 0.60, 95% confidence interval (CI) 0.40-0.89, p = 0.01]. Poor inhibition, set-shifting, working memory (WM) updating, inductive reasoning, and global cognition sequentially forecasted heightened GAD. However, processing speed, verbal WM, verbal fluency, and episodic memory did not predict future GAD. CONCLUSION Global cognition, inductive reasoning, inhibition, set-shifting, and WM updating EF impairments may be distal risk factors for elevated GAD nearly a decade later.
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Affiliation(s)
- Nur Hani Zainal
- Department of Psychology,The Pennsylvania State University,University Park,PA 16802,USA
| | - Michelle G Newman
- Department of Psychology,The Pennsylvania State University,University Park,PA 16802,USA
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van der Meer D, Hoekstra PJ, van Rooij D, Winkler AM, van Ewijk H, Heslenfeld DJ, Oosterlaan J, Faraone SV, Franke B, Buitelaar JK, Hartman CA. Anxiety modulates the relation between attention-deficit/hyperactivity disorder severity and working memory-related brain activity. World J Biol Psychiatry 2018; 19. [PMID: 28635543 PMCID: PMC5581282 DOI: 10.1080/15622975.2017.1287952] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Individuals with attention-deficit/hyperactivity disorder (ADHD) often have heightened levels of anxiety, which has been associated with worse performance on working memory tasks. Knowledge of the neural pathways underlying the combined presence of ADHD and anxiety may aid in a better understanding of their co-occurrence. Therefore, we investigated how anxiety modulates the effect of ADHD severity on neural activity during a visuospatial working memory (VSWM) task. METHODS Neuroimaging data were available for 371 adolescents and young adults participating in the multicentre cohort study NeuroIMAGE (average age 17.1 years). We analysed the effects of ADHD severity, anxiety severity and their interaction on-task accuracy, and on neural activity associated with working memory (VSWM trials minus baseline), and memory load (high memory load trials minus low load trials). RESULTS Anxiety significantly modulated the relation between ADHD severity and neural activity in the cerebellum for the working memory contrast, and bilaterally in the striatum and thalamus for the memory load contrast. CONCLUSIONS We found that ADHD with co-occurring anxiety is associated with lowered neural activity during a VSWM task in regions important for information gating. This fits well with previous theorising on ADHD with co-occurring anxiety, and illustrates the neurobiological heterogeneity of ADHD.
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Affiliation(s)
- Dennis van der Meer
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands,Corresponding author: ; University of Groningen, University Medical Center Groningen, Department of Psychiatry; P.O. Box 30001, 9700 RB Groningen, The Netherlands
| | - Pieter J. Hoekstra
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
| | - Daan van Rooij
- Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Anderson M. Winkler
- Oxford Centre for Functional MRI of the Brain, University of Oxford, Oxford, UK
| | - Hanneke van Ewijk
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - Dirk J. Heslenfeld
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - Jaap Oosterlaan
- Department of Clinical Neuropsychology, VU University Amsterdam, Amsterdam, the Netherlands
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, USA
| | - Barbara Franke
- Departments of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Jan K. Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, The Netherlands,Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
| | - Catharina A. Hartman
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, The Netherlands
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Coplan JD, Webler R, Gopinath S, Abdallah CG, Mathew SJ. Neurobiology of the dorsolateral prefrontal cortex in GAD: Aberrant neurometabolic correlation to hippocampus and relationship to anxiety sensitivity and IQ. J Affect Disord 2018; 229:1-13. [PMID: 29288871 DOI: 10.1016/j.jad.2017.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 09/27/2017] [Accepted: 12/01/2017] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The neurometabolism underlying the cognitive and affective symptoms associated with generalized anxiety disorder (GAD) remain poorly understood. After we have linked worry to intelligence in patients with GAD, we hypothesized that aberrant neurometabolic correlations between hippocampus and neocortical regions may underlie a shared substrate in GAD patients for both anxiety sensitivity and intelligence. METHODS GAD patients (n = 16; F = 11) and healthy volunteers (n = 16; F = 10) were assessed using 1H-MRSI. Co-axial planes I [hippocampus (HIPP)] and co-axial plane III [dorsolateral prefrontal cortex (DLPFC), central gyrus (CG)] were examined. Using general linear models, we examined resting metabolite concentrations using HIPP as a hub to CG and DLPFC. Neocortical ROIs were related to Anxiety Sensitivity Index (ASI) and Full Scale IQ (FSIQ) in GAD patients versus controls. RESULTS Right hippocampal Cho/Cr directly predicted left DLPFC Cho/Cr in GAD (r = 0.75), an effect distinguishable (p = 0.0004) from controls. Left HIPP Cho/Cr positively predicted left CG Cho/Cr in GAD, an effect distinguishable from controls. In patients, both left and right DLPFC Cho/Cr positively predicted ASI but only left DLPFC Cho/Cr inversely predicted IQ. By contrast, IQ in controls correlated directly with left CG Cho/Cr. LIMITATIONS Small sample size precluded us from investigating how gender and FSIQ subscales related to neurochemical correlations in the ROIs examined. CONCLUSIONS Aberrant resting state neurochemical correlation between left DLPFC and right HIPP may contribute to GAD symptomatology. Unlike controls, in GAD, IQ and worry may share a common yet inverse neurometabolic substrate in left DLPFC.
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Affiliation(s)
- Jeremy D Coplan
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA.
| | - Ryan Webler
- Yale Depression Research Program, New Haven, CT, USA
| | - Srinath Gopinath
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Chadi G Abdallah
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Clinical Neuroscience Division, National Center for PTSD, West Haven, CT, USA
| | - Sanjay J Mathew
- Mental Health Care Line, Michael E. Debakey VA Medical Center, Houston, TX, USA; Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Buff C, Schmidt C, Brinkmann L, Gathmann B, Tupak S, Straube T. Directed threat imagery in generalized anxiety disorder. Psychol Med 2018; 48:617-628. [PMID: 28735579 DOI: 10.1017/s0033291717001957] [Citation(s) in RCA: 12] [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: 01/19/2023]
Abstract
BACKGROUND Worrying has been suggested to prevent emotional and elaborative processing of fears. In cognitive-behavioral therapy (CBT), generalized anxiety disorder (GAD) patients are exposed to their fears during the method of directed threat imagery by inducing emotional reactivity. However, studies investigating neural correlates of directed threat imagery and emotional reactivity in GAD patients are lacking. The present functional magnetic resonance imaging (fMRI) study aimed at delineating neural correlates of directed threat imagery in GAD patients. METHOD Nineteen GAD patients and 19 healthy controls (HC) were exposed to narrative scripts of either disorder-related or neutral content and were encouraged to imagine it as vividly as possible. RESULTS Rating results showed that GAD patients experienced disorder-related scripts as more anxiety inducing and arousing than HC. These results were also reflected in fMRI data: Disorder-related v. neutral scripts elicited elevated activity in the amygdala, dorsomedial prefrontal cortex, ventrolateral prefrontal cortex and the thalamus as well as reduced activity in the ventromedial prefrontal cortex/subgenual anterior cingulate cortex in GAD patients relative to HC. CONCLUSION The present study presents the first behavioral and neural evidence for emotional reactivity during directed threat imagery in GAD. The brain activity pattern suggests an involvement of a fear processing network as a neural correlate of initial exposure during directed imagery in CBT in GAD.
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Affiliation(s)
- C Buff
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - C Schmidt
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - L Brinkmann
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - B Gathmann
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - S Tupak
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
| | - T Straube
- Institute of Medical Psychology and Systems Neuroscience,University of Muenster,Von-Esmarch-Str. 52, 48149 Muenster,Germany
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Moon CM, Jeong GW. Associations of neurofunctional, morphometric and metabolic abnormalities with clinical symptom severity and recognition deficit in obsessive-compulsive disorder. J Affect Disord 2018; 227:603-612. [PMID: 29172053 DOI: 10.1016/j.jad.2017.11.059] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 09/29/2017] [Accepted: 11/12/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) causes neural dysfunction associated with cognitive deficit and emotional dysregulation. This study assessed the associations of the neurofunctional changes, gray matter (GM) and white matter (WM) volume alterations in conjunction with in vivo metabolic changes on the working memory tasks in patients with OCD. METHODS Eighteen patients with OCD and 18 healthy controls matched for age, sex, and educational levels underwent high-resolution T1-weighted magnetic resonance imaging (MRI), event-related functional MRI (fMRI), and proton magnetic resonance spectroscopy (1H-MRS) at 3T. RESULTS In fMRI, patients with OCD showed lower activities in the cerebellum, inferior temporal gyrus, orbitofrontal gyrus, dorsolateral prefrontal cortex and calcarine gyrus compared to the controls. In VBM, the patients showed significantly reduced GM volumes, especially in the cerebellum, hippocampus, and superior temporal gyrus, together with significantly reduced WM volumes in the retrolenticular part of the internal capsule, dorsolateral prefrontal cortex (DLPFC) and orbitofrontal gyrus. In 1H-MRS, the ratios of N-acetylaspartate/creatine and choline/creatine were significantly lower in the DLPFC of the patients than in the controls, whereas the ratio of β∙γ-glutamine-glutamate/creatine was significantly higher in the patients than in the controls. LIMITATIONS This study examined small numbers of subjects in each one of the groups. CONCLUSIONS The findings will be helpful to aid us in understanding of neurocognitive impairment in OCD, and thus, enhancing the diagnostic accuracy for OCD by additional information on the associated brain functional deficit, cerebral volume change and metabolic abnormality.
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Affiliation(s)
- Chung-Man Moon
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Advanced Institute of Aging Science, Chonnam National University, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Medical School, Gwangju, Republic of Korea.
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Qiao J, Li A, Cao C, Wang Z, Sun J, Xu G. Aberrant Functional Network Connectivity as a Biomarker of Generalized Anxiety Disorder. Front Hum Neurosci 2017; 11:626. [PMID: 29375339 PMCID: PMC5770732 DOI: 10.3389/fnhum.2017.00626] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/08/2017] [Indexed: 12/14/2022] Open
Abstract
Neural disruptions during emotion regulation are common of generalized anxiety disorder (GAD). Identifying distinct functional and effective connectivity patterns in GAD may provide biomarkers for their diagnoses. This study aims to investigate the differences of features of brain network connectivity between GAD patients and healthy controls (HC), and to assess whether those differences can serve as biomarkers to distinguish GAD from controls. Independent component analysis (ICA) with hierarchical partner matching (HPM-ICA) was conducted on resting-state functional magnetic resonance imaging data collected from 20 GAD patients with medicine-free and 20 matched HC, identifying nine highly reproducible and significantly different functional brain connectivity patterns across diagnostic groups. We then utilized Granger causality (GC) to study the effective connectivity between the regions that identified by HPM-ICA. The linear discriminant analysis was finally used to distinguish GAD from controls with these measures of neural connectivity. The GAD patients showed stronger functional connectivity in amygdala, insula, putamen, thalamus, and posterior cingulate cortex, but weaker in frontal and temporal cortex compared with controls. Besides, the effective connectivity in GAD was decreased from the cortex to amygdala and basal ganglia. Applying the ICA and GC features to the classifier led to a classification accuracy of 87.5%, with a sensitivity of 90.0% and a specificity of 85.0%. These findings suggest that the presence of emotion dysregulation circuits may contribute to the pathophysiology of GAD, and these aberrant brain features may serve as robust brain biomarkers for GAD.
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Affiliation(s)
- Jianping Qiao
- School of Physics and Electronics, Shandong Normal University, Jinan, China.,Shandong Province Key Laboratory of Medical Physics and Image Processing Technology, Shandong Normal University, Jinan, China.,Institute of Data Science and Technology, Shandong Normal University, Jinan, China
| | - Anning Li
- Department of Radiology, Qilu Hospital of Shandong University, Jinan, China
| | - Chongfeng Cao
- Department of Emergency, Jinan Central Hospital Affiliated to Shandong University, Jinan, China
| | - Zhishun Wang
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Jiande Sun
- Institute of Data Science and Technology, Shandong Normal University, Jinan, China.,School of Information Science and Engineering, Shandong Normal University, Jinan, China
| | - Guangrun Xu
- Department of Neurology, Qilu Hospital of Shandong University, Jinan, China
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Sankar A, Adams TM, Costafreda SG, Marangell LB, Fu CH. Effects of antidepressant therapy on neural components of verbal working memory in depression. J Psychopharmacol 2017; 31:1176-1183. [PMID: 28857654 DOI: 10.1177/0269881117724594] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Impairments in verbal working memory are evident in major depression. Verbal working memory is comprised of the components of encoding, maintenance and retrieval. Whether the neural impairments are expressed in specific components, and how pharmacological therapy could modify the neural correlates are not well understood. We investigated the neural correlates of verbal working memory components in depression using the Sternberg task in a longitudinal magnetic resonance imaging study. Serial scans were acquired in 23 patients (mean age 39.8 years) during an acute depressive episode and following 12 weeks of pharmacological therapy with duloxetine and in 22 matched healthy controls (mean age 39.1 years) at the same time points. A significant group by time interaction was evident during the long maintenance phase, extending from the left middle frontal to the middle temporal and caudate regions, in which there was reduced activation in healthy participants at the follow -up scan but there were no changes in patients. Persistent neural engagement during the maintenance phase following treatment was revealed in major depression. The findings emphasize that impairments in verbal working memory may be initiated in the maintenance phase in major depression in order to sustain performance. Further research with larger sample size and using randomized, placebo-controlled double-blind studies are required to confirm our results.
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Affiliation(s)
- Anjali Sankar
- 1 Department of Psychiatry, Stony Brook University, Stony Brook, USA
| | - Tracey M Adams
- 2 Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | | | | | - Cynthia Hy Fu
- 5 School of Psychology, University of East London, London, UK.,6 Centre for Affective Disorders, King's College London, London, UK
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35
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Moon CM, Jeong GW. Functional and morphological alterations associated with working memory dysfunction in patients with generalized anxiety disorder. Acta Radiol 2017; 58:344-352. [PMID: 27235455 DOI: 10.1177/0284185116649794] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background Generalized anxiety disorder (GAD) has been related to functional brain activities and structural brain abnormalities. Purpose To investigate the neural mechanism on working memory dysfunction in patients with GAD in terms of the combined functional and morphological brain abnormalities. Material and Methods Patients with GAD and healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted (T1W) magnetic resonance imaging (MRI) and functional MRI (fMRI). In this study, fMRI and voxel-based morphometry (VBM) were used for assessing the differential brain activation patterns, as well as for comparing the morphological alterations between the two groups. Results In response to the neutral distractors, the patients showed significantly lower activities in the regions of the fusiform gyrus (FuG), superior parietal gyrus (SPG), precuneus (PCu), superior occipital gyrus (SOG), lingual gyrus (LiG), cuneus (Cun), calcarine cortex (CaC), parahippocampal gyrus (PHG) and cerebellar cortex (Cb) compared to the controls. In response to the anxiety-inducing distractors, the patients showed significantly higher activity in the hippocampus and lower activities in the regions of the dorsolateral prefrontal cortex (DLPFC), FuG, SPG, PCu, SOG, and Cb. Also, the patients showed a significant reduction of the white matter volumes in the DLPFC, anterior limb of the internal capsule (ALIC) and midbrain. Conclusion This study provides the first evidence for the association between the morphometric alterations and functional deficit in the working memory processing with the neutral and anxiety-inducing distractors in GAD patients. These findings would be helpful to understand the neural mechanisms on working memory impairment in connection with GAD symptoms.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
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Miller MB, Van Reen E, Barker DH, Roane BM, Borsari B, McGeary JE, Seifer R, Carskadon MA. The impact of sleep and psychiatric symptoms on alcohol consequences among young adults. Addict Behav 2017; 66:138-144. [PMID: 27940388 DOI: 10.1016/j.addbeh.2016.11.023] [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: 05/27/2016] [Revised: 11/23/2016] [Accepted: 11/30/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Independent lines of research have documented links between psychiatric symptoms and poor sleep quality, psychiatric symptoms and alcohol use, and alcohol use and poor sleep quality. The current study examined the synergistic effect of poor sleep quality and psychiatric symptoms on alcohol-related consequences in heavy-drinking young adults. METHOD Matriculating college students reporting at least one heavy drinking episode over the first nine weeks of the semester (N=385, 52% female) were categorized as experiencing 'good' (n=280) versus 'poor' sleep quality (n=105) and screening 'positive' (n=203) or 'negative' (n=182) for a psychiatric disorder. Sleep quality was assessed using the Pittsburgh Sleep Quality Index; psychiatric diagnosis was assessed using the Psychiatric Diagnostic Screening Questionnaire; and alcohol-related consequences were assessed using the Brief Young Adult Alcohol Consequences Questionnaire. General linear models were used to examine the main effects and interaction between sleep quality and psychiatric symptoms on alcohol-related consequences. RESULTS Sleep quality moderated the association between psychiatric screen and alcohol-related consequences among heavy-drinking college students, such that psychiatric symptoms were associated with more alcohol-related consequences in the context of poor sleep quality. CONCLUSIONS The combination of poor sleep quality and psychiatric symptoms is associated with increased alcohol-related consequences among heavy-drinking college students. Given the significant interaction between these symptoms, healthcare providers are encouraged to screen for the presence of sleep and psychiatric disorders among heavy-drinking young adults and to provide empirically-supported treatments as appropriate.
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Affiliation(s)
- Mary Beth Miller
- Center for Alcohol and Addiction Studies, Department of Behavioral and Social Sciences, Brown University School of Public Health, Box G-S121-4, Providence, RI 02912, United States.
| | - Eliza Van Reen
- Sleep for Science Research Lab, Brown University, 300 Duncan Drive, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 1 Hoppin Street, Coro West Suite 204, Providence, RI 02903, United States
| | - David H Barker
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 1 Hoppin Street, Coro West Suite 204, Providence, RI 02903, United States; Sleep for Science Research Lab, Brown University, 300 Duncan Drive, Providence, RI 02906, United States
| | - Brandy M Roane
- Sleep for Science Research Lab, Brown University, 300 Duncan Drive, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 1 Hoppin Street, Coro West Suite 204, Providence, RI 02903, United States; University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, United States
| | - Brian Borsari
- San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121, United States
| | - John E McGeary
- Providence VA Medical Center, 830 Chalkstone Ave, Providence, RI 02908, United States; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 1 Hoppin Street, Coro West Suite 204, Providence, RI 02903, United States
| | - Ronald Seifer
- Sleep for Science Research Lab, Brown University, 300 Duncan Drive, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 1 Hoppin Street, Coro West Suite 204, Providence, RI 02903, United States
| | - Mary A Carskadon
- Sleep for Science Research Lab, Brown University, 300 Duncan Drive, Providence, RI 02906, United States; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, 1 Hoppin Street, Coro West Suite 204, Providence, RI 02903, United States; School of Psychology, Social Work, and Social Policy, University of South Australia, Adelaide, South Australia, Australia
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Moon CM, Jeong GW. Abnormalities in gray and white matter volumes associated with explicit memory dysfunction in patients with generalized anxiety disorder. Acta Radiol 2017; 58:353-361. [PMID: 27273376 DOI: 10.1177/0284185116649796] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background The neuroanatomical abnormalities associated with behavioral dysfunction on explicit memory in patients generalized anxiety disorder (GAD) have not yet been clearly identified. Purpose To investigate the regional gray matter (GM) and white matter (WM) volume alterations over the whole brain in patients with GAD, as well as the correlation between the brain structural abnormality and explicit memory dysfunction. Material and Methods Twenty patients with GAD and 20 healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted magnetic resonance imaging (MRI). The participants performed the explicit memory tasks with the neutral and anxiety-inducing words. Results Patients with GAD showed significantly reduced GM volumes in the midbrain (MB), thalamus, hippocampus (Hip), insula, and superior temporal gyrus (STG); and reduced WM volumes in the MB, anterior limb of the internal capsule (ALIC), dorsolateral prefrontal cortex (DLPFC), and precentral gyrus (PrG). It is important to note that the GM volume of the Hip and the WM volume of the DLPFC were positively correlated with the recognition accuracy (%) in the explicit memory tasks with neutral and anxiety-inducing words, respectively. On the other hand, the WM volume of the PrG was negatively correlated with the reaction time in the same memory tasks. Conclusion This study demonstrated the regional volume changes on whole-brain GM and WM and the correlation between the brain structural alteration and explicit memory dysfunction in GAD patients. These findings would be helpful to understand the association between the brain structure abnormality and the functional deficit in the explicit memory in GAD.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
- Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea
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Xia L, Li S, Wang T, Guo Y, Meng L, Feng Y, Cui Y, Wang F, Ma J, Jiang G. Spontaneous alterations of regional brain activity in patients with adult generalized anxiety disorder. Neuropsychiatr Dis Treat 2017; 13:1957-1965. [PMID: 28790831 PMCID: PMC5530096 DOI: 10.2147/ndt.s133853] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE We aimed to examine how spontaneous brain activity might be related to the pathophysiology of generalized anxiety disorder (GAD). PATIENTS AND METHODS Using resting-state functional MRI, we examined spontaneous regional brain activity in 31 GAD patients (mean age, 36.87±9.16 years) and 36 healthy control participants (mean age, 39.53±8.83 years) matched for age, education, and sex from December 2014 to October 2015. We performed a two-sample t-test on the voxel-based analysis of the regional homogeneity (ReHo) maps. We used Pearson correlation analysis to compare scores from the Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, State-Trait Anxiety Scale-Trait Scale, and mean ReHo values. RESULTS We found abnormal spontaneous activity in multiple regions of brain in GAD patients, especially in the sensorimotor cortex and emotional regions. GAD patients showed decreased ReHo values in the right orbital middle frontal gyrus, left anterior cingulate cortex, right middle frontal gyrus, and bilateral supplementary motor areas, with increased ReHo values in the left middle temporal gyrus, left superior temporal gyrus, and right superior occipital gyrus. The ReHo value of the left middle temporal gyrus correlated positively with the Hamilton Anxiety Rating Scale scores. CONCLUSION These results suggest that altered local synchronization of spontaneous brain activity may be related to the pathophysiology of GAD.
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Affiliation(s)
- Likun Xia
- Department of Magnetic Resonance Imaging, People's Hospital of Yuxi City, Yuxi
| | - Shumei Li
- Department of Medical Imaging, Guangdong No 2 Provincial People's Hospital, Guangzhou
| | - Tianyue Wang
- Department of Medical Imaging, Guangdong No 2 Provincial People's Hospital, Guangzhou
| | - Yaping Guo
- Department of Rehabilitation Medicine, People's Hospital of Yuxi City, Yuxi, People's Republic of China
| | - Lihong Meng
- Department of Rehabilitation Medicine, People's Hospital of Yuxi City, Yuxi, People's Republic of China
| | - Yunping Feng
- Department of Rehabilitation Medicine, People's Hospital of Yuxi City, Yuxi, People's Republic of China
| | - Yu Cui
- Department of Magnetic Resonance Imaging, People's Hospital of Yuxi City, Yuxi
| | - Fan Wang
- Department of Magnetic Resonance Imaging, People's Hospital of Yuxi City, Yuxi
| | - Jian Ma
- Department of Magnetic Resonance Imaging, People's Hospital of Yuxi City, Yuxi
| | - Guihua Jiang
- Department of Medical Imaging, Guangdong No 2 Provincial People's Hospital, Guangzhou
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Buff C, Brinkmann L, Neumeister P, Feldker K, Heitmann C, Gathmann B, Andor T, Straube T. Specifically altered brain responses to threat in generalized anxiety disorder relative to social anxiety disorder and panic disorder. NEUROIMAGE-CLINICAL 2016; 12:698-706. [PMID: 27761400 PMCID: PMC5065042 DOI: 10.1016/j.nicl.2016.09.023] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 09/14/2016] [Accepted: 09/30/2016] [Indexed: 11/23/2022]
Abstract
Background Despite considerable effort, the neurobiological underpinnings of hyper-responsive threat processing specific to patients suffering from generalized anxiety disorder (GAD) remain poorly understood. The current functional magnetic resonance imaging (fMRI) study aims to delineate GAD-specific brain activity during immediate threat processing by comparing GAD patients to healthy controls (HC), to social anxiety disorder (SAD) and to panic disorder (PD) patients. Method Brain activation and functional connectivity patterns to threat vs. neutral pictures were investigated using event-related fMRI. The sample consisted of 21 GAD, 21 PD, 21 SAD and 21 HC. Results GAD-specific elevated activity to threat vs. neutral pictures was found in cingulate cortex, dorsal anterior insula/frontal operculum (daI/FO) and posterior dorsolateral prefrontal cortex (dlPFC). Defining these effects as seed regions, we detected GAD-specific increased functional connectivity to threat vs. neutral pictures between posterior dlPFC and ventrolateral prefrontal cortex, between cingulate cortex and amygdala, between cingulate cortex and anterior insula, as well as decreased functional connectivity between daI/FO and mid-dlPFC. Conclusion The findings present the first evidence for GAD-specific neural correlates of hyper-responsive threat processing, possibly reflecting exaggerated threat sensitivity, maladaptive appraisal and attention-allocation processes. Threat processing investigation across multiple anxiety disorders First neural evidence of GAD-specific threat-related alterations GAD-specific alterations primarily located in prefrontal cortex Alterations are suggestive of exaggerated threat sensitivity
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Affiliation(s)
- Christine Buff
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany
- Corresponding author.
| | - Leonie Brinkmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany
| | - Paula Neumeister
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany
| | - Katharina Feldker
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany
| | - Carina Heitmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany
| | - Bettina Gathmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany
| | - Tanja Andor
- Institute of Psychology, University of Muenster, Fliednerstr. 21, 48149 Muenster, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany
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40
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Moon CM, Sundaram T, Choi NG, Jeong GW. Working memory dysfunction associated with brain functional deficits and cellular metabolic changes in patients with generalized anxiety disorder. Psychiatry Res Neuroimaging 2016; 254:137-144. [PMID: 27442922 DOI: 10.1016/j.pscychresns.2016.06.013] [Citation(s) in RCA: 16] [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] [Received: 09/05/2015] [Revised: 06/24/2016] [Accepted: 06/24/2016] [Indexed: 12/14/2022]
Abstract
Generalized anxiety disorder (GAD) is associated with brain functional and morphological changes in connected with emotional dysregulation and cognitive deficit. This study dealt with the neural functional deficits and metabolic abnormalities in working memory (WM) task with emotion-inducing distractors in patients with GAD. Fourteen patients with GAD and 14 healthy controls underwent functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy ((1)H-MRS) at 3T. In response to the emotional distractors in WM tasks, the patients concurrently showed higher activity in the hippocampus and lower activities in the superior occipital gyrus, superior parietal gyrus, dorsolateral prefrontal cortex (DLPFC) and precentral gyrus compared to the controls. MRS revealed significantly lower choline/creatine (Cho/Cr) and choline/N-acetylaspartate (Cho/NAA) ratios in the DLPFC. In particular, the Cho ratios were positively correlated with the brain activities based on blood oxygenation level-dependent signal change in the DLPFC. This study provides the first evidence for the association between the metabolic alterations and functional deficit in WM processing with emotion-inducing distractors in GAD. These findings will be helpful to understand the neural dysfunction in connection with WM impairment in GAD.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Thirunavukkarasu Sundaram
- Department of Radiology, Rajah Muthiah Medical College Hospital, Annamalai University, Annamalai Nagar, Chidambaram, India
| | - Nam-Gil Choi
- Department of Radiology, DongShin University, Naju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam Natioanl University Medical School, Gwangju, Republic of Korea.
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41
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Sonuga-Barke EJS, Cortese S, Fairchild G, Stringaris A. Annual Research Review: Transdiagnostic neuroscience of child and adolescent mental disorders--differentiating decision making in attention-deficit/hyperactivity disorder, conduct disorder, depression, and anxiety. J Child Psychol Psychiatry 2016; 57:321-49. [PMID: 26705858 PMCID: PMC4762324 DOI: 10.1111/jcpp.12496] [Citation(s) in RCA: 93] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2015] [Indexed: 12/18/2022]
Abstract
BACKGROUND Ineffective decision making is a major source of everyday functional impairment and reduced quality of life for young people with mental disorders. However, very little is known about what distinguishes decision making by individuals with different disorders or the neuropsychological processes or brain systems underlying these. This is the focus of the current review. SCOPE AND METHODOLOGY We first propose a neuroeconomic model of the decision-making process with separate stages for the prechoice evaluation of expected utility of future options; choice execution and postchoice management; the appraisal of outcome against expectation; and the updating of value estimates to guide future decisions. According to the proposed model, decision making is mediated by neuropsychological processes operating within three domains: (a) self-referential processes involved in autobiographical reflection on past, and prospection about future, experiences; (b) executive functions, such as working memory, inhibition, and planning, that regulate the implementation of decisions; and (c) processes involved in value estimation and outcome appraisal and learning. These processes are underpinned by the interplay of multiple brain networks, especially medial and lateralized cortical components of the default mode network, dorsal corticostriatal circuits underpinning higher order cognitive and behavioral control, and ventral frontostriatal circuits, connecting to brain regions implicated in emotion processing, that control valuation and learning processes. FINDINGS AND CONCLUSION Based on clinical insights and considering each of the decision-making stages in turn, we outline disorder-specific hypotheses about impaired decision making in four childhood disorders: attention-deficit/hyperactivity disorder (ADHD), conduct disorder (CD), depression, and anxiety. We hypothesize that decision making in ADHD is deficient (i.e. inefficient, insufficiently reflective, and inconsistent) and impulsive (biased toward immediate over delayed alternatives). In CD, it is reckless and insensitive to negative consequences. In depression, it is disengaged, perseverative, and pessimistic, while in anxiety, it is hesitant, risk-averse, and self-deprecating. A survey of current empirical indications related to these disorder-specific hypotheses highlights the limited and fragmentary nature of the evidence base and illustrates the need for a major research initiative in decision making in childhood disorders. The final section highlights a number of important additional general themes that need to be considered in future research.
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Affiliation(s)
- Edmund J S Sonuga-Barke
- Developmental Brain-Behaviour Laboratory, Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Samuele Cortese
- Developmental Brain-Behaviour Laboratory, Academic Unit of Psychology, University of Southampton, Southampton, UK
- Child Study Center at NYU Langone Medical Center, New York, NY, USA
| | - Graeme Fairchild
- Developmental Brain-Behaviour Laboratory, Academic Unit of Psychology, University of Southampton, Southampton, UK
| | - Argyris Stringaris
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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42
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Cui H, Zhang J, Liu Y, Li Q, Li H, Zhang L, Hu Q, Cheng W, Luo Q, Li J, Li W, Wang J, Feng J, Li C, Northoff G. Differential alterations of resting-state functional connectivity in generalized anxiety disorder and panic disorder. Hum Brain Mapp 2016; 37:1459-73. [PMID: 26800659 DOI: 10.1002/hbm.23113] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/14/2015] [Accepted: 12/29/2015] [Indexed: 12/12/2022] Open
Abstract
Generalized anxiety disorder (GAD) and panic disorder (PD) are most common anxiety disorders with high lifetime prevalence while the pathophysiology and disease-specific alterations still remain largely unclear. Few studies have taken a whole-brain perspective in the functional connectivity (FC) analysis of these two disorders in resting state. It limits the ability to identify regionally and psychopathologically specific network abnormalities with their subsequent use as diagnostic marker and novel treatment strategy. The whole brain FC using a novel FC metric was compared, that is, scaled correlation, which they demonstrated to be a reliable FC statistics, but have higher statistical power in two-sample t-test of whole brain FC analysis. About 21 GAD and 18 PD patients were compared with 22 matched control subjects during resting-state, respectively. It was found that GAD patients demonstrated increased FC between hippocampus/parahippocampus and fusiform gyrus among the most significantly changed FC, while PD was mainly associated with greater FC between somatosensory cortex and thalamus. Besides such regional specificity, it was observed that psychopathological specificity in that the disrupted FC pattern in PD and GAD correlated with their respective symptom severity. The findings suggested that the increased FC between hippocampus/parahippocampus and fusiform gyrus in GAD were mainly associated with a fear generalization related neural circuit, while the greater FC between somatosensory cortex and thalamus in PD were more likely linked to interoceptive processing. Due to the observed regional and psychopathological specificity, their findings bear important clinical implications for the potential treatment strategy.
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Affiliation(s)
- Huiru Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jie Zhang
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China.,Department of Radiology, Jinling Hospital of Nanjing, Nanjing, People's Republic of China
| | - Yicen Liu
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China
| | - Qingwei Li
- Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai, People's Republic of China
| | - Hui Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Lanlan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Qiang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Wei Cheng
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China
| | - Qiang Luo
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, East China Normal University, Shanghai, People's Republic of China
| | - Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jianfeng Feng
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China.,Department of Computer Science, University of Warwick, Coventry, CV4 7AL, United Kingdom.,Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, People's Republic of China.,Shanghai Center for Mathematical Sciences, Shanghai, People's Republic of China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, People's Republic of China.,Centre for Brain and Consciousness, Taipei Medical University (TMU), Taipei, Taiwan
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43
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Moon CM, Jeong GW. Brain morphological alterations and cellular metabolic changes in patients with generalized anxiety disorder: A combined DARTEL-based VBM and (1)H-MRS study. Magn Reson Imaging 2015; 34:429-36. [PMID: 26708039 DOI: 10.1016/j.mri.2015.12.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 12/13/2015] [Indexed: 10/22/2022]
Abstract
Generalized anxiety disorder (GAD) is characterized by emotional dysregulation and cognitive deficit in conjunction with brain morphometric and metabolic alterations. This study assessed the combined neural morphological deficits and metabolic abnormality in patients with GAD. Thirteen patients with GAD and 13 healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted MRI and proton magnetic resonance spectroscopy ((1)H-MRS) at 3Tesla. In this study, the combination of voxel-based morphometry (VBM) and (1)H-MRS was used to assess the brain morphometric and metabolic alterations in GAD. The patients showed significantly reduced white matter (WM) volumes in the midbrain (MB), precentral gyrus (PrG), dorsolateral prefrontal cortex (DLPFC) and anterior limb of the internal capsule (ALIC) compared to the controls. In MRS study, the choline/creatine (Cho/Cr) and choline/N-acetylaspartate (Cho/NAA) ratios in the DLPFC were significantly lower in the patients. Particularly, the WM volume variation of the DLPFC was positively correlated with both of the Cho/Cr and Cho/NAA ratios in patients with GAD. This study provides an evidence for the association between the morphometric deficit and metabolic changes in GAD. This finding would be helpful to understand the neural dysfunction and pathogenesis in connection with cognitive impairments in GAD.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
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44
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Moon CM, Yang JC, Jeong GW. Explicit verbal memory impairments associated with brain functional deficits and morphological alterations in patients with generalized anxiety disorder. J Affect Disord 2015; 186:328-36. [PMID: 26277269 DOI: 10.1016/j.jad.2015.07.038] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/29/2015] [Accepted: 07/30/2015] [Indexed: 12/31/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) is associated with brain function and morphological alterations. This study investigated explicit verbal memory impairment in patients with GAD in terms of brain functional deficits in combination with morphologic changes. METHODS Seventeen patients with GAD and 17 healthy controls matched for age, sex, and education level underwent high-resolution T1-weighted MRI and fMR imaging at 3 T during explicit verbal memory tasks with emotionally neutral and anxiety-inducing words. RESULTS In response to the neutral words, the patients showed significantly lower activities in the regions of the hippocampus (Hip), middle cingulate gyrus (MCG), putamen (Pu) and head of the caudate nucleus (HCd) compared with healthy controls. In response to the anxiety-inducing words, the patients showed significantly higher activities in the ventrolateral prefrontal cortex and precentral gyrus. However, they showed lower activities in the Hip, MCG, Pu and HCd. In addition, patients with GAD showed a significant reduction in gray matter volumes, especially in the regions of the Hip, midbrain, thalamus, insula and superior temporal gyrus, compared with healthy controls. LIMITATIONS This study examined a small sample sizes in each of the groups, and there was no consideration of a medication effect on brain activity and volume changes. CONCLUSIONS This study provides evidence for the association between brain functional deficits and morphometric alterations in an explicit verbal memory task for patients with GAD. This finding is helpful for understanding explicit verbal memory impairment in connection with GAD symptoms.
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Affiliation(s)
- Chung-Man Moon
- Research Institute for Medical Imaging, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Jong-Chul Yang
- Department of Psychiatry, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - Gwang-Woo Jeong
- Research Institute for Medical Imaging, Chonnam National University Hospital, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam Natioanl University Medical School, Gwangju, Republic of Korea.
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45
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Brown GG, Ostrowitzki S, Stein MB, von Kienlin M, Liu TT, Simmons A, Wierenga C, Stein OY, Bruns A, Bischoff-Grethe A, Paulus M. Temporal profile of brain response to alprazolam in patients with generalized anxiety disorder. Psychiatry Res 2015. [PMID: 26211623 DOI: 10.1016/j.pscychresns.2015.06.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study investigated the temporal pattern of brain response to emotional stimuli during 28 days of alprazolam treatment among patients with generalized anxiety disorder (GAD) randomized 2:1 to drug or placebo in a double-blind design. Functional magnetic resonance imaging scans obtained during an emotion face matching task (EFMT) and an affective stimulus expectancy task (STIMEX) were performed at baseline, one hour after initial drug administration and 28 days later. Alprazolam significantly reduced scores on the Hamilton Anxiety Scale and the Penn State Worry Questionnaire after one week and 28 days of treatment. Brain activation in the amygdala during the EFMT and in the insula during the STIMEX was reduced one hour after alprazolam administration but returned to baseline levels at Day 28. Exploratory analyses revealed significant treatment differences in brain activity during the STIMEX on Day 28 in frontal lobe, caudate nucleus, middle temporal gyrus, secondary visual cortex, and supramarginal gyrus. These results are consistent with the notion that the neural mechanisms supporting sustained treatment effects of benzodiazepines in GAD differ from those underlying their acute effects.
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Affiliation(s)
- Gregory G Brown
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA.
| | - Susanne Ostrowitzki
- Neuroscience, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Murray B Stein
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Markus von Kienlin
- Neuroscience, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Thomas T Liu
- Department of Radiology, University of California San Diego, San Diego, CA, USA
| | - Alan Simmons
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Christina Wierenga
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Orah Y Stein
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Andreas Bruns
- Neuroscience, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd., Basel, Switzerland
| | | | - Martin Paulus
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA; Laureate Institute for Brain Research, Tulsa, OK, USA
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46
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Alterations in white matter volume and its correlation with clinical characteristics in patients with generalized anxiety disorder. Neuroradiology 2015; 57:1127-34. [PMID: 26293129 DOI: 10.1007/s00234-015-1572-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 08/05/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Only a few morphological studies have focused on changes in white matter (WM) volume in patients with generalized anxiety disorder (GAD). We evaluated alterations in WM volume and its correlation with symptom severity and duration of illness in adults with GAD. METHODS The 44 subjects were comprised of 22 patients with GAD (13 males and nine females) diagnosed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) and 22 age-matched healthy controls (13 males and nine females). High-resolution magnetic resonance imaging (MRI) data were processed by voxel-based morphometry (VBM) analysis based on diffeomorphic anatomical registration using the exponentiated Lie algebra (DARTEL) algorithm in SPM8. RESULTS Patients with GAD showed significantly reduced WM volume, particularly in the dorsolateral prefrontal cortex (DLPFC), anterior limb of the internal capsule (ALIC), and midbrain. In addition, DLPFC volume was negatively correlated with GAD-7 score and illness duration. ALIC volume was negatively correlated with GAD-7 score. Female patients had significantly less orbitofrontal cortex volume compared to that in male patients. CONCLUSION The findings demonstrate localized changes in WM volume associated with cognitive and emotional dysfunction in patients with GAD. The finding will be helpful for understanding the neuropathology in patients with GAD.
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