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Mandl S, Alexopoulos J, Doering S, Wildner B, Seidl R, Bartha-Doering L. The effect of prenatal maternal distress on offspring brain development: A systematic review. Early Hum Dev 2024; 192:106009. [PMID: 38642513 DOI: 10.1016/j.earlhumdev.2024.106009] [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: 03/11/2024] [Revised: 04/12/2024] [Accepted: 04/13/2024] [Indexed: 04/22/2024]
Abstract
BACKGROUND Prenatal maternal distress can negatively affect pregnancy outcomes, yet its impact on the offspring's brain structure and function remains unclear. This systematic review summarizes the available literature on the relationship between prenatal maternal distress and brain development in fetuses and infants up to 12 months of age. METHODS We searched Central, Embase, MEDLINE, PsycINFO, and PSYNDEXplus for studies published between database inception and December 2023. Studies were included if prenatal maternal anxiety, stress, and/or depression was assessed, neuroimaging was used to examine the offspring, and the offspring's brain was imaged within the first year of life. The quality of the included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies-II. RESULTS Out of the 1516 studies retrieved, 71 met our inclusion criteria. Although the studies varied greatly in their methodology, the results generally pointed to structural and functional aberrations in the limbic system, prefrontal cortex, and insula in fetuses and infants prenatally exposed to maternal distress. CONCLUSIONS The hippocampus, amygdala, and prefrontal cortex have a high density of glucocorticoid receptors, which play a key role in adapting to stressors and maintaining stress-related homeostasis. We thus conclude that in utero exposure to maternal distress prompts these brain regions to adapt by undergoing structural and functional changes, with the consequence that these alterations increase the risk for developing a neuropsychiatric illness later on. Future research should investigate the effect of providing psychological support for pregnant women on the offspring's early brain development.
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Affiliation(s)
- Sophie Mandl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
| | - Johanna Alexopoulos
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria; Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Stephan Doering
- Department of Psychoanalysis and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Brigitte Wildner
- University Library, Medical University of Vienna, Vienna, Austria
| | - Rainer Seidl
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Lisa Bartha-Doering
- Department of Pediatrics and Adolescent Medicine, Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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2
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Förstner BR, Böttger SJ, Moldavski A, Bajbouj M, Pfennig A, Manook A, Ising M, Pittig A, Heinig I, Heinz A, Mathiak K, Schulze TG, Schneider F, Kamp-Becker I, Meyer-Lindenberg A, Padberg F, Banaschewski T, Bauer M, Rupprecht R, Wittchen HU, Rapp MA, Tschorn M. The associations of Positive and Negative Valence Systems, Cognitive Systems and Social Processes on disease severity in anxiety and depressive disorders. Front Psychiatry 2023; 14:1161097. [PMID: 37398596 PMCID: PMC10313476 DOI: 10.3389/fpsyt.2023.1161097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 05/19/2023] [Indexed: 07/04/2023] Open
Abstract
Background Anxiety and depressive disorders share common features of mood dysfunctions. This has stimulated interest in transdiagnostic dimensional research as proposed by the Research Domain Criteria (RDoC) approach by the National Institute of Mental Health (NIMH) aiming to improve the understanding of underlying disease mechanisms. The purpose of this study was to investigate the processing of RDoC domains in relation to disease severity in order to identify latent disorder-specific as well as transdiagnostic indicators of disease severity in patients with anxiety and depressive disorders. Methods Within the German research network for mental disorders, 895 participants (n = 476 female, n = 602 anxiety disorder, n = 257 depressive disorder) were recruited for the Phenotypic, Diagnostic and Clinical Domain Assessment Network Germany (PD-CAN) and included in this cross-sectional study. We performed incremental regression models to investigate the association of four RDoC domains on disease severity in patients with affective disorders: Positive (PVS) and Negative Valance System (NVS), Cognitive Systems (CS) and Social Processes (SP). Results The results confirmed a transdiagnostic relationship for all four domains, as we found significant main effects on disease severity within domain-specific models (PVS: β = -0.35; NVS: β = 0.39; CS: β = -0.12; SP: β = -0.32). We also found three significant interaction effects with main diagnosis showing a disease-specific association. Limitations The cross-sectional study design prevents causal conclusions. Further limitations include possible outliers and heteroskedasticity in all regression models which we appropriately controlled for. Conclusion Our key results show that symptom burden in anxiety and depressive disorders is associated with latent RDoC indicators in transdiagnostic and disease-specific ways.
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Affiliation(s)
- Bernd R. Förstner
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Sarah Jane Böttger
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Alexander Moldavski
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Malek Bajbouj
- Charité–Universitätsmedizin Berlin, Department of Psychiatry, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - André Manook
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Marcus Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Andre Pittig
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
- Translational Psychotherapy, Institute of Psychology, University of Goettingen, Goettingen, Germany
| | - Ingmar Heinig
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy CCM, Charité–Universitätsmedizin Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Klaus Mathiak
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- JARA-Brain, Research Center Jülich, Jülich, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, United States
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, United States
| | - Frank Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, Aachen, Germany
- University Hospital Düsseldorf, Medical School, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Inge Kamp-Becker
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps University Marburg, Marburg, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Frank Padberg
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Rainer Rupprecht
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technical University Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Michael A. Rapp
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
| | - Mira Tschorn
- Social and Preventive Medicine, Department of Sports and Health Sciences, University of Potsdam, Potsdam, Germany
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3
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Lucherini Angeletti L, Scalabrini A, Ricca V, Northoff G. Topography of the Anxious Self: Abnormal Rest-Task Modulation in Social Anxiety Disorder. Neuroscientist 2023; 29:221-244. [PMID: 34282680 DOI: 10.1177/10738584211030497] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Social anxiety disorder (SAD) is characterized by social anxiety/fear, self-attention, and interoception. Functional magnetic resonance imaging studies demonstrate increased activity during symptom-sensitive tasks in regions of the default-mode network (DMN), amygdala (AMG), and salience network (SN). What is the source of this task-unspecific symptom-sensitive hyperactivity in DMN? We address this question by probing SAD resting state (rs) changes in DMN including their relation to other regions as possible source of task-unspecific hyperactivity in the same regions. Our findings show the following: (1) rs-hypoconnectivity within-DMN regions; (2) rs-hyperconnectivity between DMN and AMG/SN; (3) task-evoked hyperactivity in the abnormal rs-regions of DMN and AMG/SN during different symptom-sensitive tasks; (4) negative relationship of rest and task changes in especially anterior DMN regions as their rs-hypoconnectivity is accompanied by task-unspecific hyperactivity; (5) abnormal top-down/bottom-up modulation between anterior DMN regions and AMG during rest and task. Findings demonstrate that rs-hypoconnectivity among DMN regions is negatively related to task-unspecific hyperactivity in DMN and AMG/SN. We propose a model of "Topography of the Anxious Self" in SAD (TAS-SAD). Abnormal DMN-AMG/SN topography during rest, as trait feature of an "unstable social self", is abnormally aggravated during SAD-sensitive situations resulting in task-related hyperactivity in the same regions with an "anxious self" as state feature.
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Affiliation(s)
| | - Andrea Scalabrini
- Department of Psychological Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Valdo Ricca
- Psychiatry Unit, Department of Health Sciences, University of Florence, Florence, Italy
| | - Georg Northoff
- Mental Health Centre, Zhejiang University School of Medicine, Hangzhou, China.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, China.,The Royal's Institute of Mental Health Research & University of Ottawa, Ottawa, Ontario, Canada.,Centre for Neural Dynamics, Faculty of Medicine, Brain and Mind Research Institute, University of Ottawa, Ottawa, Ontario, Canada
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4
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Idlett-Ali SL, Salazar CA, Bell MS, Short EB, Rowland NC. Neuromodulation for treatment-resistant depression: Functional network targets contributing to antidepressive outcomes. Front Hum Neurosci 2023; 17:1125074. [PMID: 36936612 PMCID: PMC10018031 DOI: 10.3389/fnhum.2023.1125074] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 02/14/2023] [Indexed: 03/06/2023] Open
Abstract
Non-invasive brain stimulation is designed to target accessible brain regions that underlie many psychiatric disorders. One such method, transcranial magnetic stimulation (TMS), is commonly used in patients with treatment-resistant depression (TRD). However, for non-responders, the choice of an alternative therapy is unclear and often decided empirically without detailed knowledge of precise circuit dysfunction. This is also true of invasive therapies, such as deep brain stimulation (DBS), in which responses in TRD patients are linked to circuit activity that varies in each individual. If the functional networks affected by these approaches were better understood, a theoretical basis for selection of interventions could be developed to guide psychiatric treatment pathways. The mechanistic understanding of TMS is that it promotes long-term potentiation of cortical targets, such as dorsolateral prefrontal cortex (DLPFC), which are attenuated in depression. DLPFC is highly interconnected with other networks related to mood and cognition, thus TMS likely alters activity remote from DLPFC, such as in the central executive, salience and default mode networks. When deeper structures such as subcallosal cingulate cortex (SCC) are targeted using DBS for TRD, response efficacy has depended on proximity to white matter pathways that similarly engage emotion regulation and reward. Many have begun to question whether these networks, targeted by different modalities, overlap or are, in fact, the same. A major goal of current functional and structural imaging in patients with TRD is to elucidate neuromodulatory effects on the aforementioned networks so that treatment of intractable psychiatric conditions may become more predictable and targeted using the optimal technique with fewer iterations. Here, we describe several therapeutic approaches to TRD and review clinical studies of functional imaging and tractography that identify the diverse loci of modulation. We discuss differentiating factors associated with responders and non-responders to these stimulation modalities, with a focus on mechanisms of action for non-invasive and intracranial stimulation modalities. We advance the hypothesis that non-invasive and invasive neuromodulation approaches for TRD are likely impacting shared networks and critical nodes important for alleviating symptoms associated with this disorder. We close by describing a therapeutic framework that leverages personalized connectome-guided target identification for a stepwise neuromodulation paradigm.
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Affiliation(s)
- Shaquia L. Idlett-Ali
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- *Correspondence: Shaquia L. Idlett-Ali,
| | - Claudia A. Salazar
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, United States
| | - Marcus S. Bell
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, United States
| | - E. Baron Short
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Nathan C. Rowland
- Department of Neurosurgery, Medical University of South Carolina, Charleston, SC, United States
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5
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Holt-Gosselin B, Cohodes EM, McCauley S, Foster JC, Odriozola P, Zacharek SJ, Kribakaran S, Haberman JT, Hodges HR, Gee DG. Lack of robust associations between prepandemic coping strategies and frontolimbic circuitry with depression and anxiety symptoms during the COVID-19 pandemic: A preregistered longitudinal study. Behav Neurosci 2022; 136:528-540. [PMID: 36395014 PMCID: PMC9884515 DOI: 10.1037/bne0000534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The COVID-19 pandemic is an ongoing stressor that has resulted in the exacerbation of mental health problems worldwide. However, longitudinal studies that identify preexisting behavioral and neurobiological factors associated with mental health outcomes during the pandemic are lacking. Here, we examined associations between prepandemic coping strategy engagement and frontolimbic circuitry with internalizing symptoms during the pandemic. In 85 adults (71.8% female; age 18-30 years), we assessed prototypically adaptive coping strategies (Connor-Davidson Resilience Scale), resting-state functional magnetic resonance imaging functional connectivity (FC) of frontolimbic circuitry, and depression and anxiety symptoms (Beck Depression Inventory, Screen for Child Anxiety-Related Emotional Disorders-Adult, respectively). We conducted general linear models to test preregistered hypotheses that (1) lower coping engagement prepandemic and (2) weaker frontolimbic FC prepandemic would predict elevated symptoms during the pandemic; and (3) coping would interact with FC to predict symptoms during the pandemic. Depression and anxiety symptoms worsened during the pandemic (ps < .001). Prepandemic adaptive coping engagement and frontolimbic FC were not associated with depression or anxiety symptoms during the pandemic (uncorrected ps > .05). Coping interacted with insula-rostral anterior cingulate cortex (ACC) FC (p = .003, pFDR = .014) and with insula-ventral ACC FC (p < .001, pFDR < .001) to predict depression symptoms, but these findings did not survive FDR correction after removal of outliers. Findings from our preregistered study suggest that specific prepandemic factors, particularly adaptive coping and frontolimbic circuitry, are not robustly associated with emotional responses to the pandemic. Additional studies that identify preexisting neurobehavioral factors implicated in mental health outcomes during global health crises are needed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Bailey Holt-Gosselin
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
- Interdepartmental Neuroscience Graduate Program, Yale University, New Haven, CT 06520, United States
| | - Emily M. Cohodes
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
| | - Sarah McCauley
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
| | - Jordan C. Foster
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
| | - Paola Odriozola
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
| | - Sadie J. Zacharek
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
| | - Sahana Kribakaran
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
- Interdepartmental Neuroscience Graduate Program, Yale University, New Haven, CT 06520, United States
| | - Jason T. Haberman
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
| | - H. R. Hodges
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
| | - Dylan G. Gee
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, CT 06520, United States
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6
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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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7
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Schrammen E, Roesmann K, Rosenbaum D, Redlich R, Harenbrock J, Dannlowski U, Leehr EJ. Functional neural changes associated with psychotherapy in anxiety disorders - A meta-analysis of longitudinal fMRI studies. Neurosci Biobehav Rev 2022; 142:104895. [PMID: 36179918 DOI: 10.1016/j.neubiorev.2022.104895] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/12/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022]
Abstract
Successful psychotherapy for anxiety disorders is thought to be linked to functional neural changes in prefrontal control areas and fear-related limbic regions. Thus, discovering such therapy-associated neural changes might point to relevant mechanisms of action. Using AES-SDM, we conducted a coordinate-based meta-analysis of 22 whole-brain datasets (n = 419 anxiety patients) from 18 studies identified by our systematic literature search following PRISMA criteria (preregistration available at OSF: https://osf.io/dgc4p). In these studies, fMRI data was collected in response to negative stimuli during cognitive-emotional tasks before and after psychotherapy. Post-psychotherapy, activation decreased in the right insula, the anterior cingulate cortex, and the dorsolateral prefrontal cortex; no region had increased activation. A subgroup analysis for CBT revealed additional decrease in the supplementary motor area. Reduced activation in limbic and frontal regions might indicate therapy-associated normalization regarding the perception of internal and external threat, subsequent allocation of cognitive resources, and changes in effortful cognitive control. Due to the integration of diverse treatments and experimental tasks, these changes presumably reflect global effects of successful psychotherapy.
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Affiliation(s)
| | - Kati Roesmann
- Institute for Clinical Psychology and Psychotherapy, University of Siegen
| | - David Rosenbaum
- Department of Psychiatry and Psychotherapy, University Hospital of Tuebingen
| | | | - Jana Harenbrock
- Institute for Translational Psychiatry, University of Münster
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster
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8
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Zhang Z, Huang P, Li S, Liu Z, Zhang J, Li Y, Liu Z. Neural mechanisms underlying the processing of emotional stimuli in individuals with depression: An ALE meta-analysis study. Psychiatry Res 2022; 313:114598. [PMID: 35544984 DOI: 10.1016/j.psychres.2022.114598] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 04/29/2022] [Accepted: 04/30/2022] [Indexed: 12/29/2022]
Abstract
Depression is the leading cause of physiological problems and suicide. Previous studies have indicated that individuals with depression show abnormal processing of both positive and negative emotional stimuli. However, the common and distinct patterns of brain activity during the processing of positive and negative emotional stimuli in individuals with depression remain controversial. The current meta-analysis study used the activation likelihood estimation method to investigate these issues across 21 functional magnetic resonance imaging studies. Results revealed that, compared with individuals without depression, individuals with depression showed higher activation in the anterior cingulate gyrus, insula, and middle frontal gyrus (MFG) for positive emotional stimuli and higher activation in the MFG, inferior frontal gyrus, and insula for negative emotional stimuli. Moreover, we identified that the MFG was consistently activated in individuals with depression regardless of the type of emotional stimuli. However, we did not find distinct patterns of brain activity between positive and negative emotional stimuli in individuals with depression. Our results demonstrated that both positive and negative emotional stimuli processing shares the same cognitive control-related brain regions in individuals with depression.
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Affiliation(s)
- Zhenyu Zhang
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Pujiang Huang
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Shuyu Li
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Zhiyu Liu
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Jiayao Zhang
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China
| | - Ya'nan Li
- School of Education, Qinghai Normal University, Xining, China
| | - Zhiyuan Liu
- Shaanxi Key Laboratory of Behavior and Cognitive Neuroscience, School of Psychology, Shaanxi Normal University, Xi'an, China.
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9
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Kim MK, Eom H, Kwon JH, Kyeong S, Kim JJ. Neural effects of a short-term virtual reality self-training program to reduce social anxiety. Psychol Med 2022; 52:1296-1305. [PMID: 32880252 DOI: 10.1017/s0033291720003098] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Social anxiety disorder (SAD) is characterized by anxiety regarding social situations, avoidance of external social stimuli, and negative self-beliefs. Virtual reality self-training (VRS) at home may be a good interim modality for reducing social fears before formal treatment. This study aimed to find neurobiological evidence for the therapeutic effect of VRS. METHODS Fifty-two patients with SAD were randomly assigned to a VRS or waiting list (WL) group. The VRS group received an eight-session VRS program for 2 weeks, whereas the WL group received no intervention. Clinical assessments and functional magnetic resonance imaging scanning with the distress and speech evaluation tasks were repeatedly performed at baseline and after 3 weeks. RESULTS The post-VRS assessment showed significantly decreased anxiety and avoidance scores, distress index, and negative evaluation index for 'self', but no change in the negative evaluation index for 'other'. Patients showed significant responses to the distress task in various regions, including both sides of the prefrontal regions, occipital regions, insula, and thalamus, and to the speech evaluation task in the bilateral anterior cingulate cortex. Among these, significant neuronal changes after VRS were observed only in the right lingual gyrus and left thalamus. CONCLUSIONS VRS-induced improvements in the ability to pay attention to social stimuli without avoidance and even positively modulate emotional cues are based on functional changes in the visual cortices and thalamus. Based on these short-term neuronal changes, VRS can be a first intervention option for individuals with SAD who avoid society or are reluctant to receive formal treatment.
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Affiliation(s)
- Min-Kyeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyojung Eom
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Hee Kwon
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sunghyon Kyeong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Jin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
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10
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Thomas PJ, Leow A, Klumpp H, Phan KL, Ajilore O. Network Diffusion Embedding Reveals Transdiagnostic Subnetwork Disruption and Potential Treatment Targets in Internalizing Psychopathologies. Cereb Cortex 2022; 32:1823-1839. [PMID: 34521109 PMCID: PMC9070362 DOI: 10.1093/cercor/bhab314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/14/2022] Open
Abstract
Network diffusion models are a common and powerful way to study the propagation of information through a complex system and they offer straightforward approaches for studying multimodal brain network data. We developed an analytic framework to identify brain subnetworks with perturbed information diffusion capacity using the structural basis that best maps to resting state functional connectivity and applied it towards a heterogeneous dataset of internalizing psychopathologies (IPs), a set of psychiatric conditions in which similar brain network deficits are found across the swath of the disorders, but a unifying neuropathological substrate for transdiagnostic symptom expression is currently unknown. This research provides preliminary evidence of a transdiagnostic brain subnetwork deficit characterized by information diffusion impairment of the right area 8BM, a key brain region involved in organizing a broad spectrum of cognitive tasks, which may underlie previously reported dysfunction of multiple brain circuits in the IPs. We also demonstrate that models of neuromodulation involving targeting this brain region normalize IP diffusion dynamics towards those of healthy controls. These analyses provide a framework for multimodal methods that identify both brain subnetworks with disrupted information diffusion and potential targets of these subnetworks for therapeutic neuromodulatory intervention based on previously well-characterized methodology.
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Affiliation(s)
- Paul J Thomas
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Alex Leow
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
- Department of Bioengineering, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, OH 43210, USA
| | - Olusola Ajilore
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL 60612, USA
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11
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Blades R, Becerra S, Jordan S, Eusebio B, Heatwole M, Iovine J, Mahdavi K, Mamoun M, Nicodemus N, Packham H, Spivak N, Kuhn T. The Role of the Insula in Classical and Dissociative PTSD: A Double Case Study. Neurocase 2022; 28:140-148. [PMID: 35452340 DOI: 10.1080/13554794.2021.1978502] [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: 10/18/2022]
Abstract
Two service members were diagnosed with PTSD due to military trauma exposure. One presented with the classical manifestation; the other presented with the dissociative subtype. A statistical map revealed anterior localization of insula connectivity in the classical PTSD patient and posterior localization in the dissociative PTSD patient. These differences suggest that dissociative PTSD may be identified, understood, and treated as a disorder related to increased posterior insula connectivity. This double case study provides preliminary evidence for a concrete neuroanatomical discrepancy between insula function in classical and dissociative PTSD that may help explain the emergence of different coping strategies.
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Affiliation(s)
- Robin Blades
- Neurological Associates - The Interventional Group, Los Angeles, California, USA
| | - Sergio Becerra
- Neurological Associates - The Interventional Group, Los Angeles, California, USA
| | - Sheldon Jordan
- Neurological Associates - The Interventional Group, Los Angeles, California, USA.,Department of Neurology, University of California Los Angeles, Los Angeles, California, USA
| | | | | | - Jessica Iovine
- Neurological Associates - The Interventional Group, Los Angeles, California, USA
| | - Kennedy Mahdavi
- Neurological Associates - The Interventional Group, Los Angeles, California, USA
| | | | - Natalie Nicodemus
- Neurological Associates - The Interventional Group, Los Angeles, California, USA
| | - Hannah Packham
- Neurological Associates - The Interventional Group, Los Angeles, California, USA
| | - Norman Spivak
- Department of Neurosurgery, University of California Los Angeles, Los Angeles, California, USA
| | - Taylor Kuhn
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
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12
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Holt-Gosselin B, Keller AS, Chesnut M, Ling R, Grisanzio KA, Williams LM. Greater baseline connectivity of the salience and negative affect circuits are associated with natural improvements in anxiety over time in untreated participants. J Affect Disord 2021; 295:366-376. [PMID: 34492429 DOI: 10.1016/j.jad.2021.08.039] [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: 06/24/2021] [Revised: 08/18/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND There is limited research examining the natural trajectories of depression and anxiety, how these trajectories relate to baseline neural circuit function, and how symptom trajectory-circuit relationships are impacted by engagement in lifestyle activities including exercise, hobbies, and social interactions. To address these gaps, we assessed these relations over three months in untreated participants. METHODS 262 adults (59.5% female, mean age 35) with symptoms of anxiety and depression, untreated with pharmacotherapy or behavioral therapy, completed the DASS-42, WHOQOL, and custom surveys at baseline and follow-up to assess symptoms, psychosocial function, and lifestyle activity engagement. At baseline, participants underwent fMRI under task-free and task-evoked conditions. We quantified six circuits implicated in these symptoms: default mode, salience, negative and positive affect, attention, and cognitive control. RESULTS From baseline to 3 months, some participants demonstrated a natural improvement in anxiety (24%) and depression (26%) symptoms. Greater baseline salience circuit connectivity (pFDR=0.045), specifically between the left and right insula (pFDR=0.045), and greater negative affect circuit connectivity elicited by sad faces (pFDR=0.030) were associated with anxiety symptom improvement. While engagement in lifestyle activities were not associated with anxiety improvements, engagement in hobbies moderated the association between negative affect circuit connectivity and anxiety symptom improvement (p = 0.048). LIMITATIONS The observational design limits causal inference. CONCLUSIONS Our findings highlight the role of the salience and negative affect circuits as potential circuit markers of natural anxiety symptom improvements over time. Future studies that identify biomarkers associated with symptom improvements are critical for the development of personalized treatment targets.
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Affiliation(s)
- Bailey Holt-Gosselin
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States; Interdepartmental Neuroscience Graduate Program, Yale University, New Haven, CT, United States
| | - Arielle S Keller
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States; Neurosciences PhD Program, Stanford University, Stanford CA, United States
| | - Megan Chesnut
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Ruth Ling
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Katherine A Grisanzio
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States
| | - Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, United States; Mental Illness Research, Education and Clinical Center, Palo Alto VA Healthcare System, Palo Alto, CA, United States.
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13
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Chen C, Lou Y, Li H, Yuan J, Yang J, Winskel H, Qin S. Distinct neural-behavioral correspondence within face processing and attention networks for the composite face effect. Neuroimage 2021; 246:118756. [PMID: 34848297 DOI: 10.1016/j.neuroimage.2021.118756] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 11/14/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022] Open
Abstract
The composite face effect (CFE) is recognized as a hallmark for holistic face processing, but our knowledge remains sparse about its cognitive and neural loci. Using functional magnetic resonance imaging with independent localizer and complete composite face task, we here investigated its neural-behavioral correspondence within face processing and attention networks. Complementing classical comparisons, we adopted a dimensional reduction approach to explore the core cognitive constructs of the behavioral CFE measurement. Our univariate analyses found an alignment effect in regions associated with both the extended face processing network and attention networks. Further representational similarity analyses based on the Euclidian distances among all experimental conditions were used to identify cortical regions with reliable neural-behavioral correspondences. Multidimensional scaling and hierarchical clustering analyses for neural-behavioral correspondence data revealed two principal components underlying the behavioral CFE effect, which fit best to the neural responses in the bilateral insula and medial frontal gyrus. These findings highlight the distinct neurocognitive contributions of both face processing and attentional networks to the behavioral CFE outcome, which bridge the gaps between face recognition and attentional control models.
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Affiliation(s)
- Changming Chen
- School of Education, Chongqing Normal University, Chongqing 401331, China
| | - Yixue Lou
- Department of Psychology, Faculty of Education and Psychology, University of Jyvaskyla, Jyväskylä 40014, Finland; Faculty of Psychology, Southwest University, Chongqing 400715, China
| | - Hong Li
- School of Psychology, South China Normal University, Guangzhou 510631, China; Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China.
| | - Jiajin Yuan
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China.
| | - Jiemin Yang
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610066, China
| | - Heather Winskel
- Psychology, James Cook University, Singapore Campus, 387380, Singapore
| | - Shaozheng Qin
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing 100875, China; Chinese Institute for Brain Research, Beijing, China
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14
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Abstract
Culture is part of an extensive series of feedback loops, which involve multiple organismic levels including social contexts, cognitive mediations, neural processes, and behavior. Recent studies in neuroscience show that culturally contingent social processes shape some neural pathways. Studying the influence of cultural context on neural processes may yield new insights into psychiatric disorders. New methodologies in the neurosciences offer innovative ways to assess the impact of culture on mental health and illness. However, implementing these methodologies raises important theoretical and ethical concerns, which must be resolved to address patient individuality and the complexity of cultural diversity. This article discusses cultural context as a major influence on (and consequence of) human neural plasticity and advocates a culture-brain-behavior (CBB) interaction model for conceptualizing the relationship between culture, brain, and psychiatric disorders. Recommendations are made for integrating neuroscientific techniques into transcultural psychiatric research by taking a systems approach to evaluating disorders.
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15
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Joshi SA, Duval ER, Sheynin J, King AP, Phan KL, Martis B, Porter KE, Liberzon I, Rauch SAM. Neural correlates of emotional reactivity and regulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder. Psychiatry Res Neuroimaging 2020; 299:111062. [PMID: 32278278 PMCID: PMC8019332 DOI: 10.1016/j.pscychresns.2020.111062] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
Posttraumatic Stress Disorder (PTSD) is a debilitating condition often associated with difficulty in emotion regulation, including reappraising negative emotions. This study assessed neural mechanisms associated with emotion regulation in veterans prior to and following treatment for PTSD. Participants with PTSD and combat exposed controls (CC) completed diagnostic evaluation and underwent fMRI scanning while completing Emotion Regulation Task (ERT) and Emotional Faces Assessment Task (EFAT). Participants with PTSD were randomly assigned to Prolonged Exposure plus placebo (PE+PLB), Sertraline plus enhanced medication management (SERT+EMM), or PE plus SERT (PE+SERT) and repeated diagnostic evaluation and MRI scanning following treatment. The amygdala, dmPFC, and dlPFC were examined as regions of interest. On ERT, veterans with PTSD showed significantly less dmPFC activation than CCs during reappraisal vs emotional maintenance. Within the PTSD group, results demonstrated a significant association between less activation in the dmPFC during emotion reappraisal vs maintenance trials before treatment and greater reductions in symptoms from pre- to post-treatment. During the EFAT, there were no group differences between participants with PTSD and CCs in brain activation, and no relationships between brain function and PTSD symptoms. These findings suggest that less emotional reactivity might potentially reflect less need for recruitment of prefrontal regions when reappraising negative emotion, and is an individual factor associated with better treatment outcome.
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Affiliation(s)
- Sonalee A Joshi
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States; University of Michigan, Department of Psychology, 530 Church St, Ann Arbor, MI 48109, United States
| | - Elizabeth R Duval
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States
| | - Jony Sheynin
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States; Texas A&M University Health Science Center, Department of Psychiatry, 8441 Riverside Parkway, Bryan, TX 77807, United States
| | - Anthony P King
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University 1670 Upham Drive, Columbus, OH 43210, United States
| | - Brian Martis
- University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States; VA San Diego Healthcare System, 3350 Villa La Jolla Drive, San Diego, CA 92161, United States; University of California, San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92037, United States
| | - Katherine E Porter
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States
| | - Israel Liberzon
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; Texas A&M University Health Science Center, Department of Psychiatry, 8441 Riverside Parkway, Bryan, TX 77807, United States.
| | - Sheila A M Rauch
- Atlanta VA Medical Center, 1670 Clairmont Road, Decatur, GA 30033, United States; Emory University School of Medicine, 12 Executive Park, 3rd Floor, Atlanta, GA 30029, United States
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16
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Markett S, Jawinski P, Kirsch P, Gerchen MF. Specific and segregated changes to the functional connectome evoked by the processing of emotional faces: A task-based connectome study. Sci Rep 2020; 10:4822. [PMID: 32179856 PMCID: PMC7076018 DOI: 10.1038/s41598-020-61522-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Accepted: 02/28/2020] [Indexed: 12/20/2022] Open
Abstract
The functional connectome is organized into several separable intrinsic connectivity networks (ICNs) that are thought to be the building blocks of the mind. However, it is currently not well understood how these networks are engaged by emotionally salient information, and how such engagement fits into emotion theories. The current study assessed how ICNs respond during the processing of angry and fearful faces in a large sample (N = 843) and examined how connectivity changes relate to the ICNs. All ICNs were modulated by emotional faces and showed functional interactions, a finding which is in line with the "theory of constructed emotions" that assumes that basic emotion do not arise from separable ICNs but from their interplay. We further identified a set of brain regions whose connectivity changes during the tasks suggest a special role as "affective hubs" in the brain. While hubs were located in all ICNs, we observed high selectivity for the amygdala within the subcortical network, a finding which also fits into "primary emotion" theory. The topology of hubs corresponded closely to a set of brain regions that has been implicated in anxiety disorders, pointing towards a clinical relevance of the present findings. The present data are the most comprehensive mapping of connectome-wide changes in functionally connectivity evoked by an affective processing task thus far and support two competing views on how emotions are represented in the brain, suggesting that the connectome paradigm might help with unifying the two ideas.
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Affiliation(s)
| | | | - Peter Kirsch
- Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
- Bernstein Center for Computational Neuroscience Heidelberg/Mannheim, Mannheim, Germany
| | - Martin F Gerchen
- Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, Mannheim, Germany
- Bernstein Center for Computational Neuroscience Heidelberg/Mannheim, Mannheim, Germany
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17
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Howlett RDM, Lustig KA, MacDonald KJ, Cote KA. Hyperarousal Is Associated with Socioemotional Processing in Individuals with Insomnia Symptoms and Good Sleepers. Brain Sci 2020; 10:brainsci10020112. [PMID: 32093215 PMCID: PMC7071480 DOI: 10.3390/brainsci10020112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/10/2020] [Accepted: 02/18/2020] [Indexed: 12/26/2022] Open
Abstract
Despite complaints of difficulties in waking socioemotional functioning by individuals with insomnia, only a few studies have investigated emotion processing performance in this group. Additionally, the role of sleep in socioemotional processing has not been investigated extensively nor using quantitative measures of sleep. Individuals with insomnia symptoms (n = 14) and healthy good sleepers (n = 15) completed two nights of at-home polysomnography, followed by an afternoon of in-lab performance testing on tasks measuring the processing of emotional facial expressions. The insomnia group self-reported less total sleep time, but no other group differences in sleep or task performance were observed. Greater beta EEG power throughout the night was associated with higher intensity ratings of happy, fearful and sad faces for individuals with insomnia, yet blunted sensitivity and lower accuracy for good sleepers. Thus, the presence of hyperarousal differentially impacted socioemotional processing of faces in individuals with insomnia symptoms and good sleepers.
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Affiliation(s)
| | | | | | - Kimberly A. Cote
- Correspondence: ; Tel.: +1-905-688-5550 (ext. 4806); Fax: +1-905-688-6922
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18
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Role of the anterior agranular insular cortex in the modulation of fear and anxiety. Brain Res Bull 2020; 155:174-183. [DOI: 10.1016/j.brainresbull.2019.12.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 12/04/2019] [Accepted: 12/04/2019] [Indexed: 12/14/2022]
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19
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Task MRI-Based Functional Brain Network of Anxiety. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:3-20. [PMID: 32002919 DOI: 10.1007/978-981-32-9705-0_1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Magnetic resonance imaging (MRI) is a good tool for researchers to understand the biological mechanisms and pathophysiology of the brain due to the translational characteristics of MRI methods. For the psychiatric illness, this kind of mental disorders usually have minor alterations when compared to traditional neurological disorders. Therefore the functional study, such as functional connectivity, would play a significant role for understanding the pathophysiology of mental disorders. This chapter would focus on the discussion of task MRI-based functional network studies in anxiety. For social anxiety disorder, the limbic system, such as the temporal lobe, amygdala, and hippocampus, would show alterations in the functional connectivity with frontal regions, such as anterior cingulate, prefrontal, and orbitofrontal cortices. PD has anterior cingulate cortex-amygdala alterations in fear conditioning, frontoparietal alterations in attention network task, and limbic-prefrontal alterations in emotional task. A similar amygdala-based aberrant functional connectivity in specific phobia is observed. The mesocorticolimbic and limbic-prefrontal functional alterations are found in generalized anxiety disorder. The major components of task MRI-based functional connectivity in anxiety include limbic and frontal regions which might play a vital role for the origination of anxiety under different scenarios and tasks.
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20
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Assari S, Akhlaghipour G, Saqib M, Boyce S, Bazargan M. Prefrontal Cortex Response to Threat: Race by Age Variation in 9-10 Year Old Children. JOURNAL OF MENTAL HEALTH & CLINICAL PSYCHOLOGY 2020; 4:1-12. [PMID: 33241232 DOI: 10.29245/2578-2959/2020/4.1209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Considerable research has suggested that race and age are two major determinants of brain development, including but not limited to development of the prefrontal cortex (PFC). Minorities' Diminished Returns (MDRs), however, suggests that race (as a proxy of racism) may interact with various determinants of human and brain development. Minimal knowledge, however, exists on whether age and race also interact on shaping PFC response to threat among American children. PURPOSE Using data from a task-based functional brain imaging study and considering race as a sociological rather than a biological construct, we investigated combined effects of race and age on prefrontal cortical (PFC) response to threat. We explored racial heterogeneities in the association between age and PFC response to threat by comparing Black and White children. METHODS This study used the task-based functional Magnetic Resonance Imaging (fMRI) data from the Adolescents Brain Cognitive Development (ABCD) study, a national, landmark, multi-center brain imaging investigation of 9-10 years old children in the US. The primary outcomes were mean beta weights of n-back runs measuring PFC response to threating versus neutral face contrast in the following regions of interest (ROIs): left hemisphere-lateral orbito-frontal, left hemisphere -superior-frontal, right hemisphere -caudal middle frontal, and right hemisphere -superior frontal cortex. The independent variable was age. Covariates were sex, ethnicity, family socioeconomic status, and neighborhood socioeconomic status. Race was the focal moderator. To analyze the data, we used linear regression models without and with interactions and SES as covariates. RESULTS We included 5,066 9-10 years old children. Age and race did not show direct effects on PFC response to threatening relative to neutral faces. While ethnicity, sex, and socioeconomic status were controlled, age and race showed a systematic interaction on PFC response to threatening relative to neutral faces. CONCLUSIONS For American children, race and age do not have direct effects but multiplicative effects on PFC response to threat. The results may be reflective of social inequalities in how Black and White children are socialized and developed. The results are important given the role of the PFC in regulating the limbic system response to threat. Coordinated work of the limbic system and PFC is a core element of children's behavioral and emotional development. Future research is needed on how social stratification and racism shape emotion processing and regulation of American children in response to threat.
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Affiliation(s)
- Shervin Assari
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA.,Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | | | - Mohammed Saqib
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Shanika Boyce
- Department of Pediatrics, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
| | - Mohsen Bazargan
- Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, USA
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21
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Leehr EJ, Redlich R, Zaremba D, Dohm K, Böhnlein J, Grotegerd D, Kähler C, Repple J, Förster K, Opel N, Meinert S, Enneking V, Bürger C, Hahn T, Wilkens E, Dernbecher M, Kugel H, Arolt V, Dannlowski U. Structural and functional neural correlates of vigilant and avoidant regulation style. J Affect Disord 2019; 258:96-101. [PMID: 31400629 DOI: 10.1016/j.jad.2019.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/30/2019] [Accepted: 08/02/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND Regulation of emotional arousal is a relevant factor for mental health. The investigation of neural underpinnings of regulation styles in healthy individuals may provide important insights regarding potential risk factors. To fill the gap of structural correlates of regulation styles and to expand previous results, we focused on the association between brain structure, neural responsiveness and vigilant/avoidant regulation style. METHODS In n = 302 healthy individuals regulation style was assessed with the Mainz Coping Inventory (MCI). Participants underwent structural and functional MRI during an emotion-processing paradigm. Structural MRI (voxel-based morphometry) and functional MRI were analysed in two regions of interest (amygdala and anterior cingulate cortex [ACC]). RESULTS Regulation styles did not show an association with brain structure after correction for gender, age, trait anxiety, depressive symptoms. During emotion processing, a vigilant regulation style was negatively associated with ACC activation. LIMITATIONS The cross-sectional study in a non-pathological sample is not adequate to unveil causalities or draw conclusions regarding prevention interventions. CONCLUSION Regulation styles are associated with specific neural activation patterns. The association of a high-vigilant regulation style and low ACC activation during emotion processing in healthy participants might be a potential risk factor.
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Affiliation(s)
- Elisabeth J Leehr
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany.
| | - Ronny Redlich
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Dario Zaremba
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Katharina Dohm
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Joscha Böhnlein
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Dominik Grotegerd
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Claas Kähler
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Jonathan Repple
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Katharina Förster
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Nils Opel
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Susanne Meinert
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Verena Enneking
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Christian Bürger
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Tim Hahn
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Elena Wilkens
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Marius Dernbecher
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Harald Kugel
- Department of Clinical Radiology, University of Muenster, Albert Schweitzer-Campus 1, G A1, 48149 Muenster, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
| | - Udo Dannlowski
- Department of Psychiatry and Psychotherapy, University of Muenster, Albert Schweitzer-Campus 1, G 9A, 48149 Muenster, Germany
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22
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Laird KT, Siddarth P, Krause B, Kilpatrick L, Milillo M, Aguilar Y, Narr KL, Lavretsky H. Anxiety symptoms are associated with smaller insular and orbitofrontal cortex volumes in late-life depression. J Affect Disord 2019; 256:282-287. [PMID: 31200165 PMCID: PMC6750975 DOI: 10.1016/j.jad.2019.05.066] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 04/19/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Increasing understanding of the neural correlates of anxiety symptoms in late-life depression (LLD) could inform the development of more targeted and effective treatments. METHODS Grey matter volume (GMV) was assessed with volumetric magnetic resonance imaging in a sample of 113 adults ≥60 years with MDD using the following regions of interest: amygdala, anterior cingulate cortex (ACC), insula, orbitofrontal cortex (OFC), and temporal cortex. RESULTS After controlling for demographic (age, sex, education) and clinical variables (antidepressant use, anxiolytic use, duration of illness, medical comorbidity, cognitive functioning), greater severity of anxiety symptoms was associated with lower GMV bilaterally in the insula, F(1,102) = 6.63, p = 0.01, and OFC, F(1,102) = 8.35, p = 0.005. By contrast, depressive symptom severity was significantly associated with lower bilateral insula volumes, F(1,102) = 6.43, p = 0.01, but not OFC volumes, F(1,102) = 5.37, p = 0.02. LIMITATIONS Limitations include (1) the relatively mild nature of anxiety symptoms in our sample; (2) the cross-sectional research design, which prohibits inferences of directionality; (3) the relatively homogenous demographic of the sample, and (4) the exclusion of participants with significant psychiatric comorbidity, suicidality, or cognitive impairment. CONCLUSIONS Decreased OFC volumes may serve as a unique biomarker of anxiety symptoms in LLD. Future longitudinal and clinical studies with long-term follow up and more diverse samples will help further elucidate the biological, psychological, and social factors affecting associations between anxiety and brain morphology in LLD.
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Affiliation(s)
| | | | | | | | | | | | | | - Helen Lavretsky
- Department of Psychology and Human Development, University of California, Los Angeles (UCLA), 760 Westwood Plaza, Los Angeles, CA 90095, United States.
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Auday ES, Pérez-Edgar KE. Limbic and prefrontal neural volume modulate social anxiety in children at temperamental risk. Depress Anxiety 2019; 36:690-700. [PMID: 31373755 PMCID: PMC6684311 DOI: 10.1002/da.22941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 05/22/2019] [Accepted: 06/05/2019] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Clinical levels of a social anxiety disorder (SAD) often appear during childhood and rise to a peak during late adolescence. The temperament trait behavioral inhibition (BI), evident early in childhood, has been linked to increased risk for SAD. Functional and structural variations in brain regions associated with the identification of, and response to, fear may support the BI-SAD relation. Whereas relevant functional studies are emerging, the few extant structural studies have focused on adult samples with mixed findings. METHODS A moderated-mediation model was used to examine the relations between BI, SAD symptoms, and brain-volume individual differences in a sample of children at risk for anxiety (ages 9-12; N = 130, 52 BI). RESULTS Our findings indicate that at higher levels of BI, children with smaller anterior insula volumes showed stronger correlations between BI and SAD. In addition, larger ventrolateral prefrontal cortex (vlPFC) volumes were associated with fewer SAD symptoms. CONCLUSIONS These findings support previous reports linking SAD levels with variations in volume and reactivity in both limbic (insula) and prefrontal (vlPFC) regions. These findings set the foundation for further examination of networks of neural structures that influence the transition from BI to SAD across development, helping further clarify mechanisms of risk and resilience.
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Affiliation(s)
- Eran S. Auday
- The Pennsylvania State University,Geisinger Health System
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24
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Insula serotonin 2A receptor binding and gene expression contribute to serotonin transporter polymorphism anxious phenotype in primates. Proc Natl Acad Sci U S A 2019; 116:14761-14768. [PMID: 31266890 PMCID: PMC6642374 DOI: 10.1073/pnas.1902087116] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Genetic variation in the serotonin transporter gene (SLC6A4) is associated with vulnerability to affective disorders and pharmacotherapy efficacy. We recently identified sequence polymorphisms in the common marmoset SLC6A4 repeat region (AC/C/G and CT/T/C) associated with individual differences in anxiety-like trait, gene expression, and response to antidepressants. The mechanisms underlying the effects of these polymorphisms are unknown, but a key mediator of serotonin action is the serotonin 2A receptor (5HT2A). Thus, we correlated 5HT2A binding potential (BP) and RNA gene expression in 16 SLC6A4 genotyped marmosets with responsivity to 5HT2A antagonism during the human intruder test of anxiety. Voxel-based analysis and RNA measurements showed a reduction in 5HT2A BP and gene expression specifically in the right posterior insula of individuals homozygous for the anxiety-related variant AC/C/G. These same marmosets displayed an anxiogenic, dose-dependent response to the human intruder after 5HT2A pharmacological antagonism, while CT/T/C individuals showed no effect. A voxel-based correlation analysis, independent of SLC6A4 genotype, revealed that 5HT2A BP in the adjacent right anterior insula and insula proisocortex was negatively correlated with trait anxiety scores. Moreover, 5HT2A BP in both regions was a good predictor of the size and direction of the acute emotional response to the human intruder threat after 5HT2A antagonism. Our findings suggest that genetic variation in the SLC6A4 repeat region may contribute to the trait anxious phenotype via neurochemical changes in brain areas implicated in interoceptive and emotional processing, with a critical role for the right insula 5HT2A in the regulation of affective responses to threat.
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25
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Burkhouse KL, Kujawa A, Hosseini B, Klumpp H, Fitzgerald KD, Langenecker SA, Monk CS, Phan KL. Anterior cingulate activation to implicit threat before and after treatment for pediatric anxiety disorders. Prog Neuropsychopharmacol Biol Psychiatry 2018; 84. [PMID: 29535037 PMCID: PMC5912209 DOI: 10.1016/j.pnpbp.2018.03.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Research suggests that individuals with anxiety have difficulty ignoring threat distractors when completing tasks with competing stimuli. Studies examining the neural correlates of these emotional processing difficulties in youth anxiety highlight reduced recruitment of regions associated with goal-directed attention, such as the anterior cingulate cortex (ACC). In the current study, we examined neural activation during an emotional conflict task in youth with anxiety disorders before and after treatment. METHODS Twenty-five youth (ages 9-19 years) with generalized, separation, and/or social anxiety disorder and 25 healthy controls underwent 2 functional magnetic resonance imaging scans approximately 13 weeks apart. At each scan, participants completed a task in which they matched shapes in the context of emotional distractors (happy and threatening faces). Between scans, anxious youth were treated with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT). RESULTS Prior to treatment, anxious youth exhibited reduced activation of the medial prefrontal cortex, encompassing the rostral ACC, when matching shapes in the context of threat distractors relative to healthy controls. Activation in this region increased in anxious youth after treatment, but remained unchanged in the healthy control group. Increases in rostral ACC activation were related to greater reductions in social anxiety and avoidance symptoms following treatment. CONCLUSIONS Effective treatments for pediatric anxiety may enhance rostral ACC response during attempts to filter out threat-relevant stimuli. Enhanced recruitment of this region may constitute one manner in which CBT and SSRI treatment reduce youth anxiety symptoms, particularly social anxiety and avoidance.
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Affiliation(s)
- Katie L. Burkhouse
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Autumn Kujawa
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee
| | - Bobby Hosseini
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois,Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | | | - Scott A. Langenecker
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois,Department of Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - Christopher S. Monk
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, Illinois,Department of Psychology, University of Illinois at Chicago, Chicago, Illinois,Department of Anatomy and Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, Illinois
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26
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Duval ER, Joshi SA, Block SR, Abelson JL, Liberzon I. Insula activation is modulated by attention shifting in social anxiety disorder. J Anxiety Disord 2018; 56:56-62. [PMID: 29729828 PMCID: PMC5985215 DOI: 10.1016/j.janxdis.2018.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 04/12/2018] [Accepted: 04/13/2018] [Indexed: 12/22/2022]
Abstract
Social anxiety disorder (SAD) is characterized by exaggerated reactivity to social threat, often documented by biased attention to threatening information, and increased activation in brain regions involved in salience/threat processing. Attention training has been developed to ameliorate the attention bias documented in individuals with SAD, with mixed results. We investigated patterns of brain activation underlying acute attention modulation in 41 participants (29 with SAD and 12 health controls). We then investigated how brain activation changed over time in both groups in response to a 4-session attention training protocol (toward threat, away from threat, no-training control). Results revealed diminished pre-training deactivation in the insula in SAD participants during attention modulation. SAD participants also demonstrated an increase in insula deactivation over time, suggestive of an improvement in attention modulation of emotion, and this was associated with a decrease in symptom severity. Attention training did not, itself, lead to clinical improvement, though there was a trend level effect of training toward threat on increased insula deactivation over time. While deficits in attentional control and emotion modulation are documented in individuals with SAD, current attention training protocols are not robustly effective in ameliorating aberrant functioning. Pursuit of training protocols that have more robust impacts on the relevant neural circuitry may have some value.
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Affiliation(s)
- Elizabeth R. Duval
- Corresponding Author: Elizabeth Duval, University of Michigan, Department of Psychiatry 4250 Plymouth Rd, Ann Arbor, MI 48109, USA, Telephone: 734-936-4397,
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27
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Auday ES, Taber-Thomas BC, Pérez-Edgar KE. Neural correlates of attention bias to masked facial threat cues: Examining children at-risk for social anxiety disorder. NEUROIMAGE-CLINICAL 2018; 19:202-212. [PMID: 30023170 PMCID: PMC6050468 DOI: 10.1016/j.nicl.2018.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 02/04/2018] [Accepted: 04/01/2018] [Indexed: 01/04/2023]
Abstract
Background Behavioral inhibition (BI) is an early-appearing temperament trait and a robust predictor of social anxiety disorder (SAD). Both BI and anxiety may have distinct patterns of emotion processing marked by heightened neural responses to threat cues. BI and anxious children display similar frontolimbic patterns when completing an emotion-face attention bias task with supraliminal presentation. Anxious children also show a distinct neural response to the same task with subliminal face presentations, probing stimulus-driven attention networks. We do not have parallel data available for BI children, limiting our understanding of underlying affective mechanisms potentially linking early BI to the later emergence of anxiety. Method We examined the neural response to subliminal threat presentation during an emotion-face masked dot-probe task in children oversampled for BI (N = 67; 30 BI, 9–12 yrs). Results Non-BI children displayed greater activation versus BI children in several regions in response to threat faces versus neutral faces, including striatum, prefrontal and temporal lobes. When comparing congruent and incongruent trials, which require attention disengagement, BI children showed greater activation than non-BI children in the cerebellum, which is implicated in rapidly coordinating information processing, aversive conditioning, and learning the precise timing of anticipatory responses. Conclusions Non-BI children may more readily engage rapid coordinated frontolimbic circuitry to salient stimuli, whereas BI children may preferentially engage subcortical circuitry, in response to limbic “alarms” triggered by subliminal threat cues. These data help reveal the extent to which temperamental risk shares similar neurocircuitry previously documented in anxious adolescents and young adults in response to masked threat. All children displayed amygdala activation in response to brief threat cues. Non-BI children displayed activation in striatum, PFC and temporal lobes. BI children showed greater activation in the cerebellum.
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Affiliation(s)
- Eran S Auday
- The Pennsylvania State University, United States.
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28
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Luo L, Becker B, Geng Y, Zhao Z, Gao S, Zhao W, Yao S, Zheng X, Ma X, Gao Z, Hu J, Kendrick KM. Sex-dependent neural effect of oxytocin during subliminal processing of negative emotion faces. Neuroimage 2017; 162:127-137. [PMID: 28877512 DOI: 10.1016/j.neuroimage.2017.08.079] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 08/28/2017] [Accepted: 08/30/2017] [Indexed: 02/07/2023] Open
Abstract
In line with animal models indicating sexually dimorphic effects of oxytocin (OXT) on social-emotional processing, a growing number of OXT-administration studies in humans have also reported sex-dependent effects during social information processing. To explore whether sex-dependent effects already occur during early, subliminal, processing stages the present pharmacological fMRI-study combined the intranasal-application of either OXT or placebo (n = 86-43 males) with a backward-masking emotional face paradigm. Results showed that while OXT suppressed inferior frontal gyrus, dorsal anterior cingulate and anterior insula responses to threatening face stimuli in men it increased them in women. In women increased anterior cingulate reactivity during subliminal threat processing was also positively associated with trait anxiety. On the network level, sex-dependent effects were observed on amygdala, anterior cingulate and inferior frontal gyrus functional connectivity that were mainly driven by reduced coupling in women following OXT. Our findings demonstrate that OXT produces sex-dependent effects even at the early stages of social-emotional processing, and suggest that while it attenuates neural responses to threatening social stimuli in men it increases them in women. Thus in a therapeutic context OXT may potentially produce different effects on anxiety disorders in men and women.
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Affiliation(s)
- Lizhu Luo
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Benjamin Becker
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Yayuan Geng
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Zhiying Zhao
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Shan Gao
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Weihua Zhao
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Shuxia Yao
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Xiaoxiao Zheng
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Xiaole Ma
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Zhao Gao
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Jiehui Hu
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China
| | - Keith M Kendrick
- Key Laboratory for NeuroInformation of Ministry of Education, Center for Information in Medicine, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, Sichuan 611731, China.
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29
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MacNamara A, Klumpp H, Kennedy AE, Langenecker SA, Phan KL. Transdiagnostic neural correlates of affective face processing in anxiety and depression. Depress Anxiety 2017; 34:621-631. [PMID: 28453905 PMCID: PMC5501757 DOI: 10.1002/da.22631] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 03/10/2017] [Accepted: 03/14/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND It is unknown whether there are neurobiologic differences between various anxiety and depressive disorders, or whether they are characterized by shared neurobiologic variation that cuts across diagnostic boundaries. For instance, multiple anxiety disorders and depression may be characterized by abnormalities in blood oxygen-level dependent (BOLD) response during the processing of affective scenes and faces. To interrogate the shared or unique nature of these aberrations, research that examines the influence of transdiagnostic, dimensional predictors across multiple diagnoses is needed. METHODS One hundred ninety-nine individuals, 142 with primary diagnoses of social anxiety disorder (SAD), generalized anxiety disorder (GAD), or major depressive disorder (MDD) and 57 free from psychiatric diagnoses (healthy controls, HCs), performed a face-matching task involving fearful, angry, and happy faces (and geometric shapes) while undergoing functional magnetic resonance imaging. RESULTS Across the three primary diagnoses, anxiety symptom scores were associated with increased Angry > Shapes activation in the bilateral insula, anterior/midcingulate, and dorsolateral prefrontal cortex (dlPFC), while depressive symptoms were associated with reduced dlPFC activation for Angry > Shapes. Patient > HC differences were limited to non a priori regions, and no differences in BOLD activation were observed between diagnostic groups. CONCLUSIONS (1) Activation in paralimbic, cingulate, and lateral prefrontal regions in response to angry faces is associated with transdiagnostic anxiety and depressive symptomatology. (2) Anxiety and depressive symptoms may exert opposing influences on lateral prefrontal activation. (3) Abnormal threat processing in GAD, SAD, and MDD may reflect shared neural dysfunction that varies with symptom load.
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Affiliation(s)
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Department of Psychology, University of Illinois at Chicago, Chicago, IL
| | - Amy E. Kennedy
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL
| | - Scott A. Langenecker
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Department of Psychology, University of Illinois at Chicago, Chicago, IL
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL,Department of Psychology, University of Illinois at Chicago, Chicago, IL,Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL,Department of Anatomy and Cell Biology and the Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL
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30
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Marin MF, Zsido RG, Song H, Lasko NB, Killgore WDS, Rauch SL, Simon NM, Milad MR. Skin Conductance Responses and Neural Activations During Fear Conditioning and Extinction Recall Across Anxiety Disorders. JAMA Psychiatry 2017; 74:622-631. [PMID: 28403387 PMCID: PMC5539837 DOI: 10.1001/jamapsychiatry.2017.0329] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
IMPORTANCE The fear conditioning and extinction neurocircuitry has been extensively studied in healthy and clinical populations, with a particular focus on posttraumatic stress disorder. Despite significant overlap of symptoms between posttraumatic stress disorder and anxiety disorders, the latter has received less attention. Given that dysregulated fear levels characterize anxiety disorders, examining the neural correlates of fear and extinction learning may shed light on the pathogenesis of underlying anxiety disorders. OBJECTIVES To investigate the psychophysiological and neural correlates of fear conditioning and extinction recall in anxiety disorders and to document how these features differ as a function of multiple diagnoses or anxiety severity. DESIGN, SETTING, AND PARTICIPANTS This investigation was a cross-sectional, case-control, functional magnetic resonance imaging study at an academic medical center. Participants were healthy controls and individuals with at least 1 of the following anxiety disorders: generalized anxiety disorder, social anxiety disorder, specific phobia, and panic disorder. The study dates were between March 2013 and May 2015. EXPOSURES Two-day fear conditioning and extinction paradigm. MAIN OUTCOMES AND MEASURES Skin conductance responses, blood oxygenation level-dependent responses, trait anxiety scores from the State Trait Anxiety Inventory-Trait Form, and functional connectivity. RESULTS This study included 21 healthy controls (10 women) and 61 individuals with anxiety disorders (36 women). P values reported for the neuroimaging results are all familywise error corrected. Skin conductance responses during extinction recall did not differ between individuals with anxiety disorders and healthy controls (ηp2 = 0.001, P = .79), where ηp2 is partial eta squared. The anxiety group had lower activation of the ventromedial prefrontal cortex (vmPFC) during extinction recall (ηp2 = 0.178, P = .02). A similar hypoactive pattern was found during early conditioning (ηp2 = 0.106, P = .009). The vmPFC hypoactivation was associated with anxiety symptom severity (r = -0.420, P = .01 for conditioning and r = -0.464, P = .004 for extinction recall) and the number of co-occuring anxiety disorders diagnosed (ηp2 = 0.137, P = .009 for conditioning and ηp2 = 0.227, P = .004 for extinction recall). Psychophysiological interaction analyses revealed that the fear network connectivity differed between healthy controls and the anxiety group during fear learning (ηp2 range between 0.088 and 0.176 and P range between 0.02 and 0.003) and extinction recall (ηp2 range between 0.111 and 0.235 and P range between 0.02 and 0.002). CONCLUSIONS AND RELEVANCE Despite no skin conductance response group differences during extinction recall, brain activation patterns between anxious and healthy individuals differed. These findings encourage future studies to examine the conditions longitudinally and in the context of treatment trials to improve and guide therapeutics via advanced neurobiological understanding of each disorder.
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Affiliation(s)
- Marie-France Marin
- Department of Psychiatry, Massachusetts General Hospital, Boston,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,currently with the Research Center of the Montreal Mental Health University Institute, Department of Psychiatry, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Rachel G. Zsido
- Department of Psychiatry, Massachusetts General Hospital, Boston
| | - Huijin Song
- Department of Psychiatry, Massachusetts General Hospital, Boston,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Natasha B. Lasko
- Department of Psychiatry, Massachusetts General Hospital, Boston,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - William D. S. Killgore
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Department of Psychiatry, McLean Hospital, Belmont, Massachusetts,currently with the Social, Cognitive, and Affective Neuroscience Laboratory, University of Arizona College of Medicine, Tucson
| | - Scott L. Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Department of Psychiatry, McLean Hospital, Belmont, Massachusetts
| | - Naomi M. Simon
- Department of Psychiatry, Massachusetts General Hospital, Boston,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Mohammed R. Milad
- Department of Psychiatry, Massachusetts General Hospital, Boston,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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31
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Burkhouse KL, Kujawa A, Keenan K, Klumpp H, Fitzgerald KD, Monk CS, Phan KL. The relation between parent depressive symptoms and neural correlates of attentional control in offspring: A preliminary study. Psychiatry Res 2017; 263:26-31. [PMID: 28314202 PMCID: PMC5415428 DOI: 10.1016/j.pscychresns.2017.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 02/21/2017] [Accepted: 03/03/2017] [Indexed: 11/22/2022]
Abstract
Offspring of depressed parents are at significantly elevated risk for depressive disorders themselves; however, the specific mechanisms associated with this risk are not well known. Given the well-established link between parental depression and biased attention for negative stimuli in children, this preliminary study sought to examine the neural correlates of directing attention toward and away from emotional faces in children and adolescents in association with parent's current depressive symptoms. Forty-two youth (age 7-18 years) completed a task with conditions that manipulated whether participants were instructed to match emotional faces (explicit emotion processing) or match shapes in the context of emotional face distractors (implicit emotion processing) during functional magnetic resonance imaging. Results revealed a positive correlation between parent depressive symptoms and youths' recruitment of the dorsal anterior cingulate cortex (ACC) during attempts to direct attention away (implicit processing) from negative faces. These findings were maintained after accounting for current anxiety and depressive symptoms among youth suggesting that the findings were not fully attributable to offspring's psychopathology. These preliminary findings suggest that altered dorsal ACC function may contribute to the biased attention for negative information typically demonstrated in youth at high risk for depression by disrupting efficient inhibition of negative stimuli.
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Affiliation(s)
- Katie L Burkhouse
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Autumn Kujawa
- Department of Psychiatry, Penn State College of Medicine, Hershey, PA, USA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA; Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Kate D Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Christopher S Monk
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA; Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - K Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA; Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA; Department of Anatomy and Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, USA
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32
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Burkhouse KL, Kujawa A, Klumpp H, Fitzgerald KD, Monk CS, Phan KL. Neural correlates of explicit and implicit emotion processing in relation to treatment response in pediatric anxiety. J Child Psychol Psychiatry 2017; 58:546-554. [PMID: 27861879 PMCID: PMC5393919 DOI: 10.1111/jcpp.12658] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/19/2016] [Indexed: 11/29/2022]
Abstract
BACKGROUND Approximately 40%-45% of youth with anxiety disorders do not achieve remission (or a substantial reduction in symptoms) following treatment, highlighting the need to identify predictors of treatment response. Given the well-established link between attentional biases and anxiety disorders in youth and adults, this study examined the neural correlates of directing attention toward and away from emotional faces in relation to pediatric anxiety treatment response. METHOD Prior to beginning treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT), 37 youth (age 7-19 years) with generalized and/or social anxiety disorder completed a task with conditions that manipulated whether participants were instructed to match emotional faces (explicit emotion processing) or match shapes in the context of emotional face distractors (implicit emotion processing) during functional magnetic resonance imaging. RESULTS Results revealed that reduced activation in superior frontal gyrus (SFG), encompassing the dorsal anterior cingulate cortex (ACC) and dorsomedial prefrontal cortex (PFC), during implicit processing of emotional faces predicted a greater reduction in anxiety severity pre-to-post treatment. Post hoc analyses indicated that effects were not significantly moderated by the type of treatment or anxiety type. CONCLUSIONS Findings suggest that less recruitment of SFG, including the dorsal ACC and dorsomedial PFC, during implicit emotion processing predicts a greater reduction in youth anxiety symptoms pre-to-post treatment. Youth who exhibit reduced activation in these areas while matching shapes in the context of emotional face distractors may have more to gain from CBT and SSRI treatment due to preexisting deficits in attentional control. These findings suggest that neuroimaging may be a useful tool for predicting which youth are most likely to benefit from anxiety treatment.
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Affiliation(s)
| | - Autumn Kujawa
- Department of Psychiatry, University of Illinois at Chicago, IL
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, IL
,Department of Psychology, University of Illinois at Chicago, Chicago, IL
| | | | - Christopher S. Monk
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
,Department of Psychology, University of Michigan, Ann Arbor, MI
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, IL
,Department of Psychology, University of Illinois at Chicago, Chicago, IL
,Department of Anatomy and Cell Biology, and Graduate Program in Neuroscience, University of Illinois at Chicago, Chicago, IL, USA
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33
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Klumpp H, Fitzgerald JM, Kinney KL, Kennedy AE, Shankman SA, Langenecker SA, Phan KL. Predicting cognitive behavioral therapy response in social anxiety disorder with anterior cingulate cortex and amygdala during emotion regulation. NEUROIMAGE-CLINICAL 2017; 15:25-34. [PMID: 28462086 PMCID: PMC5403806 DOI: 10.1016/j.nicl.2017.04.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 03/23/2017] [Accepted: 04/10/2017] [Indexed: 02/06/2023]
Abstract
Background Cognitive Behavioral Therapy (CBT) for social anxiety disorder (SAD) and other internalizing conditions attempts to improve emotion regulation. Accumulating data indicate anterior cingulate cortex (ACC), and to a lesser extent amygdala, activation in various tasks predicts treatment outcome. However, little is known about ACC and amygdala activation to emotion regulation in predicting clinical improvement following CBT in SAD. Methods Before treatment, 38 SAD patients completed implicit and explicit emotion regulation paradigms during fMRI. Implicit regulation involved attentional control over negative distractors. Explicit regulation comprised cognitive reappraisal to negative images. Pre-CBT brain activity was circumscribed to anatomical-based ACC sub-regions (rostral, dorsal) and amygdala masks, which were submitted to ROC curves to examine predictive validity as well as correlational analysis to evaluate prognostic change in symptom severity. Results More rostral (rACC) activity in implicit regulation and less rACC activity during explicit regulation distinguished responders (34%) from non-responders. Greater amygdala response in implicit regulation also foretold responder status. Baseline rACC and amygdala activity during attentional control correlated with pre-to-post CBT change in symptom severity such that more activation was related to greater decline in symptoms. No significant correlations were observed for explicit regulation. Conclusions Across forms of regulation, rACC activity predicted responder status whereas amygdala as a neuromarker was limited to implicit regulation. While the direction of effects (enhanced vs. reduced) in rACC activity was task-dependent, results suggest SAD patients with deficient regulation benefited more from CBT. Findings support previous studies involving patients with depression and suggest the rACC may be a viable marker of clinical improvement in SAD. Anterior cingulate cortex is a replicated treatment neuromarker in depression. Cognitive behavioral therapy (CBT) is evidence-based psychotherapy for social phobia. CBT attempts to improve emotion regulation ability. Baseline anterior cingulate cortex activity in regulation predicted CBT response. Baseline amygdala activity during regulation also predicted CBT response.
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Affiliation(s)
- Heide Klumpp
- Mood and Anxiety Disorders Research Program, Department of Psychiatry (HK, AEK, SAL, KLP), University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology (HK, JMF, KLK, SAS, KLP), University of Illinois at Chicago, Chicago, IL, United States.
| | - Jacklynn M Fitzgerald
- Department of Psychology (HK, JMF, KLK, SAS, KLP), University of Illinois at Chicago, Chicago, IL, United States
| | - Kerry L Kinney
- Department of Psychology (HK, JMF, KLK, SAS, KLP), University of Illinois at Chicago, Chicago, IL, United States
| | - Amy E Kennedy
- Mood and Anxiety Disorders Research Program, Department of Psychiatry (HK, AEK, SAL, KLP), University of Illinois at Chicago, Chicago, IL, United States; Mental Health Service (AEK, KLP), Jesse Brown VA Medical Center, Chicago, IL, United States
| | - Stewart A Shankman
- Department of Psychology (HK, JMF, KLK, SAS, KLP), University of Illinois at Chicago, Chicago, IL, United States
| | - Scott A Langenecker
- Mood and Anxiety Disorders Research Program, Department of Psychiatry (HK, AEK, SAL, KLP), University of Illinois at Chicago, Chicago, IL, United States
| | - K Luan Phan
- Mood and Anxiety Disorders Research Program, Department of Psychiatry (HK, AEK, SAL, KLP), University of Illinois at Chicago, Chicago, IL, United States; Department of Psychology (HK, JMF, KLK, SAS, KLP), University of Illinois at Chicago, Chicago, IL, United States; Mental Health Service (AEK, KLP), Jesse Brown VA Medical Center, Chicago, IL, United States
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Williams LM. Defining biotypes for depression and anxiety based on large-scale circuit dysfunction: a theoretical review of the evidence and future directions for clinical translation. Depress Anxiety 2017; 34:9-24. [PMID: 27653321 PMCID: PMC5702265 DOI: 10.1002/da.22556] [Citation(s) in RCA: 153] [Impact Index Per Article: 21.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 07/28/2016] [Accepted: 08/15/2016] [Indexed: 01/23/2023] Open
Abstract
Complex emotional, cognitive and self-reflective functions rely on the activation and connectivity of large-scale neural circuits. These circuits offer a relevant scale of focus for conceptualizing a taxonomy for depression and anxiety based on specific profiles (or biotypes) of neural circuit dysfunction. Here, the theoretical review first outlines the current consensus as to what constitutes the organization of large-scale circuits in the human brain identified using parcellation and meta-analysis. The focus is on neural circuits implicated in resting reflection (default mode), detection of "salience," affective processing ("threat" and "reward"), "attention," and "cognitive control." Next, the current evidence regarding which type of dysfunctions in these circuits characterize depression and anxiety disorders is reviewed, with an emphasis on published meta-analyses and reviews of circuit dysfunctions that have been identified in at least two well-powered case:control studies. Grounded in the review of these topics, a conceptual framework is proposed for considering neural circuit-defined "biotypes." In this framework, biotypes are defined by profiles of extent of dysfunction on each large-scale circuit. The clinical implications of a biotype approach for guiding classification and treatment of depression and anxiety is considered. Future research directions will develop the validity and clinical utility of a neural circuit biotype model that spans diagnostic categories and helps to translate neuroscience into clinical practice in the real world.
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Affiliation(s)
- Leanne M Williams
- Corresponding author: Leanne M Williams, PhD, Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, California, 94134-5717, , Phone: 650 723 3579
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Peters AT, Van Meter A, Pruitt PJ, Briceño EM, Ryan KA, Hagan M, Weldon AL, Kassel MT, Vederman A, Zubieta JK, McInnis M, Weisenbach SL, Langenecker SA. Acute cortisol reactivity attenuates engagement of fronto-parietal and striatal regions during emotion processing in negative mood disorders. Psychoneuroendocrinology 2016; 73:67-78. [PMID: 27474908 PMCID: PMC5048542 DOI: 10.1016/j.psyneuen.2016.07.215] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 07/21/2016] [Accepted: 07/21/2016] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Depression and bipolar disorder (negative mood disorders, NMD) are associated with dysregulated hypothalamic-pituitary-adrenal (HPA)-axis function and disrupted emotion processing. The neural networks involved in attenuation of HPA-axis reactivity overlap with the circuitry involved in perception and modulation of emotion; however, direct links between these systems are understudied. This study investigated whether cortisol activity prior to undergoing fMRI was related to neural processing of emotional information in participants with NMD. METHODS Forty-one adults (Mage=40.33, SD=15.57) with major depression (n=29) or bipolar disorder (n=12) and 23 healthy control comparisons (Mage=36.43, SD=17.33) provided salivary cortisol samples prior to completing a facial emotion perception test during 3-Tesla fMRI. RESULTS Overall, pre-scan cortisol level was positively associated with greater engagement of the dorsal anterior cingulate (dACC), inferior parietal lobule, insula, putamen, precuneus, middle and medial frontal and postcentral gyri, posterior cingulate, and inferior temporal gyrus during emotion processing of all faces. NMD status moderated this effect; in NMD participants' pre-scan cortisol was associated with attenuated activation of the insula, postcentral gyrus, precuneus, and putamen for fearful faces and the medial frontal gyrus for angry faces relative to HCs. Cortisol-related attenuation of activation among NMD participants was also observed for facial identification in the dACC, putamen, middle temporal gyrus, precuneus, and caudate. CONCLUSIONS Across all participants, cortisol was associated with greater activation in several regions involved in the perception and control of emotion. However, cortisol responsivity was associated with hypoactivation of several of these regions in the NMD group, suggesting that HPA-axis activity may selectively interfere with the potentially adaptive recruitment of circuits supporting emotion perception, processing and/or regulation in mood disorders.
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Affiliation(s)
- Amy T. Peters
- University of Illinois at Chicago, Department of Psychiatry, Chicago, IL, USA
| | - Anna Van Meter
- Ferkauf Graduate School, Yeshiva University, Bronx, NY, USA
| | - Patrick J. Pruitt
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Emily M. Briceño
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Kelly A. Ryan
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Melissa Hagan
- Department of Psychology, San Francisco State University, San Francisco, CA, USA,Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - Anne L. Weldon
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Michelle T. Kassel
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Aaron Vederman
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, USA
| | - Jon-Kar Zubieta
- Department of Psychiatry, University of Utah, Salt Lake City, UT, USA
| | - Melvin McInnis
- Department of Psychiatry, University of Michigan Medical Center, Ann Arbor, MI, USA
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Galineau L, Kas A, Worbe Y, Chaigneau M, Herard AS, Guillermier M, Delzescaux T, Féger J, Hantraye P, Tremblay L. Cortical areas involved in behavioral expression of external pallidum dysfunctions: A PET imaging study in non-human primates. Neuroimage 2016; 146:1025-1037. [PMID: 27989846 DOI: 10.1016/j.neuroimage.2016.10.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 10/25/2016] [Indexed: 01/22/2023] Open
Abstract
The external pallidum (GPe) is a component of the indirect pathway centrally placed in the basal ganglia. Studies already demonstrated that the pharmacological disinhibition of the sensorimotor, associative, and limbic GPe produced dyskinesia, hyperactivity, and compulsive behaviors, respectively. The aim of this study was to investigate the cortical regions altered by the disinhibition of each GPe functional territory. Thus, 5 macaques were injected with bicuculline in sensorimotor, associative, and limbic sites of the GPe producing dyskinesia, hyperactivity, and compulsive behaviors, and underwent in vivo positron tomography with 18F-2-fluoro-2-deoxy-D-glucose to identify cortical dysfunctions related to GPe disinhibition. Blood cortisol levels were also quantified as a biomarker of anxiety for each condition. Our results showed that pallidal bicuculline injections in anesthetized animals reproducibly modified the activity of specific ipsilateral and contralateral cortical areas depending on the pallidal territory targeted. Bicuculline injections in the limbic GPe led to increased ipsilateral activations in limbic cortical regions (anterior insula, amygdala, and hippocampus). Injections in the associative vs. sensorimotor GPe increased the activity in the ipsilateral midcingulate vs. somatosensory and parietal cortices. Moreover, bicuculline injections increased blood cortisol levels only in animals injected in their limbic GPe. These are the first functional results supporting the model of opened cortico-striato-thalamo-cortical loops where modifications in a functional pallidal territory can impact cortical activities of the same functional territory but also cortical activities of other functional territories. This highlights the importance of the GPe as a crucial node in the top-down control of the cortico-striato-thalamo-cortical circuits from the frontal cortex to influence the perception, attention, and emotional processes at downstream (or non-frontal) cortical levels. Finally, we showed the implication of the ventral pallidum with the amygdala and the insular cortex in a circuit related to aversive processing that should be crucial for the production of anxious disorders.
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Affiliation(s)
- Laurent Galineau
- UMR INSERM U930, Université François Rabelais de Tours, Tours, France
| | - Aurélie Kas
- AP-HP, Department of Nuclear Medicine, Pitié-Salpêtrière Hospital, Sorbonne University, UPMC Paris 06, CNRS UMR 7371, INSERM U1146, 75013 Paris, France
| | - Yulia Worbe
- Department of Neurology, Pitié-Salpêtrière Hospital, Sorbonne University, UMPC Paris 06, ICM, 75013 Paris, France
| | - Marion Chaigneau
- MIRCEN, CEA UMR 9199, 18 route du Panorama, 92260 Fontenay-aux-Roses, France
| | - Anne-Sophie Herard
- MIRCEN, CEA UMR 9199, 18 route du Panorama, 92260 Fontenay-aux-Roses, France
| | - Martine Guillermier
- MIRCEN, CEA UMR 9199, 18 route du Panorama, 92260 Fontenay-aux-Roses, France
| | - Thierry Delzescaux
- MIRCEN, CEA UMR 9199, 18 route du Panorama, 92260 Fontenay-aux-Roses, France
| | - Jean Féger
- UPMC Université Paris 6, UMR-S975, CRICM-Centre de Recherche de l'Institut du Cerveau et de la Moelle épinière, Paris, France
| | - Philippe Hantraye
- MIRCEN, CEA UMR 9199, 18 route du Panorama, 92260 Fontenay-aux-Roses, France
| | - Léon Tremblay
- CNRS, UMR 5229, Université de Lyon 1, Centre de Neurosciences Cognitives, 67 Boulevard Pinel, Cedex, 69675 Bron, France.
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Skagerlund K, Karlsson T, Träff U. Magnitude Processing in the Brain: An fMRI Study of Time, Space, and Numerosity as a Shared Cortical System. Front Hum Neurosci 2016; 10:500. [PMID: 27761110 PMCID: PMC5050204 DOI: 10.3389/fnhum.2016.00500] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 09/22/2016] [Indexed: 01/22/2023] Open
Abstract
Continuous dimensions, such as time, space, and numerosity, have been suggested to be subserved by common neurocognitive mechanisms. Neuroimaging studies that have investigated either one or two dimensions simultaneously have consistently identified neural correlates in the parietal cortex of the brain. However, studies investigating the degree of neural overlap across several dimensions are inconclusive, and it remains an open question whether a potential overlap can be conceptualized as a neurocognitive magnitude processing system. The current functional magnetic resonance imaging study investigated the potential neurocognitive overlap across three dimensions. A sample of adults (N = 24) performed three different magnitude processing tasks: a temporal discrimination task, a number discrimination task, and a line length discrimination task. A conjunction analysis revealed several overlapping neural substrates across multiple magnitude dimensions, and we argue that these cortical nodes comprise a distributed magnitude processing system. Key components of this predominantly right-lateralized system include the intraparietal sulcus, insula, premotor cortex/SMA, and inferior frontal gyrus. Together with previous research highlighting intraparietal sulcus, our results suggest that the insula also is a core component of the magnitude processing system. We discuss the functional role of each of these components in the magnitude processing system and suggest that further research of this system may provide insight into the etiology of neurodevelopmental disorders where cognitive deficits in magnitude processing are manifest.
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Affiliation(s)
- Kenny Skagerlund
- Department of Behavioral Sciences and Learning, Linköping University Linköping, Sweden
| | - Thomas Karlsson
- Department of Behavioral Sciences and Learning, Linköping UniversityLinköping, Sweden; Linnaeus Centre HEAD, Linköping UniversityLinköping, Sweden
| | - Ulf Träff
- Department of Behavioral Sciences and Learning, Linköping University Linköping, Sweden
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Neural Modulation in Aversive Emotion Processing: An Independent Component Analysis Study. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2016; 2016:2816567. [PMID: 27579051 PMCID: PMC4992784 DOI: 10.1155/2016/2816567] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Accepted: 07/14/2016] [Indexed: 01/20/2023]
Abstract
Emotional processing has an important role in social interaction. We report the findings about the Independent Component Analysis carried out on a fMRI set obtained with a paradigm of face emotional processing. The results showed that an independent component, mainly cerebellar-medial-frontal, had a positive modulation associated with fear processing. Also, another independent component, mainly parahippocampal-prefrontal, showed a negative modulation that could be associated with implicit reappraisal of emotional stimuli. Independent Component Analysis could serve as a method to understand complex cognitive processes and their underlying neural dynamics.
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Williams LM. Precision psychiatry: a neural circuit taxonomy for depression and anxiety. Lancet Psychiatry 2016; 3:472-80. [PMID: 27150382 PMCID: PMC4922884 DOI: 10.1016/s2215-0366(15)00579-9] [Citation(s) in RCA: 355] [Impact Index Per Article: 44.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 12/13/2015] [Accepted: 12/16/2015] [Indexed: 12/24/2022]
Abstract
Although there have been tremendous advances in the understanding of human dysfunctions in the brain circuitry for self-reflection, emotion, and cognitive control, a brain-based taxonomy for mental disease is still lacking. As a result, these advances have not been translated into actionable clinical tools, and the language of brain circuits has not been incorporated into training programmes. To address this gap, I present this synthesis of published work, with a focus on functional imaging of circuit dysfunctions across the spectrum of mood and anxiety disorders. This synthesis provides the foundation for a taxonomy of putative types of dysfunction, which cuts across traditional diagnostic boundaries for depression and anxiety and includes instead distinct types of neural circuit dysfunction that together reflect the heterogeneity of depression and anxiety. This taxonomy is suited to specifying symptoms in terms of underlying neural dysfunction at the individual level and is intended as the foundation for building mechanistic research and ultimately guiding clinical practice.
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Affiliation(s)
- Leanne M Williams
- Department of Psychiatry and Behavioral Sciences, Stanford University, CA, USA.
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40
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Disrupted prefrontal activity during emotion processing in complicated grief: An fMRI investigation. Neuroimage 2015; 124:968-976. [PMID: 26434802 DOI: 10.1016/j.neuroimage.2015.09.054] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2015] [Revised: 08/27/2015] [Accepted: 09/26/2015] [Indexed: 11/20/2022] Open
Abstract
Complicated Grief, marked by a persistent and intrusive grief lasting beyond the expected period of adaptation, is associated with a relative inability to disengage from idiographic loss-relevant stimuli (O'Connor and Arizmendi, 2014). In other populations, functional magnetic resonance imaging (fMRI) studies investigating the neural networks associated with this bias consistently implicate the anterior cingulate cortex (ACC) during emotion regulation. In the present study, twenty-eight older adults were categorized into three groups based on grief severity: Complicated Grief (n=8), Non-Complicated Grief (n=9), and Nonbereaved, married controls (n=11). Using a block design, all participants completed 8 blocks (20 stimuli per block) of the ecStroop task during fMRI data acquisition. Differences in neural activity during grief-related (as opposed to neutral) stimuli across groups were examined. Those with Complicated Grief showed an absence of increased rostral ACC (rACC) and fronto-cortical recruitment relative to Nonbereaved controls. Activity in the orbitofrontal cortex (x=6, y=54, z=-10) was significantly elevated in the Non-Complicated Grief group when compared to Nonbereaved controls. Post hoc analysis evidenced activity in the dorsal ACC in the Complicated Grief and Nonbereaved groups late in the task. These findings, supported by behavioral data, suggest a relative inability to recruit the regions necessary for successful completion of this emotional task in those with Complicated Grief. This deficit was not observed in recruitment of the orbitofrontal cortex and the rACC during processing of idiographic semantic stimuli in Non-Complicated Grief.
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Gentili C, Cristea IA, Angstadt M, Klumpp H, Tozzi L, Phan KL, Pietrini P. Beyond emotions: A meta-analysis of neural response within face processing system in social anxiety. Exp Biol Med (Maywood) 2015; 241:225-37. [PMID: 26341469 DOI: 10.1177/1535370215603514] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Patients with social anxiety disorder (SAD) experience anxiety and avoidance in face-to-face interactions. We performed a meta-analysis of functional magnetic resonance imaging (fMRI) studies in SAD to provide a comprehensive understanding of the neural underpinnings of face perception in this disorder. To this purpose, we adopted an innovative approach, asking authors for unpublished data. This is a common procedure for behavioral meta-analyses, which, however has never been used in neuroimaging studies. We searched Pubmed with the key words "Social Anxiety AND faces" and "Social Phobia AND faces." Then, we selected those fMRI studies for which we were able to obtain data for the comparison between SAD and healthy controls (HC) in a face perception task, either from the published papers or from the authors themselves. In this way, we obtained 23 studies (totaling 449 SAD and 424 HC individuals). We identified significant clusters in which faces evoked a higher response in SAD in bilateral amygdala, globus pallidus, superior temporal sulcus, visual cortex, and prefrontal cortex. We also found a higher activity for HC in the lingual gyrus and in the posterior cingulate. Our findings show that altered neural response to face in SAD is not limited to emotional structures but involves a complex network. These results may have implications for the understanding of SAD pathophysiology, as they suggest that a dysfunctional face perception process may bias patient person-to-person interactions.
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Affiliation(s)
- Claudio Gentili
- Clinical Psychology Branch - Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa 56126, Italy Department of General Psychology - University of Padua, Padua 35131, Italy
| | - Ioana Alina Cristea
- Clinical Psychology Branch - Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa 56126, Italy Department of Clinical Psychology and Psychotherapy, University Babes-Bolyai, Cluj-Napoca, RO 400015, Romania
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan 48109, USA
| | - Heide Klumpp
- Department of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL 60612, USA
| | | | - K Luan Phan
- Department of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL 60612, USA Department Anatomy and Cell Biology and the Graduate Program in Neuroscience, Chicago, IL 60612, USA Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Pietro Pietrini
- Clinical Psychology Branch - Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa 56126, Italy
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Bas-Hoogendam JM, Andela CD, van der Werff SJA, Pannekoek JN, van Steenbergen H, Meijer OC, van Buchem MA, Rombouts SARB, van der Mast RC, Biermasz NR, van der Wee NJA, Pereira AM. Altered neural processing of emotional faces in remitted Cushing's disease. Psychoneuroendocrinology 2015; 59:134-46. [PMID: 26092780 DOI: 10.1016/j.psyneuen.2015.05.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 04/29/2015] [Accepted: 05/05/2015] [Indexed: 01/28/2023]
Abstract
Patients with long-term remission of Cushing's disease (CD) demonstrate residual psychological complaints. At present, it is not known how previous exposure to hypercortisolism affects psychological functioning in the long-term. Earlier magnetic resonance imaging (MRI) studies demonstrated abnormalities of brain structure and resting-state connectivity in patients with long-term remission of CD, but no data are available on functional alterations in the brain during the performance of emotional or cognitive tasks in these patients. We performed a cross-sectional functional MRI study, investigating brain activation during emotion processing in patients with long-term remission of CD. Processing of emotional faces versus a non-emotional control condition was examined in 21 patients and 21 matched healthy controls. Analyses focused on activation and connectivity of two a priori determined regions of interest: the amygdala and the medial prefrontal-orbitofrontal cortex (mPFC-OFC). We also assessed psychological functioning, cognitive failure, and clinical disease severity. Patients showed less mPFC activation during processing of emotional faces compared to controls, whereas no differences were found in amygdala activation. An exploratory psychophysiological interaction analysis demonstrated decreased functional coupling between the ventromedial PFC and posterior cingulate cortex (a region structurally connected to the PFC) in CD-patients. The present study is the first to show alterations in brain function and task-related functional coupling in patients with long-term remission of CD relative to matched healthy controls. These alterations may, together with abnormalities in brain structure, be related to the persisting psychological morbidity in patients with CD after long-term remission.
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Affiliation(s)
- Janna Marie Bas-Hoogendam
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Cornelie D Andela
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands; Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands.
| | - Steven J A van der Werff
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - J Nienke Pannekoek
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands; Division of Brain Sciences, Centre for Neuropsychopharmacology, Imperial College London, United Kingdom
| | - Henk van Steenbergen
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Onno C Meijer
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands; Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
| | - Mark A van Buchem
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Serge A R B Rombouts
- Institute of Psychology, Leiden University, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands; Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Roos C van der Mast
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
| | - Nienke R Biermasz
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands; Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
| | - Nic J A van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands; Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - Alberto M Pereira
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands; Department of Medicine, Division of Endocrinology and Center for Endocrine Tumors, Leiden University Medical Center, Leiden, The Netherlands
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Taylor JM, Whalen PJ. Neuroimaging and Anxiety: the Neural Substrates of Pathological and Non-pathological Anxiety. Curr Psychiatry Rep 2015; 17:49. [PMID: 25957101 DOI: 10.1007/s11920-015-0586-9] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Advances in the use of noninvasive neuroimaging to study the neural correlates of pathological and non-pathological anxiety have shone new light on the underlying neural bases for both the development and manifestation of anxiety. This review summarizes the most commonly observed neural substrates of the phenotype of anxiety. We focus on the neuroimaging paradigms that have shown promise in exposing this relevant brain circuitry. In this way, we offer a broad overview of how anxiety is studied in the neuroimaging laboratory and the key findings that offer promise for future research and a clearer understanding of anxiety.
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Affiliation(s)
- James M Taylor
- Department of Psychological and Brain Sciences, Dartmouth College, 6207 Moore Hall, Hanover, NH, 03755, USA,
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Duval ER, Javanbakht A, Liberzon I. Neural circuits in anxiety and stress disorders: a focused review. Ther Clin Risk Manag 2015; 11:115-26. [PMID: 25670901 PMCID: PMC4315464 DOI: 10.2147/tcrm.s48528] [Citation(s) in RCA: 117] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Anxiety and stress disorders are among the most prevalent neuropsychiatric disorders. In recent years, multiple studies have examined brain regions and networks involved in anxiety symptomatology in an effort to better understand the mechanisms involved and to develop more effective treatments. However, much remains unknown regarding the specific abnormalities and interactions between networks of regions underlying anxiety disorder presentations. We examined recent neuroimaging literature that aims to identify neural mechanisms underlying anxiety, searching for patterns of neural dysfunction that might be specific to different anxiety disorder categories. Across different anxiety and stress disorders, patterns of hyperactivation in emotion-generating regions and hypoactivation in prefrontal/regulatory regions are common in the literature. Interestingly, evidence of differential patterns is also emerging, such that within a spectrum of disorders ranging from more fear-based to more anxiety-based, greater involvement of emotion-generating regions is reported in panic disorder and specific phobia, and greater involvement of prefrontal regions is reported in generalized anxiety disorder and posttraumatic stress disorder. We summarize the pertinent literature and suggest areas for continued investigation.
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Affiliation(s)
- Elizabeth R Duval
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Arash Javanbakht
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
| | - Israel Liberzon
- Department of Psychiatry, University of Michigan Health System, Ann Arbor, MI, USA
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Cecchini M, Iannoni ME, Pandolfo AL, Aceto P, Lai C. Attachment style dimensions are associated with brain activity in response to gaze interaction. Soc Neurosci 2015; 10:282-93. [DOI: 10.1080/17470919.2014.998344] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Neuroimaging in social anxiety disorder—A meta-analytic review resulting in a new neurofunctional model. Neurosci Biobehav Rev 2014; 47:260-80. [PMID: 25124509 DOI: 10.1016/j.neubiorev.2014.08.003] [Citation(s) in RCA: 237] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Revised: 06/26/2014] [Accepted: 08/01/2014] [Indexed: 01/30/2023]
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Binelli C, Subirà S, Batalla A, Muñiz A, Sugranyés G, Crippa J, Farré M, Pérez-Jurado L, Martín-Santos R. Common and distinct neural correlates of facial emotion processing in social anxiety disorder and Williams syndrome: A systematic review and voxel-based meta-analysis of functional resonance imaging studies. Neuropsychologia 2014; 64:205-17. [DOI: 10.1016/j.neuropsychologia.2014.08.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2014] [Revised: 08/01/2014] [Accepted: 08/16/2014] [Indexed: 12/27/2022]
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Swartz JR, Phan KL, Angstadt M, Klumpp H, Fitzgerald KD, Monk CS. Altered activation of the rostral anterior cingulate cortex in the context of emotional face distractors in children and adolescents with anxiety disorders. Depress Anxiety 2014; 31:870-9. [PMID: 24995682 PMCID: PMC4205191 DOI: 10.1002/da.22289] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 05/30/2014] [Accepted: 06/02/2014] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Pediatric and adult anxiety disorder patients exhibit attention bias to threat and difficulty disengaging attention away from threat. Cognitive frameworks suggest that these patterns are associated with hyperactivation of regions associated with detecting threat, such as the amygdala, and hypoactivation of regions associated with regulating attention, including the lateral prefrontal cortex and rostral anterior cingulate cortex (rACC). The aim of the present study was to examine the neural correlates of these processes in children and adolescents with anxiety disorders. METHODS Participants with an anxiety disorder 7 to 19 years old (n = 34) and typically developing controls (n = 35) underwent fMRI scanning. During scanning, they completed a task with conditions that manipulated whether participants were instructed to match emotional faces (direct emotion processing) or match shapes in the context of emotional face distractors (attentional control). RESULTS Results revealed a significant difference in rACC activation during shape versus face matching, with controls evidencing greater rACC activation relative to patients. CONCLUSIONS This study identifies abnormalities in rACC activation as a potential neural mediator associated with pediatric anxiety disorders, which can inform frameworks for understanding their development and treatment.
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Affiliation(s)
- Johnna R. Swartz
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60607, USA
| | - Mike Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, 60607, USA
| | - Kate D. Fitzgerald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Christopher S. Monk
- Department of Psychology, University of Michigan, Ann Arbor, MI, 48109, USA,Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA,Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI 48109, USA
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Klumpp H, Fitzgerald DA, Angstadt M, Post D, Phan KL. Neural response during attentional control and emotion processing predicts improvement after cognitive behavioral therapy in generalized social anxiety disorder. Psychol Med 2014; 44:3109-21. [PMID: 25066308 PMCID: PMC4376309 DOI: 10.1017/s0033291714000567] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Individuals with generalized social anxiety disorder (gSAD) exhibit attentional bias to salient stimuli, which is reduced in patients whose symptoms improve after treatment, indicating that mechanisms of bias mediate treatment success. Therefore, pre-treatment activity in regions implicated in attentional control over socio-emotional signals (e.g. anterior cingulate cortex, dorsolateral prefrontal cortex) may predict response to cognitive behavioral therapy (CBT), evidence-based psychotherapy for gSAD. METHOD During functional magnetic resonance imaging, 21 participants with gSAD viewed images comprising a trio of geometric shapes (circles, rectangles or triangles) alongside a trio of faces (angry, fearful or happy) within the same field of view. Attentional control was evaluated with the instruction to 'match shapes', directing attention away from faces, which was contrasted with 'match faces', whereby attention was directed to emotional faces. RESULTS Whole-brain voxel-wise analyses showed that symptom improvement was predicted by enhanced pre-treatment activity in the presence of emotional face distractors in the dorsal anterior cingulate cortex and dorsal medial prefrontal cortex. Additionally, CBT success was foretold by less activity in the amygdala and/or increased activity in the medial orbitofrontal gyrus during emotion processing. CONCLUSIONS CBT response was predicted by pre-treatment activity in prefrontal regions and the amygdala. The direction of activity suggests that individuals with intact attentional control in the presence of emotional distractors, regulatory capacity over emotional faces and/or less reactivity to such faces are more likely to benefit from CBT. Findings indicate that baseline neural activity in the context of attentional control and emotion processing may serve as a step towards delineating mechanisms by which CBT exerts its effects.
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Affiliation(s)
- H. Klumpp
- Mood and Anxiety Disorders Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - D. A. Fitzgerald
- Mood and Anxiety Disorders Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
- Mental Health Service, Jesse Brown VA Medical Center, Chicago, IL, USA
| | - M. Angstadt
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - D. Post
- Mood and Anxiety Disorders Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - K. L. Phan
- Mood and Anxiety Disorders Research Program, Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
- Mental Health Service, Jesse Brown VA Medical Center, Chicago, IL, USA
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Attention to Emotional Information in Social Anxiety Disorder With and Without Co-Occurring Depression. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9643-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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