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Yan H, Han Y, Shan X, Li H, Liu F, Zhao J, Li P, Guo W. Shared and distinctive dysconnectivity patterns underlying pure generalized anxiety disorder (GAD) and comorbid GAD and depressive symptoms. J Psychiatr Res 2024; 170:225-236. [PMID: 38159347 DOI: 10.1016/j.jpsychires.2023.12.031] [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: 06/27/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
The resting-state connectivity features underlying pure generalized anxiety disorder (GAD, G1) and comorbid GAD and depressive symptoms (G2) have not been directly compared. Furthermore, it is unclear whether these features might serve as potential prognostic biomarkers and change with treatment. Degree centrality (DC) in G1 (40 subjects), G2 (58 subjects), and healthy controls (HCs, 54 subjects) was compared before treatment, and the DC of G1 or G2 at baseline was compared with that after 4 weeks of paroxetine treatment. Using support vector regression (SVR), voxel-wise DC across the entire brain and abnormal DC at baseline were employed to predict treatment response. At baseline, G1 and G2 exhibited lower DC in the left mid-cingulate cortex and vermis IV/V compared to HCs. Additionally, compared to HCs, G1 had lower DC in the left middle temporal gyrus, while G2 showed higher DC in the right inferior temporal/fusiform gyrus. However, there was no significant difference in DC between G1 and G2. The SVR based on abnormal DC at baseline could successfully predict treatment response in responders in G2 or in G1 and G2. Notably, the predictive performance based on abnormal DC at baseline surpassed that based on DC across the entire brain. After treatment, G2 responders showed lower DC in the right medial orbital frontal gyrus, while no change in DC was identified in G1 responders. The G1 and G2 showed common and distinct dysconnectivity patterns and they could potentially serve as prognostic biomarkers. Furthermore, DC in patients with GAD could change with treatment.
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Affiliation(s)
- Haohao Yan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Yiding Han
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Xiaoxiao Shan
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Huabing Li
- Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China
| | - Feng Liu
- Department of Radiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jingping Zhao
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Ping Li
- Department of Psychiatry, Qiqihar Medical University, Qiqihar, Heilongjiang, 161006, China
| | - Wenbin Guo
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, National Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
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Zugman A, Jett L, Antonacci C, Winkler AM, Pine DS. A systematic review and meta-analysis of resting-state fMRI in anxiety disorders: Need for data sharing to move the field forward. J Anxiety Disord 2023; 99:102773. [PMID: 37741177 PMCID: PMC10753861 DOI: 10.1016/j.janxdis.2023.102773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023]
Abstract
Anxiety disorders are among the most prevalent psychiatric disorders. Neuroimaging findings remain uncertain, and resting state functional magnetic resonance (rs-fMRI) connectivity is of particular interest since it is a scalable functional imaging modality. Given heterogeneous past findings for rs-fMRI in anxious individuals, we characterize patterns across anxiety disorders by conducting a systematic review and meta-analysis. Studies were included if they contained at the time of scanning both a healthy group and a patient group. Due to insufficient study numbers, the quantitative meta-analysis only included seed-based studies. We performed an activation likelihood estimation (ALE) analysis that compared patients and healthy volunteers. All analyses were corrected for family-wise error with a cluster-level threshold of p < .05. Patients exhibited hypo-connectivity between the amygdala and the medial frontal gyrus, anterior cingulate cortex, and cingulate gyrus. This finding, however, was not robust to potential file-drawer effects. Though limited by strict inclusion criteria, our results highlight the heterogeneous nature of reported findings. This underscores the need for data sharing when attempting to detect reliable patterns of disruption in brain activity across anxiety disorders.
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Affiliation(s)
- André Zugman
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States.
| | - Laura Jett
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Child Emotion Lab, University of Wisconsin, Madison, Madison, WI, United States.
| | - Chase Antonacci
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Department of Psychology, Stanford University, Stanford, CA, United States.
| | - Anderson M Winkler
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States; Division of Human Genetics, School of Medicine, The University of Texas Rio Grande Valley, Brownsville, Texas, United States.
| | - Daniel S Pine
- Section on Development and Affective Neuroscience (SDAN), Emotion and Development Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States.
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