Trait anxiety and the neural efficiency of manipulation in working memory

Rumination and Overrecruitment of Cognitive Control Circuits in Depression

BACKGROUND

Rumination is associated with greater cognitive dysfunction and treatment resistance in major depressive disorder (MDD), but its underlying neural mechanisms are not well understood. Because rumination is characterized by difficulty in controlling negative thoughts, the current study investigated whether rumination was associated with aberrant cognitive control in the absence of negative emotional information.

METHODS

Individuals with MDD (n = 176) and healthy control individuals (n = 52) completed the stop signal task with varied stop signal difficulty during functional magnetic resonance imaging. In the task, a longer stop signal asynchrony made stopping difficult (hard stop), whereas a shorter stop signal asynchrony allowed more time for stopping (easy stop).

RESULTS

In participants with MDD, higher rumination intensity was associated with greater neural activity in response to difficult inhibitory control in the frontoparietal regions. Greater activation for difficult inhibitory control associated with rumination was also positively related to state fear. The imaging results provide compelling evidence for the neural basis of inhibitory control difficulties in individuals with MDD with high rumination.

CONCLUSIONS

The association between higher rumination intensity and greater neural activity in regions involved in difficult inhibitory control tasks may provide treatment targets for interventions aimed at improving inhibitory control and reducing rumination in this population.

Anxiety symptoms without depression are associated with cognitive control network (CNN) dysfunction: An fNIRS study

Anxiety is a common psychological disorder associated with other mental disorders, with depression being the most common comorbidity. Few studies have examined the neural mechanisms underlying anxiety after controlling for depression. This study aimed to explore whether there are differences in cortical activation in anxiety patients with different severities whose depression are normal. In the current study, depression levels were normal for 366 subjects-139 healthy subjects, 117 with mild anxiety, and 110 with major anxiety. Using the Hospital Anxiety and Depression Scale (HADS) and a verbal fluency task (VFT) to test subjects' anxiety and depression and cognitive function, respectively. A 53-channel guided near-infrared spectroscopic imaging technology (fNIRS) detected the concentration of oxyhemoglobin (oxy-Hb). Correlation analysis between anxiety severity and oxy-Hb concentration in the brain cortex was performed, as well as ANOVA analysis of oxy-Hb concentration among the three anxiety severity groups. The results showed that anxiety severity was significantly and negatively correlated with oxy-Hb concentrations in the left frontal eye field (lFEF) and in the right dorsolateral prefrontal area (rDLPFC). The oxy-Hb concentration in the lFEF and the rDLPFC were significantly lower in the major anxiety disorder group than that in the control group. This suggests that decreased cortical activity of the lFEF and rDLPFC may be neural markers of anxiety symptoms after controlling for depression. Anxiety symptoms without depression may be result from the dysfunction of the cognitive control network (CCN) which includes the lFEF and rDLPFC.

Interleaved TMS/fMRI shows that threat decreases dlPFC-mediated top-down regulation of emotion processing

Background

The right dorsolateral prefrontal cortex (dlPFC) has been indicated to be a key region in the cognitive regulation of emotion by many previous neuromodulation and neuroimaging studies. However, there is little direct causal evidence supporting this top-down regulation hypothesis. Furthermore, it is unclear whether contextual threat impacts this top-down regulation. By combining TMS/fMRI, this study aimed to uncover the impact of unpredictable threat on TMS-evoked BOLD response in dlPFC-regulated emotional networks. Based on the previous findings linking the dlPFC to the downregulation of emotional network activity, we hypothesized TMS pulses would deactivate activity in anxiety expression regions, and that threat would reduce this top-down regulation.

Methods

44 healthy controls (no current or history of psychiatric disorders) were recruited to take part in a broader study. Subjects completed the neutral, predictable, and unpredictable (NPU) threat task while receiving TMS pulses to either the right dlPFC or a control region. dlPFC targeting was based on data from a separate targeting session, where subjects completed the Sternberg working memory (WM) task inside the MRI scanner.

Results

When compared to safe conditions, subjects reported significantly higher levels of anxiety under threat conditions. Additionally, TMS-evoked responses in the left insula (LI), right sensory/motor cortex (RSM), and a region encompassing the bilateral SMA regions (BSMA) differed significantly between safe and threat conditions. There was a significant TMS-evoked deactivation in safe periods that was significantly attenuated in threat periods across all 3 regions.

Conclusions

These findings suggest that threat decreases dlPFC-regulated emotional processing by attenuating the top-down control of emotion, like the left insula. Critically, these findings provide support for the use of right dlPFC stimulation as a potential intervention in anxiety disorders.

Anxious individuals shift emotion control from lateral frontal pole to dorsolateral prefrontal cortex

Anxious individuals consistently fail in controlling emotional behavior, leading to excessive avoidance, a trait that prevents learning through exposure. Although the origin of this failure is unclear, one candidate system involves control of emotional actions, coordinated through lateral frontopolar cortex (FPl) via amygdala and sensorimotor connections. Using structural, functional, and neurochemical evidence, we show how FPl-based emotional action control fails in highly-anxious individuals. Their FPl is overexcitable, as indexed by GABA/glutamate ratio at rest, and receives stronger amygdalofugal projections than non-anxious male participants. Yet, high-anxious individuals fail to recruit FPl during emotional action control, relying instead on dorsolateral and medial prefrontal areas. This functional anatomical shift is proportional to FPl excitability and amygdalofugal projections strength. The findings characterize circuit-level vulnerabilities in anxious individuals, showing that even mild emotional challenges can saturate FPl neural range, leading to a neural bottleneck in the control of emotional action tendencies.

Avoidance-motivational intensity modulated the effect of negative emotion on working memory

Although many studies have explored the association between negative emotion and working memory, the findings remain controversial. The present study investigated the role of avoidance-motivational intensity in modulating the effect of negative emotion on different processes (maintenance versus manipulation) of verbal and spatial working memory. Two experiments employed the modified delayed match-to-sample paradigms to separate the two processes of verbal and spatial working memory under different emotional states, respectively. In Experiment 1, participants were asked to perform the delayed match-to-sample task with or without reordering the characters (manipulation process of verbal working memory). In Experiment 2, mental rotation was used as the manipulation process of spatial working memory. The results showed that negative emotion only affected the manipulation process, but not the maintenance process. Relative to neutral and low avoidance-motivated negative conditions, the manipulation processes of both types of working memory were impaired under the high avoidance-motivated negative condition. No significant difference was observed between low avoidance-motivated negative condition and neutral condition. Our results are discussed in relation to efficiency processing theory and motivational dimensional model of affect. We conclude that negative emotional states with high avoidance-motivational intensity impair the manipulation process of verbal and spatial working memory.

Assessment-related anxiety among older adults: associations with neuropsychological test performance

Anxiety disrupts test performance across academic/testing contexts; however, the impact of anxiety on neuropsychological testing has been examined less frequently among older adults, despite clinical observations of high anxiety and dementia worry among elderly individuals in assessment contexts. The present study examined the impact of trait, state, and test anxiety on measures of processing speed, working memory, verbal memory, and aspects of executive functioning (i.e., set shifting and inhibition). We hypothesized that anxiety specific to neuropsychological assessment would correlate with test performance more consistently than state or trait anxiety. Ninety-three older adults aged 55 to 89 underwent a three-and-a-half-hour comprehensive assessment battery measuring anxiety and neuropsychological test performance. All participants completed the Feelings About Neuropsychological Testing State (FANT-S) and Test (FANT-T) questionnaires, Generalized Anxiety Disorder-seven item (GAD-7), and neuropsychological tests in the domains of processing speed, working memory, verbal memory, and executive functioning. When test scores were regressed on these anxiety measures, increases in test anxiety predicted decreased performance on measures of executive functioning, specifically inhibitory control. State anxiety demonstrated the opposite relationship to performance and predicted increased performance on one measure. Trait anxiety did not predict cognitive assessment performance. Findings were consistent with previous research indicating measures of test anxiety are more sensitive to changes in test performance than measures of trait or state anxiety. Results demonstrated that older adults, even those not referred for a clinical neuropsychological assessment, can show decreased test performance when self-reported anxiety relevant to the neuropsychological assessment context is high.

The role of dlPFC laterality in the expression and regulation of anxiety

Anxiety disorders are the most common mental health disorder. Therefore, elucidating brain mechanisms implicated in anxiety disorders is important avenue for developing novel treatments and improving care. The dorsolateral prefrontal cortex (dlPFC) is thought to be critically involved in working memory processes (i.e. maintenance, manipulation, suppression, etc.). In addition, there is evidence that this region is involved in anxiety regulation. However, it is unclear how working memory related dlPFC processes contribute to anxiety regulation. Furthermore, we know that laterality plays an important role in working memory related dlPFC processing, however there is no current model of dlPFC mediated anxiety regulation that accounts for potential laterality effects. To address this gap, we propose a potential framework where the dlPFC contributes to emotion regulation via working memory processing. According to this framework, working memory is a fundamental process executed by the dlPFC. However, the domain of content differs across the left and right dlPFC, with the left dlPFC sensitive to primarily verbal content, and the right dlPFC sensitive to primarily non-verbal (affective content). Critically, working memory processes allow for both the retention and suppression of affective information in working memory and the overall net effect of processing on mood will depend on the balance of retention and suppression, the valence of the information being processed (positive vs. negative), and the domain of the information (verbal vs. non-verbal). If accurate, the proposed framework predicts that effects of neuromodulation targeting the dlPFC may be dependent upon the context during which the stimulation is presented. This article is part of the Special Issue on 'Fear, Anxiety and PTSD'.

General deficits of attentional inhibition in high trait anxiety: ERP evidence

Behavioral evidence shows that individuals with high trait anxiety tend to be distracted by irrelevant stimulation not only for threat-related stimuli but also for non-emotional neutral stimuli. These findings suggest that there may be a general deficit of attentional control in trait anxiety. However, the neural mechanism underlying the anxiety-related deficit in attentional control, especially inhibition function, is still unclear. Here, we examined the attentional processing of the non-emotional neutral distractor on 66 young adults with different levels of trait anxiety, using the ERP indices of attentional selection (N2pc) and top-down inhibition (Pd) in a search task with geometric stimuli. We found that the distractor-evoked N2pc amplitude did not vary with anxiety levels, but increased anxiety was associated with smaller Pds (i.e. worse inhibition). Besides, delayed attentional selection of targets was associated with higher anxiety levels. These correlations of trait anxiety remained significant even after controlling for state anxiety, and state anxiety did not affect the attentional processing of distractors and targets, suggesting that trait anxiety, not current anxiety, affects attentional function. Our findings clarify the mechanism underlying the general attentional deficits in trait anxiety, e.g. reduced distractor inhibition and delayed target selection.

Relations Between Executive Functioning and Internalizing Symptoms Vary as a Function of Frontoparietal-amygdala Resting State Connectivity

The prefrontal cortex and the frontoparietal network are associated with a variety of regulatory behaviors. Functional connections between these brain regions and the amygdala are implicated in risk for anxiety disorders. The prefrontal cortex and frontoparietal network are also linked to executive functioning, or behaviors that help orient action towards higher order goals. Where much research has been focused on deleterious effects of under-controlled behavior, a body of work suggests that over-controlled behavior may also pose a risk for internalizing problems. Indeed, while work suggests that high levels of attention shifting may still be protective against internalizing problems, there is evidence that high levels of inhibitory control may be a risk factor for socioemotional difficulties. In the ABCD sample, which offers large sample sizes as well as sociodemographic diversity, we test the interaction between frontoparietal network-amygdala resting state functional connectivity and executive functioning behaviors on longitudinal changes in internalizing symptoms from approximately 10 to 12 years of age. We found that higher proficiency in attention shifting indeed predicts fewer internalizing behaviors over time. In addition, higher proficiency in inhibitory control predicts fewer internalizing symptoms over time, but only for children showing resting state connectivity moderately above the sample average between the frontoparietal network and amygdala. This finding supports the idea that top-down control may not be adaptive for all children, and relations between executive functioning and anxiety risk may vary as a function of trait-level regulation.

Sex-related differences in violence exposure, neural reactivity to threat, and mental health

The prefrontal cortex (PFC), hippocampus, and amygdala play an important role in emotional health. However, adverse life events (e.g., violence exposure) affect the function of these brain regions, which may lead to disorders such as depression and anxiety. Depression and anxiety disproportionately affect women compared to men, and this disparity may reflect sex differences in the neural processes that underlie emotion expression and regulation. The present study investigated sex differences in the relationship between violence exposure and the neural processes that underlie emotion regulation. In the present study, 200 participants completed a Pavlovian fear conditioning procedure in which cued and non-cued threats (i.e., unconditioned stimuli) were presented during functional magnetic resonance imaging. Violence exposure was previously assessed at four separate time points when participants were 11-19 years of age. Significant threat type (cued versus non-cued) × sex and sex × violence exposure interactions were observed. Specifically, women and men differed in amygdala and parahippocampal gyrus reactivity to cued versus non-cued threat. Further, dorsolateral PFC (dlPFC) and inferior parietal lobule (IPL) reactivity to threat varied positively with violence exposure among women, but not men. Similarly, threat-elicited skin conductance responses varied positively with violence exposure among women. Finally, women reported greater depression and anxiety symptoms than men. These findings suggest that sex differences in threat-related brain and psychophysiological activity may have implications for mental health.

Altered local gyrification index and corresponding resting-state functional connectivity in individuals with high test anxiety

Previous studies have reported that test anxiety is closely related to unreasonable cognitive patterns and maladaptive emotional responses. However, its underlying brain structural and functional basis has not been thoroughly studied. This study aimed to evaluate the potential difference in local gyration index (LGI) and corresponding resting-state functional connectivity (RSFC) in individuals with high test anxiety (HTA) compared with low test anxiety (LTA). Twenty-six individuals with HTA and 28 individuals with LTA underwent T1-weighted structural and resting-state functional magnetic resonance imaging scans. Using FreeSurfer software, we contrasted the LGI between the HTA and LTA groups using a surface-based general linear model to map group contrasts on a vertex-by-vertex basis. By selecting the cortical regions with significant differences in the LGI analysis as the regions of interest, the seed-based RSFC analysis was further carried out using the Resting-State fMRI Data Analysis Toolkit to examine the differences in the functional connectivity of these cortical regions with the whole brain between the two groups. The results showed that the LGI in several cortical regions of the executive control network (ECN) and the right lateral occipital gyrus was lower in the HTA group than in the LTA group. Furthermore, compared with the LTA group, the HTA group exhibited abnormal RSFC within the ECN, between the ECN and the visual network, and between the ECN and the sensorimotor network. Our findings might provide preliminary evidence for brain morphology and functional alterations in individuals with HTA and contribute to a better understanding of the pathophysiology of TA. DATA STATEMENT: The data that support the findings of this study are available from the corresponding author upon reasonable request after completing a formal data sharing agreement.

Heterogeneity in PFC-amygdala connectivity in middle childhood, and concurrent interrelations with inhibitory control and anxiety symptoms

The prefrontal cortex (PFC) is a key brain area in considering adaptive regulatory behaviors. This includes regulatory projections to regions of the limbic system such as the amygdala, where the nature of functional connections may confer lower risk for anxiety disorders. The PFC is also associated with behaviors like executive functioning. Inhibitory control is a behavior encompassed by executive functioning and is generally viewed favorably for adaptive socioemotional development. Yet, some research suggests that high levels of inhibitory control may actually be a risk factor for some maladaptive developmental outcomes, like anxiety disorders. In a sample of 51 children ranging from 7 to 9 years old, we examined resting state functional connectivity between regions of the PFC and the amygdala. We used Subgrouping Group Iterative Multiple Model Estimation (S-GIMME) to identify and characterize data-driven subgroups of individuals with similar networks of connectivity between these brain regions. Generated subgroups were collapsed into children characterized by the presence or absence of recovered connections between the PFC and amygdala. For subsets of children with available data (N = 38-44), we then tested whether inhibitory control, as measured by a stop signal task, moderated the relation between these subgroups and child-reported anxiety symptoms. We found an inverse relation between stop-signal reaction times and reported count of anxiety symptoms when covarying for connectivity group, suggesting that greater inhibitory control was actually related to greater anxiety symptoms, but only when accounting for patterns of PFC-amygdala connectivity. These data suggest that there is a great deal of heterogeneity in the nature of functional connections between the PFC and amygdala during this stage of development. The findings also provide support for the notion of high levels of inhibitory control as a risk factor for anxiety, but trait-level biopsychosocial factors may be important to consider in assessing the nature of risk.

The dysregulation of top-down control in individuals with high test anxiety: A resting state fMRI study

BACKGROUND

Individuals with high test anxiety (HTA) have deficits in attentional control and in stress responses when faced with tests. However, little is known about the underlying neural mechanism. Anterior cingulate cortex (ACC) is involved in both attention and emotion networks, therefore this study examined the neural functional dysregulation in test anxiety from the perspective of functional connectivity (FC) using bilateral ACC as the regions of interest.

METHODS

Fifty-one participants were divided into HTA (n = 23) and low test anxiety (LTA, n = 28) group according to their Test Anxiety Scale (TAS) scores. Brain imaging data in resting, preparing, and recovering phases of a modified social evaluative threat task were collected, and emotional changes were assessed.

RESULTS

Compared with the LTA group, the HTA group exhibited significantly lower FCs between the ACC and superior frontal gyrus (SFG) in all 3 phases, significantly lower FCs between the ACC and inferior parietal gyrus (IPG), and significantly higher FCs between the ACC superior temporal gyrus (STG) in the preparing phase. Moreover, in the HTA group, the resting state IPG-ACC FC was associated with their TAS score, the preparing state STG-ACC FC was associated with the increased anxiety.

CONCLUSIONS

Individuals with HTA have general prefrontal control deficits. When facing a test, they tend to recruit more resources to deal with high emotional interference. The dysregulated control of the ACC by the frontal-parietal network may underlie the pathophysiology of test anxiety.

Continuous Theta Burst Stimulation to the Right Dorsolateral Prefrontal Cortex may increase Potentiated Startle in healthy individuals

Background

Convergent neuroimaging and neuromodulation studies implicate the right dorsolateral prefrontal cortex (dlPFC) as a key region involved in anxiety-cognition interactions. However, neuroimaging data are correlational, and neuromodulation studies often lack appropriate methodological controls. Accordingly, this work was designed to explore the role of right prefrontal cognitive control mechanisms in the expression/regulation of anxiety using continuous theta-burst transcranial magnetic stimulation (cTBS) and threat of unpredictable shock. Based on prior neuromodulation studies, we hypothesized that the right dlPFC contributed to anxiety expression, and that cTBS should downregulate this expression.

Methods

We measured potentiated startle and performance on the Sternberg working memory paradigm in 28 healthy participants before and after 4 sessions (600 pulses/session) of active or sham cTBS. Stimulation was individualized to the right dlPFC site of maximal working memory-related activity and optimized using electric-field modeling.

Results

Compared with sham cTBS, active cTBS, which is thought to induce long-term depression-like synaptic changes, increased startle during threat of shock, but the effect was similar for predictable and unpredictable threat. As a measure of target (dis)engagement, we also showed that active but not sham cTBS decreased accuracy on the Sternberg task.

Conclusions

Counter to our initial hypothesis, cTBS to the right dlPFC made individuals more anxious, rather than less anxious. Although preliminary, these results are unlikely to be due to transient effects of the stimulation, because anxiety was measured 24 hours after cTBS. In addition, these results are unlikely to be due to off-target effects, because target disengagement was evident from the Sternberg performance data.

Working Memory Performance for Differentially Conditioned Stimuli

Previous work suggests that threat-related stimuli are stored to a greater degree in working memory compared to neutral stimuli. However, most of this research has focused on stimuli with physically salient threat attributes (e.g., angry faces), failing to account for how a "neutral" stimulus that has acquired threat-related associations through differential aversive conditioning influences working memory. The current study examined how differentially conditioned safe (i.e., CS-) and threat (i.e., CS+) stimuli are stored in working memory relative to a novel, non-associated (i.e., N) stimuli. Participants (n = 69) completed a differential fear conditioning task followed by a change detection task consisting of three conditions (CS+, CS-, N) across two loads (small, large). Results revealed individuals successfully learned to distinguishing CS+ from CS- conditions during the differential aversive conditioning task. Our working memory outcomes indicated successful load manipulation effects, but no statistically significant differences in accuracy, response time (RT), or Pashler's K measures of working memory capacity between CS+, CS-, or N conditions. However, we observed significantly reduced RT difference scores for the CS+ compared to CS- condition, indicating greater RT differences between the CS+ and N condition vs. the CS- and N condition. These findings suggest that differentially conditioned stimuli have little impact on behavioral outcomes of working memory compared to novel stimuli that had not been associated with previous safe of aversive outcomes, at least in healthy populations.

Frontal neural metabolite changes in schizophrenia and their association with cognitive control: A systematic review

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GABA levels are decreased in medial frontal brain areas of schizophrenia patients.

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Glutamate levels are lower in medial and lateral frontal areas in chronic patients.

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Working memory performance is associated with frontal GABA and Glu.

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Prediction errors are associated Glu and medial frontal GABA.

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Processing speed correlates with medial frontal GABA levels.

A large proportion of patients with schizophrenia exhibit deficits in cognitive control functions including working memory, processing speed and inhibitory control, which have been associated with frontal brain areas. In this systematic review, we investigated differences between chronic schizophrenia patients, first-episode (FEP) patients and healthy control groups in the neurometabolite levels of GABA, glutamate, glutamine and Glx in frontal brain areas. Additionally, we reviewed correlations between cognitive control functions or negative symptoms and these neurometabolite levels. Several studies reported decreased GABA or glutamate concentrations in frontal lobe areas, particularly in chronic schizophrenia patients, while the results were mixed for FEP patients. Working memory performance and prediction errors have been associated with frontal GABA and glutamate levels, and processing speed with frontomedial GABA levels in chronic patients. The relationship between metabolites and negative symptom severity was somewhat inconsistent. Future studies should take the participants' age, medication status or responsivity, disease stage and precise anatomical location of the voxel into account when comparing neurometabolite levels between schizophrenia patients and healthy controls.

Assessment-related anxiety among older adults: development of a measure

Older adults are the largest population seeking neuropsychological assessment services. Anxiety has been shown to impact test scores, yet no anxiety measure currently exists specific to older adult neuropsychological assessment. This study piloted and validated the Feelings About Neuropsychological Testing measure (FANT), a measure of neuropsychological assessment anxiety developed to measure the cognitive, affective, and physiological aspects of test and state anxiety. The measure was validated on 105 community based older adults aged 55 and older. All participants were administered the FANT, the Generalized Anxiety Disorder- seven item (GAD-7), Test Anxiety Inventory- Short Form (TAI-SF), Patient Health Questionnaire- nine item (PHQ-9), Pittsburgh Sleep Quality Index (PSQI), Dementia Worry Scale (DWS), and PROMIS Cognitive Function Short Form- 6a (CFSF). The measure proved feasible to administer, both the State and Test-specific dimensions demonstrated good internal consistency (state: α =.832; test: α =.894), discriminant validity, and external validity (compared to GAD-7, TAI-SF, PHQ-9, DWS, and CFSF). FANT scores may reveal patients for whom anxiety disrupts attention and attentional control, and therefore has promise as a measure that may inform assessment findings and guide possible intervention to maximize performance during testing sessions and to inform data interpretation.

Medial prefrontal cortex encoding of stress and anxiety

The prefrontal cortex (PFC) is involved in adaptive control of behavior and optimizing action selection. When an organism is experiencing an aversive event, such as a sustained state of anxiety or an overt experience of fear or stress, the mechanisms that govern PFC regulation of action selection may be critical for survival. A large body of literature has shown that acute aversive states influence the activity of PFC neurons and the release of neurotransmitters in this region. These states also result in long-term neurobiological changes in the PFC and expression of PFC-dependent motivated behaviors. The mechanism for how these changes lead to modifying action selection is only recently beginning to emerge. Here, we review animal and human studies into the neural mechanisms which may mediate the adaptive changes in the PFC that emerge during negative affective states. We then highlight recent advances in approaches for understanding how anxiety influences action selection and related cortical processes. We conclude by proposing that PFC neurons selectively influence action encoding during conditions where actions toward obtaining a reward or avoiding harm are executed under a fog of fear and anxiety.

Social anxiety is related to impaired ability to filter out irrelevant information but not reduced storage capacity

Individuals with social anxiety have deficits in inhibiting task-irrelevant threatening information, but the mechanism is poorly understood. In this study, we instructed participants with high and low social anxiety to perform a variant change-detection task, recording their accuracy and electrophysiological data. The results indicated that individuals with high social anxiety showed impaired ability to filter out irrelevant information in disgust facial expression condition rather than neutral facial expression. While individuals with low social anxiety didn't show filter efficiency defects under both disgust and neutral facial expressions. Furthermore, we found high socially anxious individuals could hold more information in visual working memory than low socially anxious individuals. These results suggest that the abundance of cognitive resources in socially anxious individuals compensates the presumed weak performance in accuracy produced by impaired filter efficiency. These results provide support for the claims of efficiency and effectiveness in attentional control theory.

Psychological power alters cognitive efficiency

Power is known to promote cognitive processing in a goal-directed way. However, it is unknown whether powerful individuals invest more resources when pursuing their goals or whether they invest their resources more efficiently. We examined how experiencing high versus low power affects the efficient investment of cognitive resources using electroencephalography (EEG). Specifically, event-related desynchronization (ERD) in the upper alpha band (10.5-12.75 Hz) was used to quantify the use of cognitive resources during task completion. Results showed that high-power participants used fewer neural resources compared to low-power participants across the whole brain but task performance did not differ between groups. These findings demonstrate that, instead of investing more resources, high-power participants performed the task with greater cognitive efficiency compared to low-power participants. Performing tasks efficiently could help powerholders deal with their demanding jobs and responsibilities.

Investigating Principal Working Memory Features in Generalized, Panic, and Social Anxiety Spectrum Disorders

Anxiety spectrum disorders are characterized by excessive and uncontrollable worrying about potential negative events in the short- and long-term future. Various reports linked anxiety spectrum disorders with working memory (WM) deficits despite conflicting results stemming from different study approaches. It remains unclear, however, how different anxiety spectrum disorders such as generalized anxiety disorder (GAD), social anxiety disorder (SAD), and panic disorder (PD), differ in WM function. In this study, we utilized verbal, numerical, and sequential evaluations of WM to cover most possible facets of the WM data space. We used principal component analysis to extract the uncorrelated/whitened components of WM based on these measures. We evaluated medication-free patients with GAD, SAD, and PD patients as well as matched healthy individuals using a battery that measures WM duration and load. We found that patients with GAD and SAD, but not PD, exhibited poor performance only in the WM principal component that represents maintenance. There were no other significant differences between the four groups. Further, different WM components significantly predicted the severity of anxiety symptoms in the groups. We explored the clinical utility of WM components for differentiating patients with anxiety spectrum disorders from healthy individuals. By only using the WM components that represent maintenance and encoding, we managed to differentiate patients from controls in 84% of cases. For the first time, we present multiple novel approaches to examine cognitive function and design cognitive screening, and potentially diagnostics, for psychiatric disorders.

Patients with anxiety disorders rely on bilateral dlPFC activation during verbal working memory

One of the hallmarks of anxiety disorders is impaired cognitive control, affecting working memory (WM). The dorsolateral prefrontal cortex (dlPFC) is critical for WM; however, it is still unclear how dlPFC activity relates to WM impairments in patients. Forty-one healthy volunteers and 32 anxiety (general and/or social anxiety disorder) patients completed the Sternberg WM paradigm during safety and unpredictable shock threat. On each trial, a series of letters was presented, followed by brief retention and response intervals. On low- and high-load trials, subjects retained the series (five and eight letters, respectively) in the original order, while on sort trials, subjects rearranged the series (five letters) in alphabetical order. We sampled the blood oxygenation level-dependent activity during retention using a bilateral anatomical dlPFC mask. Compared to controls, patients showed increased reaction time during high-load trials, greater right dlPFC activity and reduced dlPFC activity during threat. These results suggest that WM performance for patients and controls may rely on distinct patterns of dlPFC activity with patients requiring bilateral dlPFC activity. These results are consistent with reduced efficiency of WM in anxiety patients. This reduced efficiency may be due to an inefficient allocation of dlPFC resources across hemispheres or a decreased overall dlPFC capacity.

The Role of Sleep Quality, Trait Anxiety and Hypothalamic-Pituitary-Adrenal Axis Measures in Cognitive Abilities of Healthy Individuals

Sleep plays a crucial role in cognitive processes. Sleep and wake memory consolidation seem to be regulated by glucocorticoids, pointing out the potential role of the hypothalamic-pituitary-adrenal (HPA) axis in the relationship between sleep quality and cognitive abilities. Trait anxiety is another factor that is likely to moderate the relationship between sleep and cognition, because poorer sleep quality and subtle HPA axis abnormalities have been reported in people with high trait anxiety. The current study aimed to explore whether HPA axis activity or trait anxiety moderate the relationship between sleep quality and cognitive abilities in healthy individuals. We studied 203 healthy individuals. We measured verbal and visual memory, working memory, processing speed, attention and executive function. Sleep quality was assessed with the Pittsburgh Sleep Quality Index. Trait anxiety was assessed with the State-Trait Anxiety Inventory. HPA axis measures included the cortisol awakening response (CAR), diurnal cortisol slope and cortisol levels during the day. Multiple linear regression analyses explored the relationship between sleep quality and cognition and tested potential moderating effects by HPA axis measures and trait anxiety. Poor sleep quality was associated with poorer performance in memory, processing speed and executive function tasks. In people with poorer sleep quality, a blunted CAR was associated with poorer verbal and visual memory and executive functions, and higher cortisol levels during the day were associated with poorer processing speed. Trait anxiety was a moderator of visual memory and executive functioning. These results suggest that subtle abnormalities in the HPA axis and higher trait anxiety contribute to the relationship between lower sleep quality and poorer cognitive functioning in healthy individuals.

Specificity of trait anxiety in anxiety and depression: Meta-analysis of the State-Trait Anxiety Inventory

The State-Trait Anxiety Inventory - Trait version (STAI-T) was developed to measure an individual's tendency to experience anxiety, but it may lack discriminant evidence of validity based on strong observed relationships with measures of depression. The present series of meta-analyses compares STAI-T scores among individuals with depressive disorders, anxiety disorders, and nonclinical comparison groups, as well as correlations with measures of anxiety and depressive symptom severity, in order to further examine discriminant and convergent validity. A total of 388 published studies (N = 31,021) were included in the analyses. Individuals with an anxiety disorder and those with a depressive disorder displayed significantly elevated scores on the STAI-T compared to nonclinical comparison groups. Furthermore, anxiety and depressive symptom severity were similarly strongly correlated with the STAI-T (mean r = .59 - .61). However, individuals with a depressive disorder had significantly higher STAI-T scores than individuals with an anxiety disorder (Hedges's g = 0.27). Given these findings, along with previous factor analyses that have observed a depression factor on the STAI-T, describing the scale as a measure of 'trait anxiety' may be a misnomer. It is proposed that the STAI-T be considered a non-specific measure of negative affectivity rather than trait anxiety per se.

State anxiety reduces working memory capacity but does not impact filtering cost for neutral distracters

Current theories propose that anxiety adversely impacts working memory (WM) by restricting WM capacity and interfering with efficient filtering of task-irrelevant information. The current study investigated the effect of shock-induced state anxiety on WM capacity and the ability to filter task-irrelevant neutral stimuli. We measured the contralateral delay activity (CDA), an event-related potential that indexes the number of items maintained in WM, while participants completed a lateralized change detection task. The task included low and high WM loads, as well as a low load plus distracter condition. This design was used to assess WM capacity for low and high loads and investigate an individual's ability to filter neutral task-irrelevant stimuli. Participants completed the task under two conditions, threat of shock and safe. We observed a reduced CDA in the threat compared to the safe condition that was specific for high memory load. However, we did not find any differences in CDA filtering cost between threat and safe conditions. In addition, we did not find any differences in behavioral performance between the threat and safe conditions. These findings suggest that being in an anxious state reduces the neural representation for large amounts of information in WM, but have little effect on the filtering of neutral distracters.

Serotonergic influence on depressive symptoms and trait anxiety is mediated by negative life events and frontal activation in children and adolescents

Depression and anxiety are common in childhood and adolescence. Even though cardinal symptoms differ, there is a considerable overlap regarding the pathogenic influence of serotonergic innervation, negative life experience, disturbed emotion perception/affect regulation, and impaired neural functioning in the fronto-limbic circuit. In this study, we examined the effect of the 5-HTTLPR/rs25531 genotype on depressive symptoms and trait anxiety under the consideration of the amount of negative life events in healthy children and adolescents (N = 389). In a subsample of 49 subjects, we performed fMRI to add fronto-limbic brain activation as a second interacting factor. Across all subjects, negative life events moderated the influence of the 5-HTTLPR/rs25531 genotype on both depressive symptoms and trait anxiety. In the fMRI subsample, 5-HTTLPR/rs25531 S + S/L_G + S/L_A + L_GL_A + L_GL_G genotype-associated left middle frontal gyrus (MFG) activation mediated the influence of 5-HTTLPR/rs25531 genotype on depressive symptoms, however, only in combination with negative life events. Genetic influence on trait anxiety was predominantly mediated by negative life events; only L_AL_A genotype-specific activation in the right MFG worked as a mediator in combination with negative life events. The present findings hint towards distinct mechanisms mediating the influence of 5-HTTLPR/rs25531 genotype on depressive symptoms and anxiety, with negative life events playing a crucial role in both phenotypes. With regard to depressive symptoms, however, this influence was only visible in combination with MFG activation, whereas, in anxiety, it was independent of brain activation.

Mechanistic link between right prefrontal cortical activity and anxious arousal revealed using transcranial magnetic stimulation in healthy subjects

Much of the mechanistic research on anxiety focuses on subcortical structures such as the amygdala; however, less is known about the distributed cortical circuit that also contributes to anxiety expression. One way to learn about this circuit is to probe candidate regions using transcranial magnetic stimulation (TMS). In this study, we tested the involvement of the dorsolateral prefrontal cortex (dlPFC), in anxiety expression using 10 Hz repetitive TMS (rTMS). In a within-subject, crossover experiment, the study measured anxiety in healthy subjects before and after a session of 10 Hz rTMS to the right dorsolateral prefrontal cortex (dlPFC). It used threat of predictable and unpredictable shock to induce anxiety and anxiety potentiated startle to assess anxiety. Counter to our hypotheses, results showed an increase in anxiety-potentiated startle following active but not sham rTMS. These results suggest a mechanistic link between right dlPFC activity and physiological anxiety expression. This result supports current models of prefrontal asymmetry in affect, and lays the groundwork for further exploration into the cortical mechanisms mediating anxiety, which may lead to novel anxiety treatments.

Using connectivity-based real-time fMRI neurofeedback to modulate attentional and resting state networks in people with high trait anxiety

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Controlled experiment on functional connectivity-based real-time fMRI neurofeedback.

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Reduced anxiety levels in the experimental group after neurofeedback training.

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Altered activity and connectivity in neurofeedback ROIs in the experimental group.

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Increased resting state functional connectivity in the PCC in the experimental group.

High levels of trait anxiety are associated with impaired attentional control, changes in brain activity during attentional control tasks and altered network resting state functional connectivity (RSFC). Specifically, dorsolateral prefrontal cortex to anterior cingulate cortex (DLPFC – ACC) functional connectivity, thought to be crucial for effective and efficient attentional control, is reduced in high trait anxious individuals. The current study examined the potential of connectivity-based real-time functional magnetic imaging neurofeedback (rt-fMRI-nf) for enhancing DLPFC – ACC functional connectivity in trait anxious individuals. We specifically tested if changes in DLPFC - ACC connectivity were associated with reduced anxiety levels and improved attentional control. Thirty-two high trait anxious participants were assigned to either an experimental group (EG), undergoing veridical rt-fMRI-nf, or a control group (CG) that received sham (yoked) feedback. RSFC (using resting state fMRI), anxiety levels and Stroop task performance were assessed pre- and post-rt-fMRI-nf training. Post-rt-fMRI-nf training, relative to the CG, the EG showed reduced anxiety levels and increased DLPFC-ACC functional connectivity as well as increased RSFC in the posterior default mode network. Moreover, in the EG, changes in DLPFC – ACC functional connectivity during rt-fMRI-nf training were associated with reduced anxiety levels. However, there were no group differences in Stroop task performance. We conclude that rt-fMRI-nf targeting DLPFC – ACC functional connectivity can alter network connectivity and interactions and is a feasible method for reducing trait anxiety.

Acute Exposure to the Cold Pressor Stress Impairs Working Memory Functions: An Electrophysiological Study

The results of previous literature focusing on the effects of acute stress on human working memory (WM) are equivocal. The present study explored the effects of acute stress on human WM processing using event-related potential (ERP) techniques. Twenty-four healthy participants were submitted to stressful treatments and control treatment at different times. Cold pressor stress (CPS) was used as stressful treatment, while warm water was used as the control treatment before the WM task. Exposure to CPS was associated with a significant increase in blood pressure and salivary cortisol. After the 3-min resting period, systolic blood pressure (SBP) and diastolic blood pressure (DBP) for the CPS session significantly increased relative to the control treatment session (all p ≤ 0.01), and data also showed a significant increase of 20-min post-treatment cortisol concentration (p < 0.001) for CPS. Data from the CPS session showed significantly longer reaction times, lower accuracy, and WM capacity scores than that of the control treatment session. Interestingly, a difference between the two sessions was also found in N₂pc and the late contralateral delay activity (late CDA) components. Specifically, although non-significant main effects of treatment were found for N₂pc amplitudes, there was a significant interaction between treatments and stimuli conditions (processing load) [F _(2,46) = 3.872, p = 0.028, η2 p = 0.14], which showed a pronounced trend toward equalization of N₂pc amplitude across stimuli conditions during the CPS session clearly different from that of control treatment. As for amplitudes for late CDA, a nearly significant main effect of Treatment was found (p = 0.069). That is, the mean amplitude of the late CDA (-2.56 ± 0.27) for CPS treatment was slightly larger than that (-2.27 ± 0.22) for warm water treatment. To summarize, this study not only reported performance impairments in the WM task during CPS trials but also provided high temporal resolution evidence for the detrimental effects of acute stress on processes of information encoding and maintenance.

The effects of Pythagorean Self-Awareness Intervention on breast cancer patients undergoing adjuvant therapy: A pilot randomized controlled trial

Introduction

Breast cancer patients undergo extended treatments that affect their psychological state and quality of life. There is a lack of studies examining the effects of holistic stress management interventions (that combine stress perception, cognitive and lifestyle interventions) on mental health and biological indices (e.g. cortisol concentrations) of breast cancer patients.

Materials and methods

This pilot randomized controlled trial provided the first assessment of the effects of a novel, cognitive-based intervention, the Pythagorean Self-Awareness Intervention (PSAI), on psychological symptoms, quality of life, sleep quality and lifestyle as well as on stress-related biological measures of breast cancer patients undergoing adjuvant therapy. Standardized questionnaires were administered at baseline and 8-weeksafter the intervention to evaluate quality of life, stress, depression, and anxiety (primary outcomes). Sleep quality, lifestyle and hair cortisol concentrations were also assessed (secondary outcomes).

Results

Forty-five breast cancer patients undergoing adjuvant therapy were randomly assigned to the PSAI group (n = 25) or the control group (n = 20).Women in the PSAI group reported significant improvements post-intervention in total Quality of Life, specific aspects of Quality of Life [Physical well-being, Social well-being, Emotional well-being, Functional well-being, Breast cancer concerns] as well as Perceived stress, depression, anxiety and stress. Improvements in secondary outcomes included increase in sleep quality, empowerment for healthy lifestyle and reduction of hair cortisol concentrations.

Conclusions

The PSAI was beneficial as complementary therapy in the women studied. Larger randomized controlled trials with longer follow-up are needed to ascertain these findings.

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Breast cancer patients face physical and psychological cancer-related stressors.

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Pythagorean self-awareness is a novel stress-management intervention (PSAI).

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Breast cancer patients were allocated to PSAI group and control group.

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Mental health, quality of life and sleep were ameliorated in PSAI group.

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Hair cortisol concentrations were reduced significantly in the PSAI group.

Arithmetic Skill May Refine the Performance of Individuals with High Math Anxiety, Especially in the Calculation Task: An ERP Study

As a global phenomenon, the theme of math anxiety has received increasing attention. The present study aimed to investigate the relationship between math anxiety and performance and determine the role of arithmetic skill in two different tasks. Fifty-seven college freshmen were recruited to perform a comparison task and a calculation task. Only main effect of arithmetic skill was found on the behavioral level. In the comparison task, participants with high math anxiety (HMA) showed faster latencies and greater amplitudes of N1 and longer P3b latency relative to their counterparts with low math anxiety (LMA). Number, as a negative stimulus, occupied attentional resources and delayed the speed of cognitive processing for individuals with HMA. Furthermore, among those with HMA, individuals with high arithmetic skill showed larger amplitudes and shorter latencies of P2 compared with those with low airthmetic skill in the calculation task. Thus, arithmetic skill could refine the performance efficiency of individuals with HMA, especially in the calculation task. These results suggest that educational interventions emphasizing control of negative emotional responses to math stimuli will be more effective when considering different populations of mathematically competent individuals.

Trait anxiety on effort allocation to monetary incentives: a behavioral and high-density EEG study

Trait anxiety is an important phenotype in the prediction of stress-induced neuropsychiatric disorders. While the role of trait anxiety in mental effort and cognitive impairment is well documented, much less is known about its influence on motivated behaviors and physical effort. Here, we investigated trait anxiety-related differences in behavioral and neural responses in an effort-related monetary incentive delay task. Participants prompted with different incentive levels could exert handgrip responses to earn monetary rewards while a 256-channel electroencephalography (EEG) was recorded. Participants' performance was linearly dependent on incentive level, with higher stakes prompting better accuracy and higher grip force. Importantly, we found a striking association between trait anxiety and incentive-related grip force; effort exertion was related to incentive level only in high-anxious individuals. In analyses of neural efficiency associated with effort preparation involving Contingent-negative variation (CNV), we found that the CNV amplitude was sensitive to monetary incentive levels. Source imaging analyses of CNV indicated increased activity in the anterior cingulate cortex (ACC) for the highest incentive level. Importantly, we found a significant interaction between trait anxiety and incentive level on CNV modulation at the interval ranging from -2610 to -2510 ms, with greater CNV responses to the lower monetary incentive sizes in high anxiety. Subsequent mediation analyses supported a mediation of the ACC activation on the association between trait anxiety and incentive-selective grip force. Our study reveals a role for ACC in trait anxiety-related differences on incentive processing, when rewards are dependent on effortful performance.

Amygdala and prefrontal cortex activity varies with individual differences in the emotional response to psychosocial stress

Stress elicits a variety of psychophysiological responses that show large interindividual variability. Determining the neural mechanisms that mediate individual differences in the emotional response to stress would provide new insight that would have important implications for understanding stress-related disorders. Therefore, the present study examined individual differences in the relationship between brain activity and the emotional response to stress. In the largest stress study to date, 239 participants completed the Montreal Imaging Stress Task (MIST) while heart rate, skin conductance response (SCR), cortisol, self-reported stress, and blood oxygen level dependent (BOLD) functional MRI (fMRI) signal responses were measured. The relationship between differential responses (heart rate, SCR, cortisol, and self-reported stress) and differential BOLD fMRI data was analyzed. Dorsolateral prefrontal cortex (PFC), dorsomedial PFC, ventromedial PFC, and amygdala activity varied with the behavioral response (i.e., SCR and self-reported stress). These results suggest the PFC and amygdala support processes that are important for the expression and regulation of the emotional response to stress, and that stress-related PFC and amygdala activity underlie interindividual variability in peripheral physiologic measures of the stress response. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Altered relationship between prefrontal glutamate and activation during cognitive control in people with high trait anxiety

Trait anxiety can affect cognitive control resulting in ineffective and/or inefficient task performance. Moreover, previous functional Magnetic Resonance Imaging (fMRI) studies have reported altered dorsolateral prefrontal cortex (DLPFC) activity in anxious cohorts, particularly when executive control is required. Recently, it has been demonstrated that cortical glutamate levels can predict both functional activation during cognitive control, and anxiety levels. In the present study we sought to investigate the relationship between trait anxiety, prefrontal glutamate levels and functional activation in DLPFC during a cognitive control task. Thirty-nine participants assigned to either low trait anxiety (LTA) or high trait anxiety (HTA) groups underwent ¹H-Magnetic Resonance Spectroscopy (¹H-MRS) to measure levels of resting glutamate in the prefrontal cortex (PFC). Participants also completed fMRI during a Stroop task comprising congruent and incongruent colour word trials. The HTA group showed reduced task performance relative to the LTA group. In the LTA group, there was a positive association between PFC Glu levels and DLPFC activation during incongruent trials. This association was absent in the HTA group. Individual differences in trait anxiety affect the relationship between PFC glutamate levels and DLPFC activation, possibly contributing to ineffective task performance when cognitive control is required.

Default mode network alterations in individuals with high-trait-anxiety: An EEG functional connectivity study

BACKGROUND

Although several researches investigated Default Mode Network (DMN) alterations in individuals with anxiety disorders, up to now no studies have investigated DMN functional connectivity in non-clinical individuals with high-trait-anxiety using quantitative electroencephalography (EEG). Here, the main aim was to extend previous findings investigating the association between trait anxiety and DMN EEG functional connectivity.

METHODS

Twenty-three individuals with high-trait-anxiety and twenty-four controls were enrolled. EEG was recorded during 5 min of resting state (RS). EEG analyses were conducted by means of the exact Low-Resolution Electromagnetic Tomography software (eLORETA).

RESULTS

Compared to controls, individuals with high-trait-anxiety showed a decrease of theta connectivity between right medial prefrontal cortex (mPFC) and right posterior cingulate/retrosplenial cortex. A decrease of beta connectivity was also observed between right mPFC and right anterior cingulate cortex. Furthermore, DMN functional connectivity strength was negatively related with STAI-T total score (i.e., lower connectivity was associated with higher trait anxiety), even when controlling for potential confounding variables (i.e., sex, age, and general psychopathology).

LIMITATIONS

Small sample size makes it difficult to draw definitive conclusions. Furthermore, we did not assess state variation of anxiety, which make our interpretation specific to trait anxiety.

CONCLUSIONS

Taken together, our results suggest that high-trait-anxiety individuals fail to synchronize DMN during RS, reflecting a possible top-down cognitive control deficit. These results may help in the understanding of the individual differences in functional brain networks associated with trait anxiety, a crucial aim in the prevention and in the early etiology understanding of clinical anxiety and related sequelae.

Extrinsic and default mode networks in psychiatric conditions: Relationship to excitatory-inhibitory transmitter balance and early trauma

Over the last three decades there has been an accumulation of Magnetic Resonance Imaging (MRI) studies reporting that aberrant functional networks may underlie cognitive deficits and other symptoms across a range of psychiatric diagnoses. The use of pharmacological MRI and ¹H-Magnetic Resonance Spectroscopy (¹H-MRS) has allowed researchers to investigate how changes in network dynamics are related to perturbed excitatory and inhibitory neurotransmission in individuals with psychiatric conditions. More recently, changes in functional network dynamics and excitatory/inhibitory (E/I) neurotransmission have been linked to early childhood trauma, a major antecedents for psychiatric illness in adulthood. Here we review studies investigating whether perturbed network dynamics seen across psychiatric conditions are related to changes in E/I neurotransmission, and whether such changes could be linked to childhood trauma. Whilst there is currently a paucity of studies relating early traumatic experiences to altered E/I balance and network function, the research discussed here lead towards a plausible mechanistic hypothesis, linking early traumatic experiences to cognitive dysfunction and symptoms mediated by E/I neurotransmitter imbalances.

The effects of childhood maltreatment and anxiety proneness on neuropsychological test performance in non-clinical older adolescents

BACKGROUND

The effect of childhood maltreatment (CM) on neuropsychological performance is well established, but the effect of anxiety proneness (AP) on such performance has been underexplored. We assessed the predictive ability of CM and AP, and their interaction, in non-clinical adolescents, for a range of previously documented neuropsychological deficits.

METHODS

Multiple linear regression models were used to assess the unique and combined influences of CM and AP on neuropsychological performance in 104 non-clinical adolescents, who underwent both neuropsychiatric and neuropsychological assessment.

RESULTS

The interaction of CM and AP was associated with poorer performance in executive functioning skills, processing speed, and estimated IQ. CM and AP were uniquely associated with verbal working memory performance, while verbal and visual memory performance and learning, and visuo-spatial ability, were not associated with either CM, AP or the interaction of CM and AP.

LIMITATIONS

The use of self-report measures to determine participants' levels of CM, AP, and depression. The CTQ-SF, a retrospective self-report measure, may have introduced recall bias. The neuropsychological evaluation was not conducted in the Xhosa language, the first language of most African participants. Most instruments utilized have not been validated in a South African adolescent sample. The impact of important moderator variables (e.g., age of onset of maltreatment) was not assessed.

CONCLUSIONS

Increased levels of CM and AP may be risk markers for poor performance in several key neuropsychological domains. Our findings underscore the importance of assessing the impact of both CM and anxiety-related temperamental traits on neuropsychological performance.

Worry is associated with inefficient functional activity and connectivity in prefrontal and cingulate cortices during emotional interference

INTRODUCTION

Anxiety is known to impair attentional control particularly when Task demands are high. Neuroimaging studies generally support these behavioral findings, reporting that anxiety is associated with increased (inefficient) activity in dorsolateral prefrontal cortex (DLPFC) and anterior cingulate cortex (ACC) during attentional control Tasks. However, less is known about the relationship between worry (part of the cognitive dimension of trait anxiety) and DLPFC/ACC function and connectivity during attentional control. In the present study, we sought to clarify this relationship.

METHODS

Forty-one participants underwent functional magnetic resonance imaging (fMRI) during a composite Faces and Scenes Task with high and low emotional interference conditions. Individual worry levels were assessed using the Penn State Worry Questionnaire.

RESULTS

During high but not low emotional interference, worry was associated with increased activity in ACC, DLPFC, insula, and inferior parietal cortex. During high emotional interference, worry was also associated with reduced functional connectivity between ACC and DLPFC. Trait anxiety was not associated with changes in DLPFC/ACC activity or connectivity during either Task condition.

CONCLUSIONS

The results are consistent with cognitive models that propose worry competes for limited processing resources resulting in inefficient DLPFC and ACC activity when Tasks demands are high. Limitations of the present study and directions for future work are discussed.

Trait anxiety and neural efficiency of abstract reasoning: An fMRI investigation

Worries preoccupy the working memory capacity in anxious individuals, thereby affecting their performance during tasks that require efficient attention regulation. According to the attentional control theory (ACT), trait anxiety affects the processing efficiency, i.e. the effort required for task performance, more than the accuracy of task performance. We investigated the relation between trait anxiety and neural response for a reasoning task in healthy subjects. Functional magnetic resonance imaging (fMRI) was carried out on 22 healthy participants and blood oxygenation level dependent (BOLD) contrast estimates were extracted from a priori regions of interest (ROIs) that were earlier implicated in reasoning (i.e., bilaterally caudate head, globus pallidus, thalamus, prefrontal cortex [[ostral, dorsal and ventral regions]] inferior parietal lobule and middle occipital gyrus). Controlling for the effects of age, gender, state anxiety and depressive symptoms, for equivalent levels of task performance, trait anxiety of the participants was found to be associated with an increase in task related BOLD activation in right globus pallidus, left thalamus and left middle occipital gyrus. Our results suggest a reduced processing efficiency for reasoning in high trait anxiety subjects and provides important brain-behaviour relationships with respect to sub-clinical anxiety.

Anxiety modulates the relation between attention-deficit/hyperactivity disorder severity and working memory-related brain activity

OBJECTIVES

Individuals with attention-deficit/hyperactivity disorder (ADHD) often have heightened levels of anxiety, which has been associated with worse performance on working memory tasks. Knowledge of the neural pathways underlying the combined presence of ADHD and anxiety may aid in a better understanding of their co-occurrence. Therefore, we investigated how anxiety modulates the effect of ADHD severity on neural activity during a visuospatial working memory (VSWM) task.

METHODS

Neuroimaging data were available for 371 adolescents and young adults participating in the multicentre cohort study NeuroIMAGE (average age 17.1 years). We analysed the effects of ADHD severity, anxiety severity and their interaction on-task accuracy, and on neural activity associated with working memory (VSWM trials minus baseline), and memory load (high memory load trials minus low load trials).

RESULTS

Anxiety significantly modulated the relation between ADHD severity and neural activity in the cerebellum for the working memory contrast, and bilaterally in the striatum and thalamus for the memory load contrast.

CONCLUSIONS

We found that ADHD with co-occurring anxiety is associated with lowered neural activity during a VSWM task in regions important for information gating. This fits well with previous theorising on ADHD with co-occurring anxiety, and illustrates the neurobiological heterogeneity of ADHD.

A Functional Near-Infrared Spectroscopy Study of State Anxiety and Auditory Working Memory Load

Cognitive studies have suggested that anxiety is correlated with cognitive performance. Previous research has focused on the relationship between anxiety level and the perceptual load within the frontal region, such as the dorsolateral prefrontal and anterior cingulate cortices. High-anxious individuals are predicted to have worse performance on cognitively-demanding tasks requiring efficient cognitive processing. A few functional magnetic resonance imaging studies have specifically discussed the performance and brain activity involving working memory for high-anxious individuals. This topic has been further explored with electroencephalography, although these studies have mostly provided results involving visual face-related stimuli. In this study, we used auditory stimulation to manipulate the working memory load and attempted to interpret the deficiency of cognitive function in high-anxious participants or patients using functional near infrared spectroscopy (fNIRS). The fNIRS signals of 30 participants were measured while they were performing an auditory working memory task. For the auditory n-back task, there were three experimental conditions, including two n-back task conditions of stimuli memorization with different memory load and a condition of passive listening to the stimuli. Hemodynamic responses from frontal brain regions were recorded using a wireless fNIRS device. Brain activation from the ventrolateral and orbital prefrontal cortex were measured with signals filtered and artifacts removed. The fNIRS signals were then standardized with statistical testing and group analysis was performed. The results revealed that there were significantly stronger hemodynamic responses in the right ventrolateral and orbital prefrontal cortex when subjects were attending to the auditory working memory task with higher load. Furthermore, the right lateralization of the prefrontal cortex was negatively correlated with the level of state anxiety. This study revealed the possibility of incorporating fNIRS signals as an index to evaluate cognitive performance and mood states given its flexibility regarding portable applications compared to other neuroimaging techniques.

The relationship between dlPFC activity during unpredictable threat and CO2-induced panic symptoms

Panic disorder is characterized by sudden, repeated, and unexpected attacks of intense fear and overwhelming anxiety about when another attack may strike. Patients with panic disorder and healthy individuals with a history of panic attacks show a hypersensitivity to unpredictable threats, suggesting a possible link between panic and sustained anxiety. The purpose of this study was to determine the degree to which induced symptoms of panic relate to fear and anxiety, as well as activity in the neural systems that mediate and regulate these affective states. Psychological and physiological symptoms of panic were assessed during an 8-min 7.5% CO₂ challenge task. Psychological, physiological, and neural symptoms of fear and anxiety were measured during two sessions (one psychophysiology and one functional magnetic resonance imaging where subjects experienced several blocks of no threat (N), predictable shock (P), and unpredictable shock (U; NPU threat task). We used a principle component analysis to characterize panic susceptibility (PS), and found that PS significantly predicted dorsolateral prefrontal cortex (dlPFC) activity to the unpredictable cue during the NPU threat task. When examining the weighted beta coefficients from this analysis, we observed that self-reported fear/anxiety during the CO₂ challenge negatively loaded onto dlPFC activity during the NPU task. Consistent with this observation, dlPFC activity during the unpredictable cue was also negatively correlated with anxiety during the NPU sessions. Together, these results suggest that panic symptoms and anxiety are regulated by the same prefrontal cognitive control system.