NEUROCIRCUITRY OF GENERALIZED ANXIETY DISORDER IN ADOLESCENTS: A PILOT FUNCTIONAL NEUROIMAGING AND FUNCTIONAL CONNECTIVITY STUDY
Article first published online: 24 MAY 2012
© 2012 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 29, Issue 11, pages 939–947, November 2012
How to Cite
Strawn, J. R., Bitter, S. M., Weber, W. A., Chu, W.-J., Whitsel, R. M., Adler, C., Cerullo, M. A., Eliassen, J., Strakowski, S. M. and DelBello, M. P. (2012), NEUROCIRCUITRY OF GENERALIZED ANXIETY DISORDER IN ADOLESCENTS: A PILOT FUNCTIONAL NEUROIMAGING AND FUNCTIONAL CONNECTIVITY STUDY. Depress. Anxiety, 29: 939–947. doi: 10.1002/da.21961
- Issue published online: 5 NOV 2012
- Article first published online: 24 MAY 2012
- Manuscript Accepted: 6 APR 2012
- Manuscript Revised: 27 MAR 2012
- Manuscript Received: 6 SEP 2011
- Pilot Research Grant from the American Academy of Child & Adolescent Psychiatry
- GAD; fMRI;
- anxiety disorders;
- anterior limbic network;
Dysfunction of neural systems responsible for the processing of emotional stimuli is hypothesized to be involved in the pathophysiology of generalized anxiety disorder (GAD) in adolescents. We used standard fMRI and functional connectivity analyses to examine the functional neurocircuitry of GAD in adolescents.
Ten adolescents with GAD and 10 healthy comparison subjects underwent fMRI while performing a continuous performance task with emotional and neutral distractors. Standard event-related voxel-wise fMRI and steady-state functional connectivity analyses were performed.
Increased activation was observed in the left medial prefrontal cortex and right ventrolateral prefrontal cortex (VLPFC) in response to emotional images compared to neutral imagines in youth with GAD. Connectivity analyses using the right VLPFC seed region suggested decreased connectivity between this region and the bilateral medial prefrontal cortex. Connectivity analyses using the right amygdala seed region revealed decreased correlation with the posterior cingulate cortex in adolescents with GAD. The left amygdala seed region demonstrated increased connectivity with the ipsilateral precuneus in youth with GAD compared to healthy subjects.
In addition to increased activation of the medial prefrontal cortex and right VLPFC, we observed altered connectivity between the amygdala or VLPFC and regions, which subserve mentalization (e.g. posterior cingulate cortex, precuneus, and medial prefrontal cortex). This suggests that structures that regulate emotion and affect interact abnormally with key structures that are involved in mentalization, a process known to be disrupted in GAD.