Adolescent anxiety disorders and the developing brain: comparing neuroimaging findings in adolescents and adults

Abstract

Adolescence is the peak period for the incidence of anxiety disorders. Recent findings have revealed the immaturity of neural networks underlying emotional regulation in this population. Brain vulnerability to anxiety in adolescence is related to the unsynchronised development of anxiety-relevant brain functional systems. However, our current knowledge on brain deficits in adolescent anxiety is mainly borrowed from studies on adults. Understanding adolescent-specific brain deficits is essential for developing biomarkers and brain-based therapies targeting adolescent anxiety. This article reviews and compares recent neuroimaging literature on anxiety-related brain structural and functional deficits between adolescent and adult populations, and proposes a model highlighting the differences between adolescence and adulthood in anxiety-related brain networks. This model emphasises that in adolescence the emotional control system tends to be hypoactivated, the fear conditioning system is immature, and the reward and stress response systems are hypersensitive. Furthermore, the striatum’s functional links to the amygdala and the prefrontal cortex are strengthened, while the link between the prefrontal cortex and the amygdala is weakened in adolescence. This model helps to explain why adolescents are vulnerable to anxiety disorders and provides insights into potential brain-based approaches to intervene in adolescent anxiety disorders.

The Developing Brain: Considering the Multifactorial Effects of Obesity, Physical Activity & Mental Wellbeing in Childhood and Adolescence

“…Combined, these environmental and behavioral influences put adolescents at greater risk for anxiety and stress-related disorders, which also influences structural and functional brain development [13]. Specifically, a recent review highlighted the importance of amygdala-based neural networks, the medial prefrontal cortex, the hippocampus, the striatum, and the hypothalamus in association with adolescent anxiety [14]. Importantly, these structures represent a model of neural networks which explain why adolescents are vulnerable to anxiety-related disorders, providing insight into potential brainbased approaches for targeted interventions [14].…”

“…Specifically, a recent review highlighted the importance of amygdala-based neural networks, the medial prefrontal cortex, the hippocampus, the striatum, and the hypothalamus in association with adolescent anxiety [14]. Importantly, these structures represent a model of neural networks which explain why adolescents are vulnerable to anxiety-related disorders, providing insight into potential brainbased approaches for targeted interventions [14]. Additionally, the anterior cingulate cortex and the limbic system have been identified as important structures and networks in adolescent depression psychopathology [15,16].…”

Brain-Based Classification of Youth with Anxiety Disorders: an ENIGMA-ANXIETY Transdiagnostic Examination using Machine Learning

“…Transdiagnostic case-control classifications were significantly above chance level for the specified subgroups (up to 0.63 AUC, p's<.05) but not for the entire sample (AUC=0.56, p=.093). As depicted in Figures 4-7, the multivariate neurostructural pattern behind these transdiagnostic subgroup classifications comprised of frontoparieto-limbic territories, previously linked to anxiety and its demographic (i.e., sex) and clinical (i.e., severity/medication use) and characteristics (6,7,35,(50)(51)(52)(53).…”

Two-year changes in sleep duration are associated with changes in psychological distress in adolescent girls and boys: the fit futures study

“…Depressive disorders and anxiety disorders increase dramatically during adolescence (Costello et al, 2003 ), especially among girls (Nolen-Hoeksema & Girgus, 1994 ; Xie et al, 2021 ). Subclinical symptoms of anxiety and depression are even more prevalent in this age group (Bakken, 2019 ).…”