Anxiety in patients undergoing MR imaging.

Quirk, Mark E.; Letendre, Andrew J.; Ciottone, Robert A.; Lingley, James F.

doi:10.1148/radiology.170.2.2911670

Cited by 194 publications

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“…The technical and procedural aspects of fMRI, as well as the significance and probable outcome of the fMRI report may provoke stress and stress anxiety (30). Indeed anxiety sensitivity, anxiety-related reactions, fear, panic, and claustrophobia lead to movement artifacts and negatively affect fMRI compliance (15)(16)(17). As a result of such studies, anxiety, particularly state anxiety, has been treated as a determinant of fMRI compliance.…”

Section: Discussionmentioning

confidence: 99%

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Functional MRI compliance in children with attention deficit hyperactivity disorder

Karakaş¹,

Dincer²,

Ceylan³

et al. 2015

Diagn Interv Radiol

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NEURORADIOLOGYORIGINAL ARTICLE PURPOSE We aimed to test the effect of prescan training and orientation in functional magnetic resonance imaging (fMRI) in children with attention deficit hyperactivity disorder (ADHD) and to investigate whether fMRI compliance was modified by state anxiety. METHODSSubjects included 77 males aged 6-12 years; there were 53 patients in the ADHD group and 24 participants in the healthy control group. Exclusion criteria included neurological and/or psychiatric comorbidities (other than ADHD), the use of psychoactive drugs, and an intelligence quotient outside the normal range. Children were individually subjected to prescan orientation and training. Data were acquired using a 1.5 Tesla scanner and an 8-channel head coil. Functional scans were performed using a standard neurocognitive task. RESULTSThe neurocognitive task led to reliable fMRI maps. Compliance was not significantly different between ADHD and control groups based on success, failure, and repetition rates of fMRI. Compliance of ADHD patients with extreme levels of anxiety was also not significantly different. CONCLUSIONThe fMRI compliance of ADHD children is typically lower than that of healthy children. However, compliance can be increased to the level of age-matched healthy control children by addressing concerns about the technical and procedural aspects of fMRI, providing orientation programs, and performing on-task training. In patients thus trained, compliance does not change with the level of state anxiety suggesting that the anxiety hypothesis of fMRI compliance is not supported. Functional magnetic resonance imaging (fMRI), which uses blood oxygen level-dependent contrast, is a noninvasive procedure for imaging regional brain activity. MRI exhibits high spatial resolution; even 1.5 Tesla (T) imaging used in standard clinical practice (spatial resolution of 2-4 mm) yields robust functional signal changes (1). MRI can be performed without the ethical concerns associated with the other available imaging techniques and can thus be used in children and in healthy populations. In healthy volunteers, fMRI has produced reproducible findings across scanning sites and age groups with respect to the localization and development of cognitive processes (2). Its capacity for noninvasive imaging of the brain in vivo during cognitive processing has made fMRI an exciting tool for laboratory research, as well as clinical studies and clinical practices that involve diagnosis, follow-up, and presurgical mapping (3, 4).A disorder that attracts a great deal of attention in children is attention deficit hyperactivity disorder (ADHD). This focused attention is partly due to the high incidence (0.2%-12.2%) of ADHD, which is also the most frequent diagnosis in children referred to child psychiatry departments (5-7). From the neuropsychological point of view, ADHD is associated with deficits in executive functions (8,9). Nevertheless, as the number of theories on the subject demonstrates, ADHD remains an unresolved issue, especially with res...

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Section: Discussionmentioning

confidence: 99%

“…Artifacts other than those caused by organ pulsations have been associated with anxiety or anxiety-sensitivity (15). Medium-to-severe anxiety was reported in 25%-37% of adults undergoing MRI (16,17).…”

mentioning

confidence: 99%

Functional MRI compliance in children with attention deficit hyperactivity disorder

Karakaş¹,

Dincer²,

Ceylan³

et al. 2015

Diagn Interv Radiol

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“…This goal is frequently approached by transferring behaviorally tested experimental paradigms into the MRI scanner, leading to expectations of obtaining comparable behavioral results. However, assuming comparability between data from two dissimilar settings may be erroneous, as the scanning environment can be experienced as soporific, distracting or even stressful (Quirk et al 1989). The scanning procedure as such is non-harmful and signed consent ensures that volunteers know this on an intellectual level, but limited mobility and other MR-characteristics can cause discomfort and even distress (Brennan et al 1988;Katz et al 1994;Meléndez and McCrank 1993;Quirk et al 1989).…”

Section: Introductionmentioning

confidence: 99%

“…However, assuming comparability between data from two dissimilar settings may be erroneous, as the scanning environment can be experienced as soporific, distracting or even stressful (Quirk et al 1989). The scanning procedure as such is non-harmful and signed consent ensures that volunteers know this on an intellectual level, but limited mobility and other MR-characteristics can cause discomfort and even distress (Brennan et al 1988;Katz et al 1994;Meléndez and McCrank 1993;Quirk et al 1989). Additionally to self-reported anxiety (Katz et al 1994;McIsaac et al 1998;Quirk et al 1989), observer-rated fearfulness (Katz et al 1994), and psychophysiological measures (Chapman et al 2010) caused by MR-induced discomfort have been investigated.…”

Section: Introductionmentioning

confidence: 99%

“…The scanning procedure as such is non-harmful and signed consent ensures that volunteers know this on an intellectual level, but limited mobility and other MR-characteristics can cause discomfort and even distress (Brennan et al 1988;Katz et al 1994;Meléndez and McCrank 1993;Quirk et al 1989). Additionally to self-reported anxiety (Katz et al 1994;McIsaac et al 1998;Quirk et al 1989), observer-rated fearfulness (Katz et al 1994), and psychophysiological measures (Chapman et al 2010) caused by MR-induced discomfort have been investigated. Anxiety in patients and its implications have been examined thoroughly (Brennan et al 1988;Grey et al 2000;Katz et al 1994;Munn and Jordan 2011;Quirk et al 1989;Tischler et al 2008;Törnqvist et al 2006), and even in healthy volunteers an increased anxiety (Chapman et al 2010) and hormonal reactivity have been described (Muehlhan et al 2011;Tessner et al 2006).…”

Section: Introductionmentioning

confidence: 99%

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MRI scanner environment increases pain perception in a standardized nociceptive paradigm

Ellerbrock

May

2014

Brain Imaging and Behavior

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Functional magnetic resonance imaging (MRI) has been widely used in neuroscientific studies to investigate neural correlates of perception and higher cognitive functions. Early on, the MR-scanning procedure itself has been identified to create discomfort and anxiety in some individuals, which may influence task performance and perception. The present study analyzed behavioral differences in pain intensity ratings obtained in two distinct situations: MR environment and laboratory setting. Within our longitudinal study design twenty healthy volunteers were exposed daily to an identical paradigm consisting of 60 repeated noxious heat stimuli (46 °C) on 21 consecutive days. After each block of ten stimuli, participants were prompted to rate pain intensity on a visual analog scale (VAS). On days 1, 8, 14, and 21 ratings scores were obtained during a functional imaging scan, whereas on the remaining days the sessions were conducted in a laboratory. It has come to our attention that pain intensity ratings acquired in MR environment were significantly higher than behavioral data collected in the lab setting. Given that the stimuli were standardized and no task or distraction confounded the ratings, it is likely that the attentional focus on noxious stimulation was identical in both conditions. It seems that the highly artificial scanner environment as such is sufficient to increase awareness/alertness. Given that salience rather than pure nociceptive input has been suggested to explain functional imaging results in painful conditions, these findings highlight concerns regarding the comparability of behavioral data assembled across inconsistent settings.

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Anxiety-Related Reactions Associated With Magnetic Resonance Imaging Examinations

Meléndez

McCrank²

1993

JAMA

210

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Anxiety in patients undergoing MR imaging.

Cited by 194 publications

References 0 publications

Functional MRI compliance in children with attention deficit hyperactivity disorder

Functional MRI compliance in children with attention deficit hyperactivity disorder

MRI scanner environment increases pain perception in a standardized nociceptive paradigm

Anxiety-Related Reactions Associated With Magnetic Resonance Imaging Examinations

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