Anxiety positive subjects show altered processing in the anterior insula during anticipation of negative stimuli

Simmons, Alan N.; Stein, Murray B.; Strigo, Irina A.; Arce, Estíbaliz; Hitchcock, Carla A.; Paulus, Martin P.

doi:10.1002/hbm.21154

Cited by 103 publications

(93 citation statements)

References 63 publications

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“…Only 1 previous study assessed functional connectivity in anticipatory anxiety; however, it implemented a fundamentally different region-of-interest approach. 28 This study included 14…”

Section: Discussionmentioning

confidence: 99%

Shoulder Apprehension Impacts Large-Scale Functional Brain Networks

Haller¹,

Cunningham²,

Laedermann³

et al. 2013

American Journal of Neuroradiology

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BACKROUND AND PURPOSE:Shoulder apprehension is defined as anxiety and resistance in patients with a history of anterior glenohumeral instability. It remains unclear whether shoulder apprehension is the result of true recurrent instability or a memorized subjective sensation. We tested whether visual presentation of apprehension videos modifies functional brain networks associated with motor resistance and anxiety. MATERIALS AND METHODS:This prospective study includes 15 consecutive right-handed male patients with shoulder apprehension (9 with right shoulder apprehension, 6 with left shoulder apprehension; 27.5 Ϯ 6.4 years) and 10 healthy male right-handed age-matched control participants (29.0 Ϯ 4.7 years). Multimodal MR imaging included 1) functional connectivity tensorial independent component analysis, 2) taskrelated general linear model analysis during visual stimulation of movies showing typical apprehension movements vs control videos, 3) voxelbased morphometry analysis of GM, and 4) tract-based spatial statistics analysis of WM. RESULTS:Patients with shoulder apprehension had significant (P Ͻ .05 corrected) increase in task-correlated functional connectivity, notably in the bilateral primary sensory-motor area and dorsolateral prefrontal cortex and, to a lesser degree, the bilateral dorsomedial prefrontal cortex, anterior insula, and dorsal anterior cingulate cortex (ϩ148% right, ϩ144% left). Anticorrelated functional connectivity decreased in the higher-level visual and parietal areas (Ϫ185%). There were no potentially confounding structural changes in GM or WM. CONCLUSIONS:Shoulder apprehension induces specific reorganization in apprehension-related functional connectivity of the primary sensory-motor areas (motor resistance), dorsolateral prefrontal cortex (cognitive control of motor behavior), and the dorsal anterior cingulate cortex/dorsomedial prefrontal cortex and anterior insula (anxiety and emotional regulation).ABBREVIATIONS: dACC ϭ dorsal anterior cingulate cortex; dlPFC ϭ dorsolateral prefrontal cortex; dmPFC ϭ dorsomedial prefrontal cortex; GLM ϭ general linear model; IC ϭ independent component; TBSS ϭ tract-based spatial statistics; TICA ϭ tensorial independent component analysis; VBM ϭ voxel-based morphometry S houlder apprehension is defined as anxiety and resistance in patients with a history of anterior glenohumeral instability. The apprehension sign is a physical finding in which placement of the humerus in the position of abduction to 90°and maximal external rotation produces anxiety and resistance in patients with a history of anterior glenohumeral instability.

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“…Only 1 previous study assessed functional connectivity in anticipatory anxiety; however, it implemented a fundamentally different region-of-interest approach. 28 This study included 14…”

Section: Discussionmentioning

confidence: 99%

Shoulder Apprehension Impacts Large-Scale Functional Brain Networks

Haller¹,

Cunningham²,

Laedermann³

et al. 2013

American Journal of Neuroradiology

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“…This region showed hyperactivity in anticipation of negative pictures in individuals with PTSD 155 , GAD and SAD 156 , and high trait anxiety 157 . Spider phobics showed elevated anterior insula activity while anticipating spider pictures that appeared in a temporally unpredictable manner 139 .…”

Section: Responses To Uncertainty In Anxietymentioning

confidence: 99%

Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective

2013

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Uncertainty about a possible future threat disrupts our ability to avoid it or to mitigate its negative impact, and thus results in anxiety. Here, we focus the broad literature on the neurobiology of anxiety through the lens of uncertainty. We identify five processes essential for adaptive anticipatory responses to future threat uncertainty, and propose that alterations to the neural instantiation of these processes results in maladaptive responses to uncertainty in pathological anxiety. This framework has the potential to advance the classification, diagnosis, and treatment of clinical anxiety.

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“…Specifically, whereas reflection involves contextualization by activating internal models, anxious anticipation (i.e., appraisal-related rumination) has been found to activate the right AI, and more so in trait anxious individuals (Carlson et al, 2011; Simmons et al, 2011; see The Anterior Insula as Part of the Reactive System). What is the key difference for more chronic ruminative (vs. reflective) types of dealing with novel information can be found by examining trait anxious individuals, for whom the right AI anticipatory activation showed stronger connectivity to the left IFG and DMN areas including the precuneus and PCC.…”

Section: The Dynamics Of Reactive and Predictive Control Systems In Imentioning

confidence: 99%

Internally directed cognition and mindfulness: an integrative perspective derived from predictive and reactive control systems theory

et al. 2014

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In the present paper, we will apply the predictive and reactive control systems (PARCS) theory as a framework that integrates competing theories of neural substrates of awareness by describing the “default mode network” (DMN) and anterior insula (AI) as parts of two different behavioral and homeostatic control systems. The DMN, a network that becomes active at rest when there is no external stimulation or task to perform, has been implicated in self-reflective awareness and prospection. By contrast, the AI is associated with awareness and task-related attention. This has led to competing theories stressing the role of the DMN in self-awareness vs. the role of interoceptive and emotional information integration in the AI in awareness of the emotional moment. In PARCS, the respective functions of the DMN and AI in a specific control system explains their association with different qualities of awareness, and how mental states can shift from one state (e.g., prospective self-reflection) to the other (e.g., awareness of the emotional moment) depending on the relative dominance of control systems. These shifts between reactive and predictive control are part of processes that enable the intake of novel information, integration of this novel information within existing knowledge structures, and the creation of a continuous personal context in which novel information can be integrated and understood. As such, PARCS can explain key characteristics of mental states, such as their temporal and spatial focus (e.g., a focus on the here and now vs. the future; a first person vs. a third person perspective). PARCS further relates mental states to brain states and functions, such as activation of the DMN or hemispheric asymmetry in frontal cortical functions. Together, PARCS deepens the understanding of a broad range of mental states, including mindfulness, mind wandering, rumination, autobiographical memory, imagery, and the experience of self.

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Anxiety positive subjects show altered processing in the anterior insula during anticipation of negative stimuli

Cited by 103 publications

References 63 publications

Shoulder Apprehension Impacts Large-Scale Functional Brain Networks

Shoulder Apprehension Impacts Large-Scale Functional Brain Networks

Uncertainty and anticipation in anxiety: an integrated neurobiological and psychological perspective

Internally directed cognition and mindfulness: an integrative perspective derived from predictive and reactive control systems theory

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