Effects of citalopram on worry and brain activation in patients with generalized anxiety disorder

Hoehn‐Saric, Rudolf; Schlund, Michael W.; Wong, Steven H.

doi:10.1016/j.pscychresns.2004.02.003

Cited by 146 publications

(95 citation statements)

References 33 publications

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“…Present results are, however, consistent with a recent meta-analysis of neuroimaging studies, which concluded that default mode activation alone is insufficient to capture fully the neural basis of spontaneous thought (Fox et al, 2015). Also, in the present study we sought to address the concept of cognitive "flexibility" by specifically targeting transitions from internal thoughts to externally oriented attention, and therefore focused on a different research question compared to studies directly comparing brain correlates of worrisome and neutral thoughts (e.g., Hoehn-Saric et al, 2004;Paulesu et al, 2010).…”

Section: Discussionmentioning

confidence: 68%

“…In fact, to our knowledge, only two published studies directly investigated the brain correlates of worry in GAD patients. One of them had a small sample size (n = 6 patients) and the absence of a comparison group as strong limitations (Hoehn-Saric, Schlund, & Wong, 2004). Although difficult to generalize, patients showed enhanced activation of frontal and anterior cingulate (ACC) cortices in response to worrisome sentences (Hoehn-Saric et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

“…One of them had a small sample size (n = 6 patients) and the absence of a comparison group as strong limitations (Hoehn-Saric, Schlund, & Wong, 2004). Although difficult to generalize, patients showed enhanced activation of frontal and anterior cingulate (ACC) cortices in response to worrisome sentences (Hoehn-Saric et al, 2004). The second suggested that worry induction engaged the same neural system in both GAD and healthy individuals (Paulesu et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

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Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Ottaviani

Watson

Meeten

et al. 2016

Biological Psychology

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Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder.Biological Psychology http://dx.doi.org/10. 1016/j.biopsycho.2016.06.009 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.  Trait worry was inversely related with prefrontal deactivation to target detection. HRV predicted neural activation changes produced by attentional focus switching. A worry induction increased pre-to post-target deactivation of default mode areas. The induction reduced behavioural and neurobiological differences between groups. AbstractGeneralized anxiety disorder (GAD) is characterized by difficulties in inhibiting both perseverative thoughts (worry and rumination) and autonomic arousal. We investigated the neurobiological substrates of such abnormal inhibitory processes, hypothesizing aberrant functional coupling within 'default mode' (DMN) and autonomic brain networks. Functional imaging and heart rate variability (HRV) data were acquired from GAD patients and controls during performance of three tracking tasks interspersed with a perseverative cognition (PC) induction. After detection of infrequent target stimuli, activity within putative DMN hubs was suppressed, consistent with a redirection of attentional resources from internal to external focus. This magnitude of activity change was attenuated in patients and individuals with higher trait PC, but was predicted by individual differences in HRV. Following the induction of PC in controls, this pattern of neural reactivity became closer to that of GAD patients. Results support, at a neural level, the association between cognitive inflexibility and autonomic rigidity.

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Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Neurobiological substrates of cognitive rigidity and autonomic inflexibility in generalized anxiety disorder

Ottaviani

Watson

Meeten

et al. 2016

Biological Psychology

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“…Others have reported that after treatment with citalopram, worry sentences, compared to neutral statements, elicit reduced BOLD responses in prefrontal regions, the striatum, insula and paralimbic regions [90]. Finally, citalopram also reduced responses within the hippocampus and medial prefrontal cortex specifically during the fear-relevant stimuli [91].…”

Section: Anxiety Phenotypesmentioning

confidence: 97%

The role of neuroimaging for the diagnosis and treatment of anxiety disorders

Paulus

2008

Depress. Anxiety

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Neuroimaging comprises a set of tools, which include different types of magnetic resonance imaging such as fMRI, MRS, ASL, and radiotracer imaging such as PET and SPECT. The focus of this review is to address the question whether functional magnetic resonance imaging (fMRI) can contribute to the diagnosis and treatment of anxiety disorders. Key anxiety processes and neural substrates are reviewed. The main findings and shortcomings of fMRI in the context of anxiety are briefly summarized. Finally, the next stages of developing fMRI for diagnosis and treatment are highlighted. The main conclusion of this review is that fMRI could become a clinical tool for the diagnosis and treatment of anxiety disorders but neuroimaging groups will need to better develop its specificity and sensitivity so that fMRI results can be meaningful for an individual patient not just for groups of individuals. fMRI -what is it and what does it measure?Functional magnetic resonance imaging (fMRI) is a technique that enables one to map cognitive, affective, and experiential processes onto brain substrates. However, fMRI is not about increased or decreased activation in a certain part of the brain; rather it is a proxy measure about how complex cognitive, emotional, social and other experiential processes are implemented in different neural systems. For example, it is important to realize that it makes little sense to talk about hyperactivity in the amygdala in individuals with anxiety disorder without referencing the process, which is being measured during the amygdala hyperactivity, i.e. the task that individuals are engaged in while the functional images are obtained. Although the human brain comprises only about 2% of the body mass, it accounts for approximately 20% of its total oxygen consumption [1]. Deoxyhemoglobin has paramagnetic effects in the blood upon the nuclear magnetic resonance transverse relaxation times of nearby water protons in the tissue [2]. The fact that changes in the oxygen level in the blood can affect the fraction of hemoglobin in the deoxygenated state can be utilized as an image contrast and was termed as blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) [3]. Recent BOLD fMRI experiments in the awake Correspondence should be sent to: Martin P Paulus, Professor in Residence,

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“…Pharmaco-MRI allows in vivo visualization of human brain activity and enables noninvasive assessments of drug-related changes in this activity (Windischberger et al, 2010). Several studies have investigated the effects of antidepressant drugs, such as selective serotonin reuptake inhibitors (SSRIs) on neural activation (Anderson et al, 2008;Arce et al, 2008), indicating area-specific and dose-dependent effects on the BOLD response in both healthy subjects (Loubinoux et al, 2002;Del-Ben et al, 2005) and patients suffering from major depression and obsessive-compulsive disorder (Hoehn-Saric et al, 2004). These effects were particularly pronounced in the amygdala, the key brain region in processing and consolidating aversive emotional cues.…”

Section: Magnetic Resonance Imaging and Pharmaco-mrimentioning

confidence: 99%