Transdiagnostic neural correlates of volitional emotion regulation in anxiety and depression

Abstract

Background: Individuals who suffer from anxiety and/or depression face difficulty in adaptively managing emotional responses, while accumulating evidence suggests impaired emotion regulation is a transdiagnostic feature of psychopathology. Effectual regulation in the context of negative stimuli is characterized by engagement of the prefrontal cortex (PFC) coupled with reduced amygdala reactivity. In anxiety disorders and major depression, PFC underengagement and atypical PFC-amygdala connectivity has been observed, although patient findings based on case-control studies have been mixed with regard to magnitude, locality, and extent of dysfunction. As anxiety disorders and major depression are heterogeneous disorders and frequently comorbid with one another, delineating relationships between reappraise-related substrates and symptoms may advance our understanding of emotion dysregulation in these populations. Methods:We examined PFC activation and its functional connectivity (FC) to the amygdala using functional magnetic resonance imaging in a large sample of patients (N = 174) with primary generalized anxiety disorder (n = 47), social anxiety disorder (n = 78), or major depressive disorder (n = 49) during a reappraisal-based emotion regulation task. Comorbidity was permitted and the majority of participants had a concurrent psychiatric illnesses.Results: Across participants, whole-brain results showed that (1) greater anxiety and depression symptom severity was related to less engagement of the dorsal anterior cingulate cortex (ACC) and (2) less FC between the amygdala and ventrolateral PFC. Results were driven by anxiety, while depression symptoms were not significant.Conclusion: These findings demonstrate that individual differences in anxiety and depression may help explain ACC and PFC dysfunction during emotion regulation observed across anxiety and depressive disorders. K E Y W O R D Sanxiety/anxiety disorders, depression, functional MRI, generalized anxiety disorder, social anxiety disorder/social phobia

In search of convergent regional brain abnormality in cognitive emotion regulation: a transdiagnostic neuroimaging meta-analysis

“…19 (Fitzgerald et al, 2017b) Non-significant results 20 (Schmitt et al, 2016) Non-significant results 21 (Light et al, 2011) Non-significant results 22 (Yip et al, 2018) Non-significant results 23 (Hilland et al, 2018) Lacking healthy controls 24 Lacking healthy controls Table S1. List of excluded studies with reasons 25 (Contreras-Rodríguez et al, 2020) Lacking healthy controls 26 (Fitzgerald et al, 2019) Lacking healthy controls 27 (Schmitgen et al, 2019) Lacking healthy controls 28 (Gorka et al, 2019) Lacking healthy controls 29 (Klumpp et al, 2017b) Lacking healthy controls 30 (Fonzo et al, 2017b) Lacking healthy controls 31 (Fonzo et al, 2017a) Lacking healthy controls 32 (Klumpp et al, 2017a) Lacking healthy controls 33 (Reinecke et al, 2018) Lacking healthy controls 34 (Klumpp et al, 2017c) Lacking healthy controls 35 (Goldin et al, 2014) Lacking healthy controls 36 (Reinecke et al, 2014) Lacking healthy controls 37 (Brühl et al, 2013) Lacking healthy controls 38 (Goldin et al, 2013a) Lacking healthy controls 39 (Heller et al, 2013) Lacking healthy controls 40 (Goldin et al, 2013b) Lacking healthy controls 41 (Hermann et al, 2009) Lacking healthy controls 42 (Kanske et al, 2015) Non-whole-brain analysis 43 (Rabinak et al, 2014) Non-whole-brain analysis 44 (Kanske et al, 2012) Non-whole-brain analysis 45 (Lang et al, 2012) Non-whole-brain analysis 46 (Erk et al, 2010) Non-whole-brain analysis 47 (Douw et al, 2020) Non-whole-brain analysis 48 (Klumpp et al, 2019) Non-whole-brain analysis 49 (Jacob et al, 2019) Non-whole-brain analysis 50 (Young et al, 2019) Non-whole-brain analysis 51 (Zhang et al, 2018) Non-whole-brain analysis 52 …”

Neurobiological Markers of Resilience to Early-Life Adversity During Adolescence

“…Converging evidence from human lesion work, meta-analysis of fMRI emotion regulation studies, and neuroanatomical tracing in non-human primates suggests that negative PFC-amygdala functional coupling during emotional events likely reflects the PFC exerting inhibitory control over amygdala activity (59)(60)(61)(62). Negative PFC-amygdala coupling is broadly considered the mature emotion regulation phenotype, as it emerges during the transition to adolescence and predicts both better regulation of negative affect and reduced risk for internalizing psychopathology (56,(63)(64)(65)(66). Similarly, disruption to (behavioral and neural) emotion regulation processes constitutes a transdiagnostic mechanism connecting ELA and psychopathology risk (67)(68)(69)(70).…”

Research Review: Brain network connectivity and the heterogeneity of depression in adolescence – a precision mental health perspective

“…Greater required engagement of these regions when faced with affective distractors suggests that depressed adolescents have insufficient top‐down regulatory abilities, contributing to difficulties in managing negative emotions and persistent rumination (Joormann & Gotlib, 2010). Indeed, less engagement of prefrontal cortex (PFC) regions during an emotion regulation task has been found to be associated with greater severity of depressive symptoms in adolescents (Fitzgerald, Klumpp, Langenecker, & Phan, 2018). Depressed adolescents have also been found to exhibit abnormalities in the subgenual and dorsal subregions of the anterior cingulate cortex (ACC).…”