Ventromedial prefrontal cortex activity and pathological worry in generalised anxiety disorder

Via, Esther; Fullana, Miquel À.; Goldberg, Ximena; Tinoco-González, Daniella; Martínez‐Zalacaín, Ignacio; Soriano‐Mas, Carles; Davey, Christopher G.; Menchón, José M.; Straube, Benjamin; Kircher, Tilo; Pujol, Jesús; Cardoner, Narcı́s; Harrison, Ben J

doi:10.1192/bjp.2018.65

Cited by 35 publications

(22 citation statements)

References 34 publications

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“…GAD showed increased dALFF variability in the hippocampus and thalamus, limbic regions which are involved in emotion processing. Of note, emotional dysfunction is the most prominent feature of GAD (Mochcoyitch, da Rocha Freire, Garcia, & Nardi, 2014;Via et al, 2018), such as reduced capacity for engaging emotion-regulation brain networks when viewing and adjusting feelings toward positive and negative affective pictures (Blair et al, 2012), attenuated blood oxygen level-dependent response of the PFC and ACC to emotional expressions (Palm et al, 2011), and inability to adapt to emotional conflict (Etkin, Prater, Hoeft, Menon, & Schatzberg, 2010). The hippocampus is involved in the ventral affective neural systems and plays a critical role in mediating anxiety states in coordination with other limbic regions (Caliskan & Stork, 2018).…”

Section: Discussionmentioning

confidence: 99%

Dynamic changes of amplitude of low‐frequency fluctuations in patients with generalized anxiety disorder

Cui

Sheng

Chen

et al. 2019

Human Brain Mapping

115

101

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Previous neuroimaging studies have mainly focused on alterations of static and dynamic functional connectivity in patients with generalized anxiety disorder (GAD). However, the characteristics of local brain activity over time in GAD are poorly understood. This study aimed to investigate the abnormal time‐varying local brain activity of GAD by using the amplitude of low‐frequency fluctuation (ALFF) method combined with sliding‐window approach. Group comparison results showed that compared with healthy controls (HCs), patients with GAD exhibited increased dynamic ALFF (dALFF) variability in widespread regions, including the bilateral dorsomedial prefrontal cortex, hippocampus, thalamus, striatum; and left orbital frontal gyrus, inferior parietal lobule, temporal pole, inferior temporal gyrus, and fusiform gyrus. The abnormal dALFF could be used to distinguish between patients with GAD and HCs. Increased dALFF variability values in the striatum were positively correlated with GAD symptom severity. These findings suggest that GAD patients are associated with abnormal temporal variability of local brain activity in regions implicated in executive, emotional, and social function. This study provides insight into the brain dysfunction of GAD from the perspective of dynamic local brain activity, highlighting the important role of dALFF variability in understanding neurophysiological mechanisms and potentially informing the diagnosis of GAD.

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Section: Discussionmentioning

confidence: 99%

Dynamic changes of amplitude of low‐frequency fluctuations in patients with generalized anxiety disorder

Cui

Sheng

Chen

et al. 2019

Human Brain Mapping

115

101

View full text Add to dashboard Cite

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“…Several studies have found alterations of specific fear-and extinction-relevant neural circuits in these diseases. For patients with generalized anxiety disorder (GAD), deficient vmPFC activity has been observed during fear-related task performance (Greenberg et al, 2013;Via et al, 2018). Individuals with PTSD show structural and functional deficits of various fear-related areas of the brain, including amygdala, PFC and hippocampus.…”

Section: Introductionmentioning

confidence: 99%

A Systematic Review on the Effect of Transcranial Direct Current and Magnetic Stimulation on Fear Memory and Extinction

Marković

Vicario

Yavari

et al. 2021

Front. Hum. Neurosci.

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Anxiety disorders are among the most prevalent mental disorders. Present treatments such as cognitive behavior therapy and pharmacological treatments show only moderate success, which emphasizes the importance for the development of new treatment protocols. Non-invasive brain stimulation methods such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) have been probed as therapeutic option for anxiety disorders in recent years. Mechanistic information about their mode of action, and most efficient protocols is however limited. Here the fear extinction model can serve as a model of exposure therapies for studying therapeutic mechanisms, and development of appropriate intervention protocols. We systematically reviewed 30 research articles that investigated the impact of rTMS and tDCS on fear memory and extinction in animal models and humans, in clinical and healthy populations. The results of these studies suggest that tDCS and rTMS can be efficient methods to modulate fear memory and extinction. Furthermore, excitability-enhancing stimulation applied over the vmPFC showed the strongest potential to enhance fear extinction. We further discuss factors that determine the efficacy of rTMS and tDCS in the context of the fear extinction model and provide future directions to optimize parameters and protocols of stimulation for research and treatment.

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“…The dysfunction of top‐down control system in human brain, especially dorsolateral prefrontal regions including the left inferior frontal gyrus and right superior frontal gyrus, is associated with self‐reported ‘trait’ anxiety of individuals (Price et al, 2011). The ventromedial prefrontal cortex has been found to play a key role in the anxiety‐related processes (Clauss et al, 2016; Delli Pizzi et al, 2016; Via et al, 2018); investigations of activity in the prefrontal cortex may help establish the understanding of the attention network activity underlying anxious behaviour. Increased function of brain regions in the attentional network may enhance the attentional bias towards external erotic stimulation (Cheng et al, 2015; De Jong, 2009; Stoléru et al, 2012), which may contribute to rapid ejaculation.…”

Section: Introductionmentioning

confidence: 99%

Increased attentional network activity in premature ejaculation patients with anxiety revealed by resting‐state functional magnetic resonance imaging

Liu

Zhang

Wang

et al. 2021

Eur J of Neuroscience

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Psychological account hypothesizes that premature ejaculation (PE) is a learned pattern of rapid ejaculation maintained by anxiety about sexual failure, whereas neuropsychological accounts hypothesizes that PE is the result of dysfunction of central nervous system regulating ejaculatory. However, the central neural mechanism underlying PE patients with anxiety remains unclear. Resting‐state functional magnetic resonance imaging (fMRI) data were collected in 20 PE (diagnoses based on PE Guidelines drafted by the International Society for Sexual Medicine [ISSM]) patients with anxiety and 25 matched healthy controls (HCs) from January 2019 to December 2020. The values of fractional amplitude of low‐frequency fluctuation (fALFF) were compared between groups. Moreover, the correlations between fALFF and the severity of PE and anxiety of patients were examined. PE patients with anxiety had increased fALFF values in the right inferior frontal gyrus (opercular part) and middle frontal gyrus. In addition, significant positive correlations were found between the scores of PE diagnostic tool (PEDT) and fALFF values of the right inferior frontal gyrus (opercular part), as well as the right middle frontal gyrus. Moreover, fALFF values of the right inferior frontal gyrus (opercular part) and middle frontal gyrus were positively correlated with the scores of self‐rating anxiety scale (SAS). Our results suggested that increased attentional network activity might play a critical role in the neural basis of PE patients with anxiety.

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Ventromedial prefrontal cortex activity and pathological worry in generalised anxiety disorder

Abstract: Poor vmPFC safety-threat differentiation might characterise GAD, and its distinctive association with GAD worries suggests a neural-based qualitative difference between healthy and pathological worries.Declaration of interestNone.

Cited by 35 publications

References 34 publications

Dynamic changes of amplitude of low‐frequency fluctuations in patients with generalized anxiety disorder

Dynamic changes of amplitude of low‐frequency fluctuations in patients with generalized anxiety disorder

A Systematic Review on the Effect of Transcranial Direct Current and Magnetic Stimulation on Fear Memory and Extinction

Increased attentional network activity in premature ejaculation patients with anxiety revealed by resting‐state functional magnetic resonance imaging

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