Common and disorder-specific neural responses to emotional faces in generalised anxiety, social anxiety and panic disorders

Background Although evidence exists for abnormal brain function across various anxiety disorders, direct comparison of neural function across diagnoses is needed to elicit abnormalities common across disorders and those distinct to a particular diagnosis. Aims To delineate common and distinct abnormalities within generalised anxiety (GAD), panic and social anxiety disorder (SAD) during affective processing. Method Fifty-nine adults (15 with GAD, 15 with panic disorder, 14 with SAD, and 15 healthy controls) underwent functional magnetic resonance imaging while completing a facial emotion matching task with fearful, angry and happy faces. Results Greater differential right amygdala activation to matching fearful v. happy facial expressions related to greater negative affectivity (i.e. trait anxiety) and was heightened across all anxiety disorder groups compared with controls. Collapsing across emotional face types, participants with panic disorder uniquely displayed greater posterior insula activation. Conclusions These preliminary results highlight a common neural basis for clinical anxiety in these diagnoses and also suggest the presence of disorder-specific dysfunction.

[1]  C. Spielberger,et al.  Manual for the State-Trait Anxiety Inventory , 1970 .

[2]  M. Torrens Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268 , 1990 .

[3]  R W Cox,et al.  AFNI: software for analysis and visualization of functional magnetic resonance neuroimages. , 1996, Computers and biomedical research, an international journal.

[4]  T. Hergueta,et al.  The mini international neuropsychiatric interview , 1998, European Psychiatry.

[5]  K. Mogg,et al.  Attentional Bias for Threatening Facial Expressions in Anxiety: Manipulation of Stimulus Duration , 1998 .

[6]  D. Sheehan,et al.  The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. , 1998, The Journal of clinical psychiatry.

[7]  B Conrad,et al.  Region‐specific encoding of sensory and affective components of pain in the human brain: A positron emission tomography correlation analysis , 1999, Annals of neurology.

[8]  J L Lancaster,et al.  Automated Talairach Atlas labels for functional brain mapping , 2000, Human brain mapping.

[9]  Sylvain Houle,et al.  Increased left posterior parietal–temporal cortex activation after d-fenfluramine in women with panic disorder , 2000, Psychiatry Research: Neuroimaging.

[10]  Yuk Lun Ronald Chen,et al.  Semantic verbal fluency deficit as a familial trait marker in schizophrenia , 2000, Psychiatry Research.

[11]  M V Mendlowicz,et al.  Quality of life in individuals with anxiety disorders. , 2000, The American journal of psychiatry.

[12]  G. Shulman,et al.  Medial prefrontal cortex and self-referential mental activity: Relation to a default mode of brain function , 2001, Proceedings of the National Academy of Sciences of the United States of America.

[13]  J. Haxby,et al.  Human neural systems for face recognition and social communication , 2002, Biological Psychiatry.

[14]  Gregory G. Brown,et al.  Increased amygdala activation to angry and contemptuous faces in generalized social phobia. , 2002, Archives of general psychiatry.

[15]  M. Buonocore,et al.  Brain regions showing increased activation by threat-related words in panic disorder , 2003, Neuroreport.

[16]  M. Schlund,et al.  Effects of citalopram on worry and brain activation in patients with generalized anxiety disorder , 2004, Psychiatry Research: Neuroimaging.

[17]  Olga V. Demler,et al.  Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. , 2005, Archives of general psychiatry.

[18]  Justin S. Feinstein,et al.  Dose-dependent decrease of activation in bilateral amygdala and insula by lorazepam during emotion processing. , 2005, Archives of general psychiatry.

[19]  A. Etkin,et al.  Functional neuroimaging of anxiety: a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia. , 2007, The American journal of psychiatry.

[20]  David Araújo,et al.  Regional gray matter abnormalities in panic disorder: A voxel-based morphometry study , 2008, Psychiatry Research: Neuroimaging.

[21]  Fausta Lui,et al.  Does It Look Painful or Disgusting? Ask Your Parietal and Cingulate Cortex , 2008, The Journal of Neuroscience.

[22]  Nicola Vanello,et al.  Differential modulation of neural activity throughout the distributed neural system for face perception in patients with Social Phobia and healthy subjects , 2008, Brain Research Bulletin.

[23]  A. David,et al.  Predictors of amygdala activation during the processing of emotional stimuli: A meta-analysis of 385 PET and fMRI studies , 2008, Brain Research Reviews.

[24]  Karine Sergerie,et al.  The role of the amygdala in emotional processing: A quantitative meta-analysis of functional neuroimaging studies , 2008, Neuroscience & Biobehavioral Reviews.

[25]  Tom Johnstone,et al.  Anticipatory activation in the amygdala and anterior cingulate in generalized anxiety disorder and prediction of treatment response. , 2009, The American journal of psychiatry.

[26]  Pradeep J Nathan,et al.  Amygdala and insula response to emotional images in patients with generalized social anxiety disorder. , 2009, Journal of psychiatry & neuroscience : JPN.

[27]  F. Ferri,et al.  Neural correlates of worry in generalized anxiety disorder and in normal controls: a functional MRI study , 2009, Psychological Medicine.

[28]  S. Medland,et al.  A genetically informed study of the association between childhood separation anxiety, sensitivity to CO(2), panic disorder, and the effect of childhood parental loss. , 2009, Archives of General Psychiatry.

[29]  A. Craig,et al.  How do you feel — now? The anterior insula and human awareness , 2009, Nature Reviews Neuroscience.

[30]  K. Domschke,et al.  Interoceptive sensitivity in anxiety and anxiety disorders: an overview and integration of neurobiological findings. , 2010, Clinical psychology review.

[31]  Katherine E. Prater,et al.  Failure of anterior cingulate activation and connectivity with the amygdala during implicit regulation of emotional processing in generalized anxiety disorder. , 2010, The American journal of psychiatry.

[32]  David Silbersweig,et al.  Changes of brain activation pre- post short-term psychodynamic inpatient psychotherapy: An fMRI study of panic disorder patients , 2010, Psychiatry Research: Neuroimaging.

[33]  A. Ehlis,et al.  Neural correlates of spontaneous panic attacks , 2011, Journal of Neural Transmission.

[34]  Murray B. Stein,et al.  Exaggerated and Disconnected Insular-Amygdalar Blood Oxygenation Level-Dependent Response to Threat-Related Emotional Faces in Women with Intimate-Partner Violence Posttraumatic Stress Disorder , 2010, Biological Psychiatry.

[35]  Mark W. Becker,et al.  Attentional selection is biased toward mood-congruent stimuli. , 2011, Emotion.

[36]  T. Egner,et al.  Emotional processing in anterior cingulate and medial prefrontal cortex , 2011, Trends in Cognitive Sciences.

[37]  A. Etkin,et al.  Common abnormalities and disorder-specific compensation during implicit regulation of emotional processing in generalized anxiety and major depressive disorders. , 2011, The American journal of psychiatry.

[38]  Justin S. Feinstein,et al.  The Human Amygdala and the Induction and Experience of Fear , 2011, Current Biology.

[39]  Murray B. Stein,et al.  Selective effects of social anxiety, anxiety sensitivity, and negative affectivity on the neural bases of emotional face processing , 2012, NeuroImage.

[40]  Janet B W Williams,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[41]  R Core Team,et al.  R: A language and environment for statistical computing. , 2014 .