Affective neuroimaging in generalized anxiety disorder: an integrated review

Abstract

Affective neuroimaging has contributed to our knowledge of generalized anxiety disorder (GAD) through measurement of blood oxygenation level-dependent (BOLD) responses, which facilitate inference on neural responses to emotional stimuli during task-based functional magnetic resonance imaging (fMRI). In this article, the authors provide an integrated review of the task-based affective fMRI literature in GAD. Studies provide evidence for variable presence and directionality of BOLD abnormalities in limbic and prefrontal regions during reactivity to, regulation of, and learning from emotional cues. We conclude that understanding the sources of this variability is key to accelerating progress in this area. We propose that the cardinal symptom of GAD—worry—predominantly reflects stimulus-independent mental processes that impose abnormal, inflexible functional brain configurations, ie, the overall pattern of information transfer among behaviorally relevant neural circuits at a given point in time. These configurations that are inflexible to change from the incoming flux of environmental stimuli may underlie inconsistent task-based findings.

Mothers’ neural response to valenced infant interactions predicts postpartum depression and anxiety

“…Underlining the potential overlap [19], documented an association between IFG and insula activation to negative emotion faces and both anxiety and depression symptoms at different postpartum times. These findings are consistent with previous anxiety research in non-peripartum populations showing differences in processing valenced stimuli in some of the same regions implicated in both normative maternal response and depression such as the insula, prefrontal cortex, anterior cingulate, and amygdala [20][21][22]. However, it remains unclear how maternal brain response to own infant across differing emotion contexts may uniquely contribute to anxiety in the postpartum.…”

Dwelling in prolonged grief: Resting state functional connectivity during oxytocin and placebo administration

“…Prolonged grief perhaps involves more automatic constraints over thought content : the continued salience of mental representations of the deceased and/or their death could underlie the prolonged emotional pain, intense yearning, and/or the intrusive nature of thoughts about the loss that characterize prolonged grief (Robinaugh et al, 2016 ). Thoughts in prolonged grief might also be less variable over time , given that grief‐related rumination likely involves core midline default network regions that have been implicated in other forms of maladaptive self‐referential thought (e.g., Fonzo & Etkin, 2017 ; Zhou et al, 2020 ) and other disorders characterized by high levels of perseveration and distress show reduced dFNC variability (e.g., Demirtaş et al, 2016 ; Kaiser et al, 2016 ). Operantly defined, higher levels of prolonged grief symptoms might be reflected in greater affective (automatic) constraints over thought content, and less variability, as evidenced by (1) positive correlation between salience network and midline default network time courses (Menon, 2011 ) and (2) fewer transitions between different dFNC “states” (transient, yet recurrent functional network configurations, and/or longer dwell time in one dFNC state.…”

Relationship between intestinal flora, inflammation, BDNF gene polymorphism and generalized anxiety disorder: A clinical investigation

“…[ 18 , 19 ] The diagnosis rate of GAD is low worldwide, which might be attributed to the less attention it receives from the public. [ 20 ] GAD has a closer relationship with genetic factors. [ 21 ] Previous research proved that the occurrence of GAD is related to the polymorphism of several genes, such as rs4680 of catechol-O-methyltransferase gene, [ 22 ] C677T of methylenetetrahydrofolate reductase gene [ 23 ] rs324981 of NPSR1 gene.…”