Reduced Dorsal Anterior Cingulate Cortical Activity During Emotional Regulation and Top-Down Attentional Control in Generalized Social Phobia, Generalized Anxiety Disorder, and Comorbid Generalized Social Phobia/Generalized Anxiety Disorder

Abstract

Background Generalized Social Phobia (GSP) and Generalized Anxiety Disorder (GAD) are both associated with emotion dysregulation. In healthy subjects, research implicates dorsal anterior cingulate (dACC) in both explicit emotion regulation and top-down attentional control. While studies have examined these processes in GSP or GAD, no work compares findings across the two disorders. Moreover, no work examines functioning in cases comorbid for both disorders (GSP/GAD). Here we compare the neural correlates of explicit emotion regulation (EER) and top-down attentional control (TAC) in GSP, GAD, and GSP/GAD. Method Medication-free adults with GSP (EER n=19; TAC n=18), GAD (EER n=17; TAC n =17), GSP/GAD (EER n=17; TAC=15), or no psychopathology (EER n=18; TAC n=18). During EER, individuals alternatively viewed, up-regulated, and down-regulated responses to emotional pictures. During TAC, they performed an emotional Stroop task. Results For both tasks, significant group-by-condition interactions emerged in dACC and parietal cortices. Healthy adults showed significantly increased recruitment during emotion regulation, relative to emotion-picture viewing. GAD, GSP, and GSP/GAD subjects showed no such increases, with all three groups differing from healthy adults but not from each other. Evidence of emotion-related disorder-specificity emerged in medial prefrontal cortex (MPFC) and amygdala. This disorder-specific responding varied as a function of stimulus emotion content but not emotion-regulatory demands. Conclusions GSP and GAD both involve reduced capacity for engaging emotion-regulation brain networks, whether explicitly or via top-down attentional control. A reduced ability to recruit regions implicated in top-down attention might represent a general risk factor for anxiety disorders.

Childhood Maltreatment and Coping in Bipolar Disorder

“…CEM related dorsal mPFC responsivity may reflect a further increase in negative selfand other-referential processing in these individuals, since the mPFC is pivotal in self-referential processing [20,[48][49][50][51][52][53]. And a recent meta-analysis suggested that dorsal mPFC responsivity to social exclusion is related with enhanced social uncertainty, social distress, and social rumination [15].…”

Neuroimaging and Anxiety: the Neural Substrates of Pathological and Non-pathological Anxiety

“…Panic patients also displayed decreased activation in the left ventral ACC following successful CBT [70]. Patients with general social phobia and GAD show difficulties engaging dorsal ACC (dACC) during tasks requiring them to reappraise emotionally evocative images [86]. Although these results conflict with other findings of enhanced ACC activation, the authors note that this deactivation may reflect a reduced capacity to engage these regions as a function of task demands, i.e., reappraise the meaning of emotionally salient images [86].…”

A systematic review of fMRI studies in generalized anxiety disorder: Evaluating its neural and cognitive basis

“…Aiming to compare GAD and social anxiety disorder (SAD) again (as did in the study from 2008 (Blair et al, 2008) and explore different cognitive tasks involved in emotion regulation, Blair et al evaluated explicit emotion regulation and top-down attentional control in these two groups of patients (Blair et al, 2012). These two cognitive functions are components of the emotional regulation process which are usually attributed to dorsal ACC.…”