Structural magnetic ressonance imaging in anxiety disorders: an update of research findings

Ferrari, Maria Cecília Freitas; Busatto, Geraldo F.; McGuire, Philip; Crippa, José Alexandre S

doi:10.1590/s1516-44462008000300013

Cited by 60 publications

(41 citation statements)

References 89 publications

(173 reference statements)

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“…There is strong evidence that the vulnerability to panic disorder is partly genetic, with heritability estimated to be about 48% (Hettema et al 2001). In addition to the gray matter reduction in medial prefrontal regions seen across anxiety disorders, replicated brain morphometric findings in panic disorder include reduced volume of lateral and medial temporal lobe regions (Ferrari et al 2008) and increased gray matter volume of the midbrain and pons (Protopopescu et al 2006;Uchida et al 2008). We could find no published studies of postmortem brain tissue from patients with panic disorder.…”

Section: Panic Disordermentioning

confidence: 99%

MR Spectroscopic Studies of the Brain in Psychiatric Disorders

Maddock

Buonocore

2011

Current Topics in Behavioral Neurosciences

225

196

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The measurement of brain metabolites with magnetic resonance spectroscopy (MRS) provides a unique perspective on the brain bases of neuropsychiatric disorders. As a context for interpreting MRS studies of neuropsychiatric disorders, we review the characteristic MRS signals, the metabolic dynamics,and the neurobiological significance of the major brain metabolites that can be measured using clinical MRS systems. These metabolites include N-acetylaspartate(NAA), creatine, choline-containing compounds, myo-inositol, glutamate and glutamine, lactate, and gamma-amino butyric acid (GABA). For the major adult neuropsychiatric disorders (schizophrenia, bipolar disorder, major depression, and the anxiety disorders), we highlight the most consistent MRS findings, with an emphasis on those with potential clinical or translational significance. Reduced NAA in specific brain regions in schizophrenia, bipolar disorder, post-traumatic stress disorder, and obsessive–compulsive disorder corroborate findings of reduced brain volumes in the same regions. Future MRS studies may help determine the extent to which the neuronal dysfunction suggested by these findings is reversible in these disorders. Elevated glutamate and glutamine (Glx) in patients with bipolar disorder and reduced Glx in patients with unipolar major depression support models of increased and decreased glutamatergic function, respectively, in those conditions. Reduced phosphomonoesters and intracellular pH in bipolar disorder and elevated dynamic lactate responses in panic disorder are consistent with metabolic models of pathogenesis in those disorders. Preliminary findings of an increased glutamine/glutamate ratio and decreased GABA in patients with schizophrenia are consistent with a model of NMDA hypofunction in that disorder. As MRS methods continue to improve, future studies may further advance our understanding of the natural history of psychiatric illnesses, improve our ability to test translational models of pathogenesis, clarify therapeutic mechanisms of action,and allow clinical monitoring of the effects of interventions on brain metabolicmarkers

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Section: Panic Disordermentioning

confidence: 99%

MR Spectroscopic Studies of the Brain in Psychiatric Disorders

Maddock

Buonocore

2011

Current Topics in Behavioral Neurosciences

225

196

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“…17; 18 As a result of aberrant communication between these cortical and subcortical regions, the system interprets and responds as if danger were present, and this over response in the system has been implicated in anxiogenesis. 18 Notably, the brain regions implicated in the fear response system have not been examined in children with epilepsy with anxiety disorders. The second aim of this study is to examine the critical neuroanatomical regions reviewed above in this distributed fear system in children with recent-onset epilepsy.…”

Section: Introductionmentioning

confidence: 99%

Children with epilepsy and anxiety: Subcortical and cortical differences

et al. 2015

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Summary Objective Using a hypothesis driven approach, subcortical and cortical regions implicated in anxiety disorders in the general population were examined in children with recent-onset epilepsy with versus without anxiety compared to controls. This study reports frequency of anxiety disorders while examining familial, clinical and demographic variables associated with anxiety in children with epilepsy. Method Participants included 88 children with epilepsy aged 8–18 years; 25 with a current anxiety disorder and 63 children with epilepsy no current anxiety disorder. 49 controls without anxiety disorders were included. T1 volumetric MRI scans were collected; subcortical volumes and cortical thickness were computed using the FreeSurfer image analysis suite. Analyses focused on adjusted measures of subcortical volumes and cortical thickness. Results Relative to controls, larger left amygdala volumes were found in the Epilepsy Anxiety group compared to the Epilepsy No Anxiety group (p = 0.027). In the hippocampus there were no significant differences between groups. Examination of cortical thickness demonstrated that the Epilepsy Anxiety group showed thinning in left medial orbitofrontal (p=0.001), right lateral orbitofrontal (p=0.017), and right frontal pole (p=0.009). There were no differences between groups in age, sex, IQ, age of onset, medications, or duration of epilepsy. There were more family members with a history of anxiety disorders in the Epilepsy Anxiety group compared to the Epilepsy No Anxiety group (p=0.005). Significance Anxiety is a common psychiatric comorbidity in children with recent-onset epilepsy with volumetric enlargement of the amygdala and thinner cortex in orbital and other regions of prefrontal cortex, suggesting structural abnormalities in brain regions that are part of the dysfunctional networks reported in individuals with anxiety disorders in the general population. These findings are evident early in the course of epilepsy, are not related to chronicity of seizures, and may be linked to a family history of anxiety and depressive disorders.

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“…Studies on the genetics, physiology and neurochemistry of GAD have shown that the amygdala, the prefrontal cortex and the temporal areas are among the brain structures identified to participate in the responses to emotional processing and social behaviors [56], and therefore may count on abnormal GABAergic transmission. However, these regions appear to abnormally function on other anxiety disorders [57], a feature that limits the specificity of the findings.…”

Section: The Neurobiology Of Anxiety: Involvement Of the Gabaergic Symentioning

confidence: 94%

Current concept of anxiety: implications from Darwin to the DSM-V for the diagnosis of generalized anxiety disorder

Coutinho

Dias

Bevilaqua

et al. 2010

Expert Review of Neurotherapeutics

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This article proposes a revision of the historical evolution of the concepts of generalized anxiety disorder (GAD). Currently, Darwin's evolutionary theory is the hegemonic paradigm for modern science and influences research on mental disorders. Throughout the 20th Century, the editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM; American Psychiatric Association) have changed the diagnostic criteria for GAD, reflecting the prevailing psychiatric understanding of this disorder. The prevalence and symptoms of major depression and GAD show the fragility of the categorical conception of these conditions. Differences in cultural views towards anxiety disorders also suggest that anxiety cannot have a uniform definition. This article provides contributions for reflecting future guidelines concerning the diagnostic criteria for GAD in DSM-V.

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Structural magnetic ressonance imaging in anxiety disorders: an update of research findings

Cited by 60 publications

References 89 publications

MR Spectroscopic Studies of the Brain in Psychiatric Disorders

MR Spectroscopic Studies of the Brain in Psychiatric Disorders

Children with epilepsy and anxiety: Subcortical and cortical differences

Current concept of anxiety: implications from Darwin to the DSM-V for the diagnosis of generalized anxiety disorder

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