Andreescu Carmen, Sheu Lei K, Tudorascu Dana, Walker Sarah, Aizenstein Howard
Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Int J Geriatr Psychiatry. 2014 Jul;29(7):704-12. doi: 10.1002/gps.4051. Epub 2013 Nov 20.
Generalized anxiety disorder (GAD) is one of the most prevalent anxiety disorders, but its neural basis is relatively understudied. This study aims to characterize the functional connectivity in the default mode network (DMN) in GAD across the lifespan.
Functional and structural magnetic resonance imaging data were collected with subjects at rest. We analyzed the resting state functional connectivity patterns in the DMN for 27 GAD participants and 39 non-anxious comparison participants. Using a two-way analysis of variance, we explored the interaction between age and GAD status on functional connectivity. In GAD participants, we analyzed the correlation of functional connectivity indices with the duration of illness and worry severity.
The age-by-anxiety interaction showed a greater anxiety effect on the functional connectivity between the posterior cingulate seed and the medial prefrontal cortex for the older group relative to the younger participants. Longer duration of illness was positively correlated with greater functional connectivity between the posterior cingulate cortex and the insula. Worry severity was inversely correlated with the functional connectivity between the posterior cingulate cortex seed and the medial prefrontal cortex.
The presence of GAD, longer duration of illness, and more severe worry exacerbate the effects of age on the functional connectivity in the DMN. These results support the need for tailored research and interventions in late-life anxiety.
广泛性焦虑障碍（GAD）是最常见的焦虑症之一，但其神经基础的研究相对较少。本研究旨在描述GAD患者全生命周期默认模式网络（DMN）中的功能连接情况。
在受试者静息状态下收集功能和结构磁共振成像数据。我们分析了27名GAD参与者和39名非焦虑对照参与者的DMN静息态功能连接模式。使用双向方差分析，我们探讨了年龄和GAD状态在功能连接上的相互作用。在GAD参与者中，我们分析了功能连接指数与病程和担忧严重程度的相关性。
年龄与焦虑的交互作用显示，与年轻参与者相比，老年组中后扣带回种子与内侧前额叶皮层之间的功能连接受焦虑影响更大。病程较长与后扣带回皮层与脑岛之间更强的功能连接呈正相关。担忧严重程度与后扣带回皮层种子与内侧前额叶皮层之间的功能连接呈负相关。
GAD的存在、较长的病程和更严重的担忧会加剧年龄对DMN功能连接的影响。这些结果支持在老年焦虑症中开展针对性研究和干预的必要性。
