Center for Neurobehavioral Research, Boys Town National Research Hospital, Omaha, NE, USA.
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.
Brain Behav. 2021 Feb;11(2):e01994. doi: 10.1002/brb3.1994. Epub 2020 Dec 25.
Generalized anxiety disorder (GAD) can significantly impair quality of life and is associated with a relatively poor long-term prognosis. Anxiety disorders are often associated with hyper-responsiveness to threat, perhaps coupled with impaired executive functioning. However, GAD, particularly adolescent GAD, has been the focus of little functional neuroimaging work compared to other anxiety disorders. Here, we examine the neural association of adolescent GAD with responsiveness to threat and response control.
The study involved 35 adolescents with GAD and 34 healthy comparison individuals (N = 69) matched on age, gender, and IQ. Participants were scanned during an affective number Stroop task.
We found significant Group-by-Task Condition interactions in regions involved in response control/motor responding (bilateral precentral gyri and cerebellum) and/or cognitive control/attention (dorsomedial and lateral frontal cortex, posterior cingulate cortex, cuneus, and precuneus). In line with predictions, the youth with GAD showed significantly less recruitment during task trials than the healthy comparison individuals. However, no indications of specific heightened responses to threat were seen.
GAD involves reduced capacity for engaging regions involved in response control/motor responding and/or cognitive control/attention. This might reflect either a secondary consequence of the patient's worry or an early risk factor for the development of worry.
广泛性焦虑障碍（GAD）会显著降低生活质量，并与较差的长期预后相关。焦虑障碍通常与对威胁的过度反应有关，也许还伴有执行功能受损。然而，与其他焦虑障碍相比，GAD，尤其是青少年 GAD，在功能神经影像学研究中受到的关注较少。在这里，我们研究了青少年 GAD 与对威胁的反应性和反应控制之间的神经关联。
这项研究涉及 35 名患有 GAD 的青少年和 34 名健康对照个体（N=69），他们在年龄、性别和智商上相匹配。参与者在进行情感数字 Stroop 任务时接受了扫描。
我们发现，在涉及反应控制/运动反应的区域（双侧中央前回和小脑）和/或认知控制/注意力的区域（背内侧和外侧额叶皮层、后扣带皮层、楔前叶和顶下小叶）中，存在显著的组-任务条件交互作用。与预测一致，患有 GAD 的青少年在任务试验中的反应明显少于健康对照组。然而，并没有发现对威胁有特定的过度反应的迹象。
GAD 涉及参与反应控制/运动反应和/或认知控制/注意力的区域的能力降低。这可能反映了患者担忧的继发后果，或者是担忧发展的早期风险因素。
