The dysregulation of top-down control in individuals with high test anxiety: A resting state fMRI study

Background: Individuals with high test anxiety (HTA) have deficits in attentional control and in stress responses when faced with tests. However, little is known about the underlying neural mechanism. Anterior cingulate cortex (ACC) is involved in both attention and emotion networks, therefore this study examined the neural functional dysregulation in test anxiety from the perspective of functional connectivity (FC) using bilateral ACC as the regions of interest. Methods: Fifty-one participants were divided into HTA (n = 23) and low test anxiety (LTA, n = 28) group ac-cording to their Test Anxiety Scale (TAS) scores. Brain imaging data in resting, preparing, and recovering phases of a modified social evaluative threat task were collected, and emotional changes were assessed. Results: Compared with the LTA group, the HTA group exhibited significantly lower FCs between the ACC and superior frontal gyrus (SFG) in all 3 phases, significantly lower FCs between the ACC and inferior parietal gyrus (IPG), and significantly higher FCs between the ACC superior temporal gyrus (STG) in the preparing phase. Moreover, in the HTA group, the resting state IPG-ACC FC was associated with their TAS score, the preparing state STG-ACC FC was associated with the increased anxiety. Conclusions: Individuals with HTA have general prefrontal control deficits. When facing a test, they tend to recruit more resources to deal with high emotional interference. The dysregulated control of the ACC by the frontal-parietal network may underlie the patho-physiology of test anxiety.

Automated summary

This study examined the neural functional dysregulation in individuals with high test anxiety (HTA) using functional connectivity (FC) analysis. The results showed that individuals with HTA have deficits in prefrontal control and tend to recruit more resources to deal with emotional interference during tests. The dysregulated functional connectivity between the ACC and frontal-parietal regions may underlie the pathophysiology of test anxiety.