Increased error-related brain activity in generalized anxiety disorder

The error-related negativity (ERN) is a negative deflection approximately 50 ms following an erroneous response, and is thought to reflect activity of the anterior cingulate cortex (ACC), a region of the medial prefrontal cortex implicated in the pathophysiology of a number of affective disorders, including generalized anxiety disorder (GAD). Pathological worry, the hallmark of GAD, has been linked to increased error-related brain activity, although no studies to date have examined the ERN among a clinical GAD sample. The present study measured electrocortical indices of error monitoring in a well-characterized, medication-free GAD sample. Brain activity was recorded in 17 GAD and 24 control subjects. The GAD group was characterized by a larger ERN and an increased difference between error and correct trials: a larger ERN was associated with increased self-reported anxiety and depression symptoms. Individuals with GAD have exaggerated early neural responses to errors, consistent with fMRI work implicating ACC abnormalities in GAD. (C) 2010 Elsevier B.V. All rights reserved.