期刊
DEPRESSION AND ANXIETY
卷 29, 期 11, 页码 939-947出版社
WILEY
DOI: 10.1002/da.21961
关键词
GAD; fMRI; anxiety disorders; anterior limbic network; youth
资金
- American Academy of Child & Adolescent Psychiatry
- Eli Lilly
- Shire
- AstraZeneca
- Johnson Johnson
- Janssen
- Pfizer
- Bristol-Myers Squibb
- Repligen
- Martek
- Somerset
- GlaxoSmithKline
- Sumitomo
- Eli Lilly Co.
- Martek Biosciences
- Nutrition 21
- Ortho McNeil/Janssen
Background Dysfunction of neural systems responsible for the processing of emotional stimuli is hypothesized to be involved in the pathophysiology of generalized anxiety disorder (GAD) in adolescents. We used standard fMRI and functional connectivity analyses to examine the functional neurocircuitry of GAD in adolescents. Methods Ten adolescents with GAD and 10 healthy comparison subjects underwent fMRI while performing a continuous performance task with emotional and neutral distractors. Standard event-related voxel-wise fMRI and steady-state functional connectivity analyses were performed. Results Increased activation was observed in the left medial prefrontal cortex and right ventrolateral prefrontal cortex (VLPFC) in response to emotional images compared to neutral imagines in youth with GAD. Connectivity analyses using the right VLPFC seed region suggested decreased connectivity between this region and the bilateral medial prefrontal cortex. Connectivity analyses using the right amygdala seed region revealed decreased correlation with the posterior cingulate cortex in adolescents with GAD. The left amygdala seed region demonstrated increased connectivity with the ipsilateral precuneus in youth with GAD compared to healthy subjects. Conclusions In addition to increased activation of the medial prefrontal cortex and right VLPFC, we observed altered connectivity between the amygdala or VLPFC and regions, which subserve mentalization (e.g. posterior cingulate cortex, precuneus, and medial prefrontal cortex). This suggests that structures that regulate emotion and affect interact abnormally with key structures that are involved in mentalization, a process known to be disrupted in GAD. Depression and Anxiety 29:939-947, 2012. (C) 2012 Wiley Periodicals, Inc.
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