Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies
Introduction Generalized anxiety disorder (GAD) is a highly prevalent mental illness that is associated with clinically significant distress, functional impairment, and poor emotional regulation. Primary functional magnetic resonance imaging (fMRI) studies of GAD report neural abnormalities in comp...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2023-03-01
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| Series: | European Psychiatry |
| Online Access: | https://www.cambridge.org/core/product/identifier/S0924933823009719/type/journal_article |
| _version_ | 1797617607881261056 |
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| author | S. K. Kahlon Z. Ali E. Pritchard S. Saravia C. Baten A. M. Klassen J. H. Shepherd G. Zamora J. Jordan M. Duran S. L. Santos D. W. Hedges J. P. Hamilton M. D. Sacchet C. H. Miller |
| author_facet | S. K. Kahlon Z. Ali E. Pritchard S. Saravia C. Baten A. M. Klassen J. H. Shepherd G. Zamora J. Jordan M. Duran S. L. Santos D. W. Hedges J. P. Hamilton M. D. Sacchet C. H. Miller |
| author_sort | S. K. Kahlon |
| collection | DOAJ |
| description |
Introduction
Generalized anxiety disorder (GAD) is a highly prevalent mental illness that is associated with clinically significant distress, functional impairment, and poor emotional regulation. Primary functional magnetic resonance imaging (fMRI) studies of GAD report neural abnormalities in comparison to healthy controls. However, many of these findings in the primary literature are inconsistent, and it is unclear whether they are specific to GAD or shared transdiagnostically across related disorders.
Objectives
This meta-analysis seeks to establish the most reliable neural abnormalities observed in individuals with GAD, as reported in the primary fMRI activation literature.
Methods
We conducted an exhaustive literature search in PubMed to identify primary studies that met our pre-specified inclusion criteria and then extracted relevant data from primary, whole-brain fMRI activation studies of GAD that reported coordinates in Talairach or MNI space. We then used multilevel kernel density analysis (MKDA) with ensemble thresholding to examine the differences between adults with GAD and healthy controls in order to identify brain regions that reached statistical significance across primary studies.
Results
Patients with GAD showed statistically significant (α=0.05–0.0001; family-wise-error-rate corrected) neural activation in various regions of the cerebral cortex and basal ganglia across a variety of experimental tasks.
Conclusions
These results inform our understanding of the neural basis of GAD and are interpreted using a frontolimbic model of anxiety as well as specific clinical symptoms of this disorder and its relation to other mood and anxiety disorders. These results also suggest possible novel targets for emerging neurostimulation therapies (e.g., transcranial magnetic stimulation) and may be used to advance our understanding of the effects of current pharmaceutical treatments and ways to improve treatment selection and symptom-targeting for patients diagnosed with GAD.
Disclosure of Interest
None Declared |
| first_indexed | 2024-03-11T07:58:11Z |
| format | Article |
| id | doaj.art-e8e71dce33554d6f828d6253343c1513 |
| institution | Directory Open Access Journal |
| issn | 0924-9338 1778-3585 |
| language | English |
| last_indexed | 2024-03-11T07:58:11Z |
| publishDate | 2023-03-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | European Psychiatry |
| spelling | doaj.art-e8e71dce33554d6f828d6253343c15132023-11-17T05:05:22ZengCambridge University PressEuropean Psychiatry0924-93381778-35852023-03-0166S452S45210.1192/j.eurpsy.2023.971Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation StudiesS. K. Kahlon0Z. Ali1E. Pritchard2S. Saravia3C. Baten4A. M. Klassen5J. H. Shepherd6G. Zamora7J. Jordan8M. Duran9S. L. Santos10D. W. Hedges11J. P. Hamilton12M. D. Sacchet13C. H. Miller14Department of Biology, Department of PsychologyDepartment of Psychology, California State University, FresnoDepartment of Psychology, California State University, FresnoDepartment of Psychology, California State University, FresnoDepartment of Psychology, California State University, FresnoDepartment of Psychology, California State University, FresnoDepartment of Psychology, California State University, FresnoDepartment of Psychology, California State University, FresnoDepartment of Biology, Department of PsychologyDepartment of Psychology, California State University, FresnoDepartment of Psychology, California State University, FresnoDepartment of Psychology, Brigham Young University, Provo, United StatesDepartment of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenMeditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United StatesDepartment of Psychology, California State University, Fresno Introduction Generalized anxiety disorder (GAD) is a highly prevalent mental illness that is associated with clinically significant distress, functional impairment, and poor emotional regulation. Primary functional magnetic resonance imaging (fMRI) studies of GAD report neural abnormalities in comparison to healthy controls. However, many of these findings in the primary literature are inconsistent, and it is unclear whether they are specific to GAD or shared transdiagnostically across related disorders. Objectives This meta-analysis seeks to establish the most reliable neural abnormalities observed in individuals with GAD, as reported in the primary fMRI activation literature. Methods We conducted an exhaustive literature search in PubMed to identify primary studies that met our pre-specified inclusion criteria and then extracted relevant data from primary, whole-brain fMRI activation studies of GAD that reported coordinates in Talairach or MNI space. We then used multilevel kernel density analysis (MKDA) with ensemble thresholding to examine the differences between adults with GAD and healthy controls in order to identify brain regions that reached statistical significance across primary studies. Results Patients with GAD showed statistically significant (α=0.05–0.0001; family-wise-error-rate corrected) neural activation in various regions of the cerebral cortex and basal ganglia across a variety of experimental tasks. Conclusions These results inform our understanding of the neural basis of GAD and are interpreted using a frontolimbic model of anxiety as well as specific clinical symptoms of this disorder and its relation to other mood and anxiety disorders. These results also suggest possible novel targets for emerging neurostimulation therapies (e.g., transcranial magnetic stimulation) and may be used to advance our understanding of the effects of current pharmaceutical treatments and ways to improve treatment selection and symptom-targeting for patients diagnosed with GAD. Disclosure of Interest None Declaredhttps://www.cambridge.org/core/product/identifier/S0924933823009719/type/journal_article |
| spellingShingle | S. K. Kahlon Z. Ali E. Pritchard S. Saravia C. Baten A. M. Klassen J. H. Shepherd G. Zamora J. Jordan M. Duran S. L. Santos D. W. Hedges J. P. Hamilton M. D. Sacchet C. H. Miller Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies European Psychiatry |
| title | Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies |
| title_full | Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies |
| title_fullStr | Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies |
| title_full_unstemmed | Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies |
| title_short | Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies |
| title_sort | neural abnormalities associated with generalized anxiety disorder a meta analysis of functional magnetic resonance imaging activation studies |
| url | https://www.cambridge.org/core/product/identifier/S0924933823009719/type/journal_article |
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