OBJECTIVE: Clinical data suggest that abnormalities in the regulation of emotional processing contribute to the pathophysiology of generalized anxiety disorder, yet these abnormalities remain poorly understood at the neurobiological level. The authors recently reported that in healthy volunteers the pregenual anterior cingulate regulates emotional conflict on a trial-by-trial basis by dampening activity in the amygdala. The authors also showed that this process is specific to the regulation of emotional, compared to nonemotional, conflict. Here the authors examined whether this form of noninstructed emotion regulation is perturbed in generalized anxiety disorder. METHOD: Seventeen patients with generalized anxiety disorder and 24 healthy comparison subjects underwent functional MRI while performing an emotional conflict task that involved categorizing facial affect while ignoring overlaid affect label words. Behavioral and neural measures were used to compare trial-by-trial changes in conflict regulation. RESULTS: Comparison subjects effectively regulated emotional conflict from trial to trial, even though they were unaware of having done so. By contrast, patients with generalized anxiety disorder were completely unable to regulate emotional conflict and failed to engage the pregenual anterior cingulate in ways that would dampen amygdalar activity. Moreover, performance and brain activation were correlated with symptoms and could be used to accurately classify the two groups. CONCLUSIONS: These data demonstrate that patients with generalized anxiety disorder show significant deficits in the noninstructed and spontaneous regulation of emotional processing. Conceptualization of anxiety as importantly involving abnormalities in emotion regulation, particularly a type occurring outside of awareness, may open up avenues for novel treatments, such as by targeting the medial prefrontal cortex.
OBJECTIVE: Clinical data suggest that abnormalities in the regulation of emotional processing contribute to the pathophysiology of generalized anxiety disorder, yet these abnormalities remain poorly understood at the neurobiological level. The authors recently reported that in healthy volunteers the pregenual anterior cingulate regulates emotional conflict on a trial-by-trial basis by dampening activity in the amygdala. The authors also showed that this process is specific to the regulation of emotional, compared to nonemotional, conflict. Here the authors examined whether this form of noninstructed emotion regulation is perturbed in generalized anxiety disorder. METHOD: Seventeen patients with generalized anxiety disorder and 24 healthy comparison subjects underwent functional MRI while performing an emotional conflict task that involved categorizing facial affect while ignoring overlaid affect label words. Behavioral and neural measures were used to compare trial-by-trial changes in conflict regulation. RESULTS: Comparison subjects effectively regulated emotional conflict from trial to trial, even though they were unaware of having done so. By contrast, patients with generalized anxiety disorder were completely unable to regulate emotional conflict and failed to engage the pregenual anterior cingulate in ways that would dampen amygdalar activity. Moreover, performance and brain activation were correlated with symptoms and could be used to accurately classify the two groups. CONCLUSIONS: These data demonstrate that patients with generalized anxiety disorder show significant deficits in the noninstructed and spontaneous regulation of emotional processing. Conceptualization of anxiety as importantly involving abnormalities in emotion regulation, particularly a type occurring outside of awareness, may open up avenues for novel treatments, such as by targeting the medial prefrontal cortex.
Authors: C M Sylvester; M Corbetta; M E Raichle; T L Rodebaugh; B L Schlaggar; Y I Sheline; C F Zorumski; E J Lenze Journal: Trends Neurosci Date: 2012-06-02 Impact factor: 13.837
Authors: Karina S Blair; Marilla Geraci; Bruce W Smith; Nick Hollon; Jeffrey DeVido; Marcela Otero; James R Blair; Daniel S Pine Journal: Biol Psychiatry Date: 2012-05-15 Impact factor: 13.382
Authors: Valérie La Buissonnière-Ariza; Jean R Séguin; Marouane Nassim; Michel Boivin; Daniel S Pine; Franco Lepore; Richard E Tremblay; Françoise S Maheu Journal: Biol Psychol Date: 2019-03-29 Impact factor: 3.251
Authors: Oliver J Robinson; Cassie Overstreet; Philip S Allen; Alison Letkiewicz; Katherine Vytal; Daniel S Pine; Christian Grillon Journal: Neuroimage Date: 2013-04-11 Impact factor: 6.556
Authors: Amy K Roy; Julie L Fudge; Clare Kelly; Justin S A Perry; Teresa Daniele; Christina Carlisi; Brenda Benson; F Xavier Castellanos; Michael P Milham; Daniel S Pine; Monique Ernst Journal: J Am Acad Child Adolesc Psychiatry Date: 2013-02-07 Impact factor: 8.829