Increased error-related brain activity in generalized anxiety disorder.

The error-related negativity (ERN) is a negative deflection approximately 50ms 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.