Carmen Andreescu1, Lei K Sheu2, Dana Tudorascu3, James J Gross4, Sarah Walker5, Layla Banihashemi2, Howard Aizenstein6. 1. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. Electronic address: Andreescuc@upmc.edu. 2. Department of Psychology, University of Pittsburgh, Pittsburgh, PA. 3. Department of Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Biostatistics, University of Pittsburgh School of Medicine, Pittsburgh, PA. 4. Department of Psychology, Stanford University, Stanford, CA. 5. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA. 6. Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
Abstract
OBJECTIVES: Generalized anxiety disorder (GAD) is one of the most prevalent mental disorders in the elderly, but its functional neuroanatomy is not well understood. Given the role of emotion dysregulation in GAD, we sought to describe the neural bases of emotion regulation in late-life GAD by analyzing the functional connectivity (FC) in the Salience Network and the Executive Control Network during worry induction and worry reappraisal. METHODS: The study included 28 elderly GAD and 31 non-anxious comparison participants. Twelve elderly GAD completed a 12-week pharmacotherapy trial. We used an in-scanner worry script that alternates blocks of worry induction and reappraisal. We assessed network FC, using the following seeds: anterior insula (AI), dorsolateral prefrontal cortex (dlPFC), the bed nucleus of stria terminalis (BNST), and the paraventricular nucleus (PVN). RESULTS: GAD participants exhibited greater FC during worry induction between the left AI and the right orbitofrontal cortex, and between the BNST and the subgenual cingulate. During worry reappraisal, the non-anxious participants had greater FC between the left dlPFC and the medial PFC, as well as between the left AI and the medial PFC, and elderly GAD patients had greater FC between the PVN and the amygdala. Following 12 weeks of pharmacotherapy, GAD participants had greater connectivity between the dlPFC and several prefrontal regions during worry reappraisal. CONCLUSION: FC during worry induction and reappraisal points toward abnormalities in both worry generation and worry reappraisal. Following successful pharmacologic treatment, we observed greater connectivity in the prefrontal nodes of the Executive Control Network during reappraisal of worry.
OBJECTIVES:Generalized anxiety disorder (GAD) is one of the most prevalent mental disorders in the elderly, but its functional neuroanatomy is not well understood. Given the role of emotion dysregulation in GAD, we sought to describe the neural bases of emotion regulation in late-life GAD by analyzing the functional connectivity (FC) in the Salience Network and the Executive Control Network during worry induction and worry reappraisal. METHODS: The study included 28 elderly GAD and 31 non-anxious comparison participants. Twelve elderly GAD completed a 12-week pharmacotherapy trial. We used an in-scanner worry script that alternates blocks of worry induction and reappraisal. We assessed network FC, using the following seeds: anterior insula (AI), dorsolateral prefrontal cortex (dlPFC), the bed nucleus of stria terminalis (BNST), and the paraventricular nucleus (PVN). RESULTS: GAD participants exhibited greater FC during worry induction between the left AI and the right orbitofrontal cortex, and between the BNST and the subgenual cingulate. During worry reappraisal, the non-anxiousparticipants had greater FC between the left dlPFC and the medial PFC, as well as between the left AI and the medial PFC, and elderly GAD patients had greater FC between the PVN and the amygdala. Following 12 weeks of pharmacotherapy, GAD participants had greater connectivity between the dlPFC and several prefrontal regions during worry reappraisal. CONCLUSION: FC during worry induction and reappraisal points toward abnormalities in both worry generation and worry reappraisal. Following successful pharmacologic treatment, we observed greater connectivity in the prefrontal nodes of the Executive Control Network during reappraisal of worry.
Authors: A T Beekman; M A Bremmer; D J Deeg; A J van Balkom; J H Smit; E de Beurs; R van Dyck; W van Tilburg Journal: Int J Geriatr Psychiatry Date: 1998-10 Impact factor: 3.485
Authors: M Wu; D S Mennin; M Ly; H T Karim; L Banihashemi; D L Tudorascu; H J Aizenstein; C Andreescu Journal: J Affect Disord Date: 2019-07-05 Impact factor: 4.839
Authors: Moji Aghajani; Ilya M Veer; Marie-José van Hoof; Serge A R B Rombouts; Nic J van der Wee; Robert R J M Vermeiren Journal: Hum Brain Mapp Date: 2016-01-06 Impact factor: 5.038
Authors: Carmen Andreescu; Douglas Mennin; Dana Tudorascu; Lei K Sheu; Sarah Walker; Layla Banihashemi; Howard Aizenstein Journal: Psychiatry Res Date: 2015-08-29 Impact factor: 3.222
Authors: Helmet T Karim; Maria Ly; Gary Yu; Robert Krafty; Dana L Tudorascu; Howard J Aizenstein; Carmen Andreescu Journal: Neurobiol Aging Date: 2021-01-20 Impact factor: 4.673