Loading…
Anticipatory Activation in the Amygdala and Anterior Cingulate in Generalized Anxiety Disorder and Prediction of Treatment Response
Objective: The anticipation of adverse outcomes, or worry, is a cardinal symptom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested...
Saved in:
Published in: | The American journal of psychiatry 2009-03, Vol.166 (3), p.302-310 |
---|---|
Main Authors: | , , , , , , |
Format: | Article |
Language: | English |
Subjects: | |
Citations: | Items that this one cites Items that cite this one |
Online Access: | Get full text |
Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
cited_by | cdi_FETCH-LOGICAL-a443t-910bb49ab148f4901c90bc05fc612fefbe3fb61a69a0d115f48e9e76bd792c3d3 |
---|---|
cites | cdi_FETCH-LOGICAL-a443t-910bb49ab148f4901c90bc05fc612fefbe3fb61a69a0d115f48e9e76bd792c3d3 |
container_end_page | 310 |
container_issue | 3 |
container_start_page | 302 |
container_title | The American journal of psychiatry |
container_volume | 166 |
creator | Nitschke, Jack B. Sarinopoulos, Issidoros Oathes, Desmond J. Johnstone, Tom Whalen, Paul J. Davidson, Richard J. Kalin, Ned H. |
description | Objective:
The anticipation of adverse outcomes, or worry, is a cardinal symptom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested whether patients with generalized anxiety disorder have alterations in anticipatory amygdala function and whether anticipatory activity in the anterior cingulate cortex predicts treatment response.
Method:
Functional magnetic resonance imaging (fMRI) was employed with 14 generalized anxiety disorder patients and 12 healthy comparison subjects matched for age, sex, and education. The event-related fMRI paradigm was composed of one warning cue that preceded aversive pictures and a second cue that preceded neutral pictures. Following the fMRI session, patients received 8 weeks of treatment with extended-release venlafaxine.
Results:
Patients with generalized anxiety disorder showed greater anticipatory activity than healthy comparison subjects in the bilateral dorsal amygdala preceding both aversive and neutral pictures. Building on prior reports of pretreatment anterior cingulate cortex activity predicting treatment response, anticipatory activity in that area was associated with clinical outcome 8 weeks later following treatment with venlafaxine. Higher levels of pretreatment anterior cingulate cortex activity in anticipation of both aversive and neutral pictures were associated with greater reductions in anxiety and worry symptoms.
Conclusions:
These findings of heightened and indiscriminate amygdala responses to anticipatory signals in generalized anxiety disorder and of anterior cingulate cortex associations with treatment response provide neurobiological support for the role of anticipatory processes in the pathophysiology of generalized anxiety disorder. |
doi_str_mv | 10.1176/appi.ajp.2008.07101682 |
format | article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2804441</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1653215101</sourcerecordid><originalsourceid>FETCH-LOGICAL-a443t-910bb49ab148f4901c90bc05fc612fefbe3fb61a69a0d115f48e9e76bd792c3d3</originalsourceid><addsrcrecordid>eNqFkUtvEzEUhUcIREPhL1QjJNgl-Ho8D2-QopQWpEogVCR21h3PndTRxB5spyJs-8dxHoTHhpVl-TvnnuuTZRfAZgB19QbH0cxwNc44Y82M1cCgavijbAJlUU5rzpvH2YQxxqeyLL6eZc9CWKUrK2r-NDsDCTwJ60n2MLfRaDNidH6bz3U09xiNs7mxebyjfL7eLjscMEfb5Yklb5zPF8YuNwNG2mHXZMnjYH7QjvhuKG7zSxOc78jvZZ88dUbvXV2f33rCuCYb888URmcDPc-e9DgEenE8z7MvV-9uF--nNx-vPyzmN1MUoohTCaxthcQWRNMLyUBL1mpW9roC3lPfUtG3FWAlkXUAZS8aklRXbVdLrouuOM_eHnzHTbumTqcMKbcavVmj3yqHRv39Ys2dWrp7xRsmhIBk8Ppo4N23DYWo1iZoGga05DZBVZWUUDc8gS__AVdu421aTqV_F3VRlFWCqgOkvQvBU39KAkztSla7klUqWe1KVr9KTsKLP_f4LTu2moBXRwCDxqH3aLUJJ44Dh6YEkbjiwO0HnSL-Z_xP4srFjw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>220473356</pqid></control><display><type>article</type><title>Anticipatory Activation in the Amygdala and Anterior Cingulate in Generalized Anxiety Disorder and Prediction of Treatment Response</title><source>American Psychiatric Publishing Inc</source><creator>Nitschke, Jack B. ; Sarinopoulos, Issidoros ; Oathes, Desmond J. ; Johnstone, Tom ; Whalen, Paul J. ; Davidson, Richard J. ; Kalin, Ned H.</creator><creatorcontrib>Nitschke, Jack B. ; Sarinopoulos, Issidoros ; Oathes, Desmond J. ; Johnstone, Tom ; Whalen, Paul J. ; Davidson, Richard J. ; Kalin, Ned H.</creatorcontrib><description>Objective:
The anticipation of adverse outcomes, or worry, is a cardinal symptom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested whether patients with generalized anxiety disorder have alterations in anticipatory amygdala function and whether anticipatory activity in the anterior cingulate cortex predicts treatment response.
Method:
Functional magnetic resonance imaging (fMRI) was employed with 14 generalized anxiety disorder patients and 12 healthy comparison subjects matched for age, sex, and education. The event-related fMRI paradigm was composed of one warning cue that preceded aversive pictures and a second cue that preceded neutral pictures. Following the fMRI session, patients received 8 weeks of treatment with extended-release venlafaxine.
Results:
Patients with generalized anxiety disorder showed greater anticipatory activity than healthy comparison subjects in the bilateral dorsal amygdala preceding both aversive and neutral pictures. Building on prior reports of pretreatment anterior cingulate cortex activity predicting treatment response, anticipatory activity in that area was associated with clinical outcome 8 weeks later following treatment with venlafaxine. Higher levels of pretreatment anterior cingulate cortex activity in anticipation of both aversive and neutral pictures were associated with greater reductions in anxiety and worry symptoms.
Conclusions:
These findings of heightened and indiscriminate amygdala responses to anticipatory signals in generalized anxiety disorder and of anterior cingulate cortex associations with treatment response provide neurobiological support for the role of anticipatory processes in the pathophysiology of generalized anxiety disorder.</description><identifier>ISSN: 0002-953X</identifier><identifier>EISSN: 1535-7228</identifier><identifier>DOI: 10.1176/appi.ajp.2008.07101682</identifier><identifier>PMID: 19122007</identifier><identifier>CODEN: AJPSAO</identifier><language>eng</language><publisher>Arlington, VA: American Psychiatric Association</publisher><subject>Adult ; Adult and adolescent clinical studies ; Amygdala - physiology ; Anxiety ; Anxiety Disorders - diagnosis ; Anxiety disorders. Neuroses ; Biological and medical sciences ; Bipolar disorder ; Brain ; Data collection ; Diagnostic and Statistical Manual of Mental Disorders ; Female ; Gyrus Cinguli - physiology ; Herbal medicine ; Humans ; Magnetic Resonance Imaging ; Male ; Medical imaging ; Medical sciences ; Mental depression ; Middle Aged ; Miscellaneous ; Older people ; Patients ; Predictive Value of Tests ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Severity of Illness Index ; Studies ; Surveys and Questionnaires ; Young Adult</subject><ispartof>The American journal of psychiatry, 2009-03, Vol.166 (3), p.302-310</ispartof><rights>2009 INIST-CNRS</rights><rights>Copyright American Psychiatric Association Mar 2009</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a443t-910bb49ab148f4901c90bc05fc612fefbe3fb61a69a0d115f48e9e76bd792c3d3</citedby><cites>FETCH-LOGICAL-a443t-910bb49ab148f4901c90bc05fc612fefbe3fb61a69a0d115f48e9e76bd792c3d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://psychiatryonline.org/doi/epdf/10.1176/appi.ajp.2008.07101682$$EPDF$$P50$$Gappi$$H</linktopdf><linktohtml>$$Uhttps://psychiatryonline.org/doi/full/10.1176/appi.ajp.2008.07101682$$EHTML$$P50$$Gappi$$H</linktohtml><link.rule.ids>230,314,780,784,885,2855,21626,21627,21628,27924,27925,77794,77799</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21218514$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19122007$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nitschke, Jack B.</creatorcontrib><creatorcontrib>Sarinopoulos, Issidoros</creatorcontrib><creatorcontrib>Oathes, Desmond J.</creatorcontrib><creatorcontrib>Johnstone, Tom</creatorcontrib><creatorcontrib>Whalen, Paul J.</creatorcontrib><creatorcontrib>Davidson, Richard J.</creatorcontrib><creatorcontrib>Kalin, Ned H.</creatorcontrib><title>Anticipatory Activation in the Amygdala and Anterior Cingulate in Generalized Anxiety Disorder and Prediction of Treatment Response</title><title>The American journal of psychiatry</title><addtitle>Am J Psychiatry</addtitle><description>Objective:
The anticipation of adverse outcomes, or worry, is a cardinal symptom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested whether patients with generalized anxiety disorder have alterations in anticipatory amygdala function and whether anticipatory activity in the anterior cingulate cortex predicts treatment response.
Method:
Functional magnetic resonance imaging (fMRI) was employed with 14 generalized anxiety disorder patients and 12 healthy comparison subjects matched for age, sex, and education. The event-related fMRI paradigm was composed of one warning cue that preceded aversive pictures and a second cue that preceded neutral pictures. Following the fMRI session, patients received 8 weeks of treatment with extended-release venlafaxine.
Results:
Patients with generalized anxiety disorder showed greater anticipatory activity than healthy comparison subjects in the bilateral dorsal amygdala preceding both aversive and neutral pictures. Building on prior reports of pretreatment anterior cingulate cortex activity predicting treatment response, anticipatory activity in that area was associated with clinical outcome 8 weeks later following treatment with venlafaxine. Higher levels of pretreatment anterior cingulate cortex activity in anticipation of both aversive and neutral pictures were associated with greater reductions in anxiety and worry symptoms.
Conclusions:
These findings of heightened and indiscriminate amygdala responses to anticipatory signals in generalized anxiety disorder and of anterior cingulate cortex associations with treatment response provide neurobiological support for the role of anticipatory processes in the pathophysiology of generalized anxiety disorder.</description><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>Amygdala - physiology</subject><subject>Anxiety</subject><subject>Anxiety Disorders - diagnosis</subject><subject>Anxiety disorders. Neuroses</subject><subject>Biological and medical sciences</subject><subject>Bipolar disorder</subject><subject>Brain</subject><subject>Data collection</subject><subject>Diagnostic and Statistical Manual of Mental Disorders</subject><subject>Female</subject><subject>Gyrus Cinguli - physiology</subject><subject>Herbal medicine</subject><subject>Humans</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Miscellaneous</subject><subject>Older people</subject><subject>Patients</subject><subject>Predictive Value of Tests</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Severity of Illness Index</subject><subject>Studies</subject><subject>Surveys and Questionnaires</subject><subject>Young Adult</subject><issn>0002-953X</issn><issn>1535-7228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><recordid>eNqFkUtvEzEUhUcIREPhL1QjJNgl-Ho8D2-QopQWpEogVCR21h3PndTRxB5spyJs-8dxHoTHhpVl-TvnnuuTZRfAZgB19QbH0cxwNc44Y82M1cCgavijbAJlUU5rzpvH2YQxxqeyLL6eZc9CWKUrK2r-NDsDCTwJ60n2MLfRaDNidH6bz3U09xiNs7mxebyjfL7eLjscMEfb5Yklb5zPF8YuNwNG2mHXZMnjYH7QjvhuKG7zSxOc78jvZZ88dUbvXV2f33rCuCYb888URmcDPc-e9DgEenE8z7MvV-9uF--nNx-vPyzmN1MUoohTCaxthcQWRNMLyUBL1mpW9roC3lPfUtG3FWAlkXUAZS8aklRXbVdLrouuOM_eHnzHTbumTqcMKbcavVmj3yqHRv39Ys2dWrp7xRsmhIBk8Ppo4N23DYWo1iZoGga05DZBVZWUUDc8gS__AVdu421aTqV_F3VRlFWCqgOkvQvBU39KAkztSla7klUqWe1KVr9KTsKLP_f4LTu2moBXRwCDxqH3aLUJJ44Dh6YEkbjiwO0HnSL-Z_xP4srFjw</recordid><startdate>20090301</startdate><enddate>20090301</enddate><creator>Nitschke, Jack B.</creator><creator>Sarinopoulos, Issidoros</creator><creator>Oathes, Desmond J.</creator><creator>Johnstone, Tom</creator><creator>Whalen, Paul J.</creator><creator>Davidson, Richard J.</creator><creator>Kalin, Ned H.</creator><general>American Psychiatric Association</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20090301</creationdate><title>Anticipatory Activation in the Amygdala and Anterior Cingulate in Generalized Anxiety Disorder and Prediction of Treatment Response</title><author>Nitschke, Jack B. ; Sarinopoulos, Issidoros ; Oathes, Desmond J. ; Johnstone, Tom ; Whalen, Paul J. ; Davidson, Richard J. ; Kalin, Ned H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-a443t-910bb49ab148f4901c90bc05fc612fefbe3fb61a69a0d115f48e9e76bd792c3d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>Amygdala - physiology</topic><topic>Anxiety</topic><topic>Anxiety Disorders - diagnosis</topic><topic>Anxiety disorders. Neuroses</topic><topic>Biological and medical sciences</topic><topic>Bipolar disorder</topic><topic>Brain</topic><topic>Data collection</topic><topic>Diagnostic and Statistical Manual of Mental Disorders</topic><topic>Female</topic><topic>Gyrus Cinguli - physiology</topic><topic>Herbal medicine</topic><topic>Humans</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Miscellaneous</topic><topic>Older people</topic><topic>Patients</topic><topic>Predictive Value of Tests</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Severity of Illness Index</topic><topic>Studies</topic><topic>Surveys and Questionnaires</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nitschke, Jack B.</creatorcontrib><creatorcontrib>Sarinopoulos, Issidoros</creatorcontrib><creatorcontrib>Oathes, Desmond J.</creatorcontrib><creatorcontrib>Johnstone, Tom</creatorcontrib><creatorcontrib>Whalen, Paul J.</creatorcontrib><creatorcontrib>Davidson, Richard J.</creatorcontrib><creatorcontrib>Kalin, Ned H.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The American journal of psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nitschke, Jack B.</au><au>Sarinopoulos, Issidoros</au><au>Oathes, Desmond J.</au><au>Johnstone, Tom</au><au>Whalen, Paul J.</au><au>Davidson, Richard J.</au><au>Kalin, Ned H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Anticipatory Activation in the Amygdala and Anterior Cingulate in Generalized Anxiety Disorder and Prediction of Treatment Response</atitle><jtitle>The American journal of psychiatry</jtitle><addtitle>Am J Psychiatry</addtitle><date>2009-03-01</date><risdate>2009</risdate><volume>166</volume><issue>3</issue><spage>302</spage><epage>310</epage><pages>302-310</pages><issn>0002-953X</issn><eissn>1535-7228</eissn><coden>AJPSAO</coden><abstract>Objective:
The anticipation of adverse outcomes, or worry, is a cardinal symptom of generalized anxiety disorder. Prior work with healthy subjects has shown that anticipating aversive events recruits a network of brain regions, including the amygdala and anterior cingulate cortex. This study tested whether patients with generalized anxiety disorder have alterations in anticipatory amygdala function and whether anticipatory activity in the anterior cingulate cortex predicts treatment response.
Method:
Functional magnetic resonance imaging (fMRI) was employed with 14 generalized anxiety disorder patients and 12 healthy comparison subjects matched for age, sex, and education. The event-related fMRI paradigm was composed of one warning cue that preceded aversive pictures and a second cue that preceded neutral pictures. Following the fMRI session, patients received 8 weeks of treatment with extended-release venlafaxine.
Results:
Patients with generalized anxiety disorder showed greater anticipatory activity than healthy comparison subjects in the bilateral dorsal amygdala preceding both aversive and neutral pictures. Building on prior reports of pretreatment anterior cingulate cortex activity predicting treatment response, anticipatory activity in that area was associated with clinical outcome 8 weeks later following treatment with venlafaxine. Higher levels of pretreatment anterior cingulate cortex activity in anticipation of both aversive and neutral pictures were associated with greater reductions in anxiety and worry symptoms.
Conclusions:
These findings of heightened and indiscriminate amygdala responses to anticipatory signals in generalized anxiety disorder and of anterior cingulate cortex associations with treatment response provide neurobiological support for the role of anticipatory processes in the pathophysiology of generalized anxiety disorder.</abstract><cop>Arlington, VA</cop><pub>American Psychiatric Association</pub><pmid>19122007</pmid><doi>10.1176/appi.ajp.2008.07101682</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 0002-953X |
ispartof | The American journal of psychiatry, 2009-03, Vol.166 (3), p.302-310 |
issn | 0002-953X 1535-7228 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_2804441 |
source | American Psychiatric Publishing Inc |
subjects | Adult Adult and adolescent clinical studies Amygdala - physiology Anxiety Anxiety Disorders - diagnosis Anxiety disorders. Neuroses Biological and medical sciences Bipolar disorder Brain Data collection Diagnostic and Statistical Manual of Mental Disorders Female Gyrus Cinguli - physiology Herbal medicine Humans Magnetic Resonance Imaging Male Medical imaging Medical sciences Mental depression Middle Aged Miscellaneous Older people Patients Predictive Value of Tests Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Severity of Illness Index Studies Surveys and Questionnaires Young Adult |
title | Anticipatory Activation in the Amygdala and Anterior Cingulate in Generalized Anxiety Disorder and Prediction of Treatment Response |
url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-24T20%3A07%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Anticipatory%20Activation%20in%20the%20Amygdala%20and%20Anterior%20Cingulate%20in%20Generalized%20Anxiety%20Disorder%20and%20Prediction%20of%20Treatment%20Response&rft.jtitle=The%20American%20journal%20of%20psychiatry&rft.au=Nitschke,%20Jack%20B.&rft.date=2009-03-01&rft.volume=166&rft.issue=3&rft.spage=302&rft.epage=310&rft.pages=302-310&rft.issn=0002-953X&rft.eissn=1535-7228&rft.coden=AJPSAO&rft_id=info:doi/10.1176/appi.ajp.2008.07101682&rft_dat=%3Cproquest_pubme%3E1653215101%3C/proquest_pubme%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-a443t-910bb49ab148f4901c90bc05fc612fefbe3fb61a69a0d115f48e9e76bd792c3d3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=220473356&rft_id=info:pmid/19122007&rfr_iscdi=true |