Ventrolateral Prefrontal Cortex Activation and Attentional Bias in Response to Angry Faces in Adolescents With Generalized Anxiety Disorder

Department of Psychology, University of Michigan, 2000 East Hall, 530 Church St., Ann Arbor, MI 48109, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 07/2006; 163(6):1091-7. DOI: 10.1176/appi.ajp.163.6.1091
Source: PubMed


While adolescent anxiety disorders represent prevalent, debilitating conditions, few studies have explored their brain physiology. Using event-related functional magnetic resonance imaging (fMRI) and a behavioral measure of attention to angry faces, the authors evaluated differences in response between healthy adolescents and adolescents with generalized anxiety disorder.
In the primary trials of interest, 18 adolescents with generalized anxiety disorder and 15 comparison subjects of equivalent age/gender/IQ viewed angry/neutral face pairs during fMRI acquisition. Following the presentation of each face pair, subjects pressed a button to indicate whether a subsequent asterisk appeared on the same (congruent) or opposite (incongruent) side as the angry face. Reaction time differences between congruent and incongruent face trials provided a measure of attention bias to angry faces.
Relative to the comparison subjects, patients with generalized anxiety disorder manifested greater right ventrolateral prefrontal cortex activation to trials containing angry faces. Patients with generalized anxiety disorder also showed greater attention bias away from angry faces. Ventrolateral prefrontal cortex activation differences remained evident when differences in attention bias were covaried. Finally, in an examination among patients of the association between degree of anxiety and brain activation, the authors found that as ventrolateral prefrontal cortex activation increased, severity of anxiety symptoms diminished.
Adolescents with generalized anxiety disorder show greater right ventrolateral prefrontal cortex activation and attentional bias away from angry faces than healthy adolescents. Among patients, increased ventrolateral prefrontal cortex activation is associated with less severe anxiety, suggesting that this activation may serve as a compensatory response.

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    • "In line with previous research (Monk et al., 2006; Pine et al., 2005; Stirling et al., 2006), our sample of older youth was characterized by attention bias away from threat. Similar results were also observed by Reinholdt-Dunne et al. (2012), with older youths displaying a bias away from threat-related pictorial stimuli. "
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    • "We adopted an event-related fMRI dot-probe task involving angry and neutral faces as used in prior studies (e.g. Hardee et al., 2013; Monk et al., 2006) to assist comparison and interpretation of findings. The incongruent-versus-congruent contrast isolates neural responses to probes that appeared in the opposite location of the threat. "
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    • "For example, clinical research has traditionally investigated groups with versus without anxiety disorders. This line of research has demonstrated important differences in both brain and behavior between patient and healthy control groups (Monk et al., 2006; Phan et al., 2005; Thayer et al., 1996; Zhao et al., 2007). Even in relatively healthy samples, prior work has often separated participants into " high " and " low " anxiety groups. "
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