Anticipation of Aversive Visual Stimuli Is Associated With Increased Insula Activation in Anxiety-Prone Subjects

Laboratory of Biological Dynamics and Theoretical Medicine, University of California San Diego, La Jolla, USA.
Biological Psychiatry (Impact Factor: 10.26). 09/2006; 60(4):402-9. DOI: 10.1016/j.biopsych.2006.04.038
Source: PubMed


Anticipation is a critical component of affective processing in general and for anxiety in particular. Prior research suggests that the right insula plays an important role in anticipation of affective processing during aversive images. This study aimed to test the hypothesis that individuals with increased anxiety-related temperamental traits (anxiety-prone [AP]) relative to anxiety-normative (AN) subjects would show an exaggerated insula response during anticipation of an aversive image.
16 AP and 16 AN individuals performed a task in the functional magnetic resonance imaging scanner, during which they viewed pictures of spiders and snakes. Subjects were prompted 4-6 sec before the onset of each aversive image. Blood oxygenation level-dependent signal was contrasted during cued anticipation of images versus non-anticipatory task performance as well as viewing images.
As hypothesized, AP subjects showed greater response than AN subjects in the bilateral insula during anticipation. In addition, these individuals had lower activity within the superior/medial frontal gyrus. During the image presentation phase, AN subjects showed greater activation than AP subjects in the bilateral temporal lobes and left superior frontal gyrus. Moreover, bilateral temporal lobe activation during image presentation was inversely correlated with bilateral insula activation during anticipation both within groups and in the combined group.
These data suggest that greater activation of the insula during visual anticipation is associated with visual processing of aversive stimuli in AP individuals. Insula hyperactivity might be a common feature in persons with elevated trait anxiety and, as such, might be a neuroimaging marker for anxiety proneness.

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Available from: Martin Paulus, Dec 12, 2014
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    • "Insula activation in adults correlates with the perception of somatic states of arousal (Straube and Miltner 2011). Third, anticipatory anxiety in response to threat-related stimuli is associated with activation of the insula in adult patients with a myriad anxiety disorders ranging from social anxiety disorder to GAD to specific phobia (Boshuisen et al. 2002;Simmons et al. 2004;Nitschke et al. 2006;Simmons et al. 2006;Stein et al. 2007;Straube et al. 2007;Boehme et al. 2014). Moreover, in anxious adolescents, 11–17 years of age, using the same task as in the present study (i.e., CPT- END), insula activity inversely correlates with the severity of FIG. 1. Treatment-related changes in activation following mindfulness-based cognitive therapy (MBCT). "
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    • "mple , the magnitude of insula activation while participants evaluated their own emotional and bodily states was found to be associated with social anxiety and neuroticism ( Terasawa et al . , 2013b ) . Insula activation has also been associated with self - report measures of anxiety ( Stein et al . , 2007 ) and anticipation of aversive exposure ( Simmons et al . , 2006 ) in anxiety - prone individuals . Here we found less insula activity to negative words in heavy marijuana users compared with controls , which was further associated with more negative emotionality at the time of scan . Together , this evidence suggests that heavy marijuana use may lead to impairment in the integration of emotional exp"
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    • "Other studies have used manipulation of the probability or temporal uncertainty of the occurrence of aversive stimuli to investigate anticipatory anxiety over longer periods (Somerville et al., 2013; Kalisch et al., 2005). Together, these studies have reported activation of a number of discrete regions during anticipation of threat, notably the extended amygdala (including the BNST), anterior insula, dorsolateral pFC (DLPFC), anterior midcingulate cortex (aMCC; as defined by Shackman et al., 2011), and VMPFC (Somerville et al., 2013; Nitschke et al., 2006; Simmons, Strigo, Matthews, Paulus, & Stein, 2006; Ploghaus et al., 1999). It has been proposed that activity in certain regions, such as the extended amygdala, aMCC, and anterior insula, may be linked to the generation and experience of anticipatory anxiety, as well as associated processes such as vigilance for threat (Straube, Mentzel, & Miltner, 2007; Kalisch et al., 2005). "
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