Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety

Background: Despite the high prevalence of generalized anxiety disorder (GAD) and its negative impact on society, its neurobiology remains obscure. This study characterizes the neurostructural abnormalities associated with key symptoms of GAD, focusing on indicators of impaired emotion regulation (e...

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Main Authors: Elena Makovac, Frances Meeten, David R. Watson, Sarah N. Garfinkel, Hugo D. Critchley, Cristina Ottaviani
Format: Article
Language:English
Published: Elsevier 2016-01-01
Series:NeuroImage: Clinical
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2213158215300395
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spelling doaj-eb6a2c3efc2540cd82b590088bbf92e12020-11-24T21:19:57ZengElsevierNeuroImage: Clinical2213-15822016-01-0110C17218110.1016/j.nicl.2015.11.022Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxietyElena Makovac0Frances Meeten1David R. Watson2Sarah N. Garfinkel3Hugo D. Critchley4Cristina Ottaviani5Neuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, ItalyClinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Falmer, UKClinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Falmer, UKClinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Falmer, UKClinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Falmer, UKNeuroimaging Laboratory, IRCCS Santa Lucia Foundation, Rome, ItalyBackground: Despite the high prevalence of generalized anxiety disorder (GAD) and its negative impact on society, its neurobiology remains obscure. This study characterizes the neurostructural abnormalities associated with key symptoms of GAD, focusing on indicators of impaired emotion regulation (excessive worry, poor concentration, low mindfulness, and physiological arousal). Methods: These domains were assessed in 19 (16 women) GAD patients and 19 healthy controls matched for age and gender, using questionnaires and a low demand behavioral task performed before and after an induction of perseverative cognition (i.e. worry and rumination). Continuous pulse oximetry was used to measure autonomic physiology (heart rate variability; HRV). Observed cognitive and physiological changes in response to the induction provided quantifiable data on emotional regulatory capacity. Participants underwent structural magnetic resonance imaging; voxel-based morphometry was used to quantify the relationship between gray matter volume and psychological and physiological measures. Results: Overall, GAD patients had lower gray matter volume than controls within supramarginal, precentral, and postcentral gyrus bilaterally. Across the GAD group, increased right amygdala volume was associated with prolonged reaction times on the tracking task (indicating increased attentional impairment following the induction) and lower scores on the ‘Act with awareness’ subscale of the Five Facets Mindfulness Questionnaire. Moreover in GAD, medial frontal cortical gray matter volume correlated positively with the ‘Non-react mindfulness’ facet. Lastly, smaller volumes of bilateral insula, bilateral opercular cortex, right supramarginal and precentral gyri, anterior cingulate and paracingulate cortex predicted the magnitude of autonomic change following the induction (i.e. a greater decrease in HRV). Conclusions: Results distinguish neural structures associated with impaired capacity for cognitive, attentional and physiological disengagement from worry, suggesting that aberrant competition between these levels of emotional regulation is intrinsic to symptom expression in GAD.http://www.sciencedirect.com/science/article/pii/S2213158215300395Generalized anxiety disorderPerseverative cognitionMagnetic resonance imagingHeart rate variabilityMindfulnessAttentional deficit
collection DOAJ
language English
format Article
sources DOAJ
author Elena Makovac
Frances Meeten
David R. Watson
Sarah N. Garfinkel
Hugo D. Critchley
Cristina Ottaviani
spellingShingle Elena Makovac
Frances Meeten
David R. Watson
Sarah N. Garfinkel
Hugo D. Critchley
Cristina Ottaviani
Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety
NeuroImage: Clinical
Generalized anxiety disorder
Perseverative cognition
Magnetic resonance imaging
Heart rate variability
Mindfulness
Attentional deficit
author_facet Elena Makovac
Frances Meeten
David R. Watson
Sarah N. Garfinkel
Hugo D. Critchley
Cristina Ottaviani
author_sort Elena Makovac
title Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety
title_short Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety
title_full Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety
title_fullStr Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety
title_full_unstemmed Neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety
title_sort neurostructural abnormalities associated with axes of emotion dysregulation in generalized anxiety
publisher Elsevier
series NeuroImage: Clinical
issn 2213-1582
publishDate 2016-01-01
description Background: Despite the high prevalence of generalized anxiety disorder (GAD) and its negative impact on society, its neurobiology remains obscure. This study characterizes the neurostructural abnormalities associated with key symptoms of GAD, focusing on indicators of impaired emotion regulation (excessive worry, poor concentration, low mindfulness, and physiological arousal). Methods: These domains were assessed in 19 (16 women) GAD patients and 19 healthy controls matched for age and gender, using questionnaires and a low demand behavioral task performed before and after an induction of perseverative cognition (i.e. worry and rumination). Continuous pulse oximetry was used to measure autonomic physiology (heart rate variability; HRV). Observed cognitive and physiological changes in response to the induction provided quantifiable data on emotional regulatory capacity. Participants underwent structural magnetic resonance imaging; voxel-based morphometry was used to quantify the relationship between gray matter volume and psychological and physiological measures. Results: Overall, GAD patients had lower gray matter volume than controls within supramarginal, precentral, and postcentral gyrus bilaterally. Across the GAD group, increased right amygdala volume was associated with prolonged reaction times on the tracking task (indicating increased attentional impairment following the induction) and lower scores on the ‘Act with awareness’ subscale of the Five Facets Mindfulness Questionnaire. Moreover in GAD, medial frontal cortical gray matter volume correlated positively with the ‘Non-react mindfulness’ facet. Lastly, smaller volumes of bilateral insula, bilateral opercular cortex, right supramarginal and precentral gyri, anterior cingulate and paracingulate cortex predicted the magnitude of autonomic change following the induction (i.e. a greater decrease in HRV). Conclusions: Results distinguish neural structures associated with impaired capacity for cognitive, attentional and physiological disengagement from worry, suggesting that aberrant competition between these levels of emotional regulation is intrinsic to symptom expression in GAD.
topic Generalized anxiety disorder
Perseverative cognition
Magnetic resonance imaging
Heart rate variability
Mindfulness
Attentional deficit
url http://www.sciencedirect.com/science/article/pii/S2213158215300395
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