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1.
Neuroimage ; 191: 380-391, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30798009

RESUMO

In Generalized Anxiety Disorder (GAD), fluctuations in ongoing thoughts (i.e., mind-wandering) often take the form of rigid and intrusive perseverative cognition, such as worry. Here, we sought to characterise the neural correlates of mind-wandering and perseverative cognition, alongside autonomic nervous system indices of central arousal, notably pupil dilation. We implemented a protocol incorporating the dynamic delivery of thought-probes within a functional neuroimaging task. Sixteen individuals with GAD and sixteen matched healthy controls (HC) underwent functional magnetic resonance imaging with concomitant pupillometry. Participants performed a series of low-demand tracking tasks, responding to occasional changes in a target stimulus. Such a task is typically accompanied by self-generated, off-task thinking. Thought-probes were triggered based on an individual's response time (RT) when responding to the change in the target. Subjective reports showed that long RT predicted off-task thinking/mind-wandering. Moreover, long RT and mind-wandering were also associated with larger pupil diameter. This effect was exaggerated in GAD patients during perseverative cognition. Within brain, during both pre-target periods and target events, there were distinct neural correlates for mind-wandering (e.g., anterior cingulate and paracingulate activation at target onset) and perseverative cognition (e.g., opposite patterns of activation in posterior cingulate and cerebellum at target onset in HC and GAD). Results suggest that not only attention systems but also sensory-motor cortices are important during off-task states. Interestingly, changes across the 'default mode network' also tracked fluctuations in pupillary size. Autonomic expression in pupillary changes mirrors brain activation patterns that occur during different forms of repetitive thinking.


Assuntos
Transtornos de Ansiedade/fisiopatologia , Encéfalo/fisiopatologia , Tempo de Reação/fisiologia , Adulto , Nível de Alerta/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pupila
2.
Psychosom Med ; 81(1): 90-99, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30300237

RESUMO

OBJECTIVE: Spider phobia is a common form of anxiety disorder for which exposure therapy is an effective first-line treatment. Motivated by the observed modulation of threat processing by afferent cardiac signals, we tested the hypothesis that interoceptive information concerning cardiovascular arousal can influence the outcomes of computerized exposure therapy for spider phobia. METHOD: Fifty-three normal healthy participants with high spider phobia scores underwent one of the following three modified computerized exposure protocols, defined by the timing of exposure to brief spider stimuli within the cardiac cycle: systole (during afferent baroreceptor firing); diastole (during baroreceptor-quiescent interbeat interval); random (noncontingent on cardiac cycle). Outcomes were judged on phobic and anxiety measures and physiological data (skin conductance). Individuals were also rated on interoceptive accuracy. RESULTS: MANCOVA analysis showed that timing group affected the outcome measures (F(10,80) = 2.405, p = .015) and there was a group interaction with interoception ability (F(15,110) = 1.808, p = .045). Subjective symptom reduction was greatest in the systolic group relative to the other two groups (diastolic (t = 3.115, ptukey = .009); random (t = 2.438, ptukey = .048)), with greatest reductions in those participants with lower interoceptive accuracy. Behavioral aversion reduced more in cardiac-contingent groups than the noncontingent (random) group (diastolic (t = 3.295, ptukey = .005); systolic (t = 2.602, ptukey = .032)). Physiological (skin conductance response) responses remained strongest for spider stimuli presented at cardiac systole. CONCLUSIONS: Interoceptive information influences exposure benefit. The reduction in the subjective expression of fear/phobia is facilitated by "bottom-up" afferent signals, whereas improvement in the behavioral expression is further dependent on "top-down" representation of self-related physiology (heart rhythm). Individual interoceptive differences moderate these effects, suggesting means to personalize therapy.


Assuntos
Resposta Galvânica da Pele/fisiologia , Terapia Implosiva , Interocepção/fisiologia , Contração Miocárdica/fisiologia , Avaliação de Resultados em Cuidados de Saúde , Transtornos Fóbicos/fisiopatologia , Transtornos Fóbicos/terapia , Adolescente , Adulto , Feminino , Humanos , Individualidade , Masculino , Terapia Assistida por Computador , Adulto Jovem
3.
Neuroimage ; 59(2): 1795-803, 2012 Jan 16.
Artigo em Inglês | MEDLINE | ID: mdl-21871572

RESUMO

This study sought to investigate the effects of manipulating social coordination on brain synchronization/de-synchronization in the mu band. Mu activation is associated with understanding and coordinating motor acts and may play a key role in mediating social interaction. Members of a dyad were required to interact with one another in a rhythmic finger movement coordination task under various instructions: intrinsic where each member of the dyad was instructed to maintain their own and ignore their partner's movement; in-phase where they were asked to synchronize with their partner's movement; and anti-phase where they were instructed to syncopate with their partner's movement. EEG and movement data were recorded simultaneously from both subjects during all three tasks and a control condition. Log power ratios of EEG activity in the active conditions versus control were used to assess the effect of task context on synchronization/de-synchronization in the mu spectral domain. Results showed clear and systematic modulation of mu band activity in the 10-12 Hz range as a function of coordination context. In the left hemisphere general levels of alpha-mu suppression increased progressively as one moved from intrinsic through in-phase to anti-phase contexts but with no specific central-parietal focus. In contrast the right hemisphere displayed context-specific changes in the central-parietal region. The intrinsic condition showed a right synchronization which disappeared with the in-phase context even as de-synchronization remained greater in the left hemisphere. Anti-phase was associated with larger mu suppression in the right in comparison with left at central-parietal region. Such asymmetrical changes were highly correlated with changing behavioral dynamics. These specific patterns of activation and deactivation of mu activity suggest that localized neural circuitry in right central-parietal regions mediates how individuals interpret the movements of others in the context of their own actions. A right sided mechanism in the 10-12 Hz range appears to be involved in integrating the mutual information among the members of a dyad that enables the dynamics of social interaction to unfold in time.


Assuntos
Algoritmos , Mapeamento Encefálico/métodos , Encéfalo/fisiologia , Eletroencefalografia/métodos , Inteligência Emocional/fisiologia , Comportamento Social , Volição/fisiologia , Adulto , Feminino , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Processamento de Sinais Assistido por Computador , Adulto Jovem
4.
Neuroradiology ; 53(10): 733-48, 2011 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21113707

RESUMO

INTRODUCTION: Understanding disease progression in Alzheimer's disease (AD) awaits the resolution of three fundamental questions: first, can we identify the location of "seed" regions where neuropathology is first present? Some studies have suggested the medial temporal lobe while others have suggested the hippocampus. Second, are there similar atrophy rates within affected regions in AD? Third, is there evidence of causality relationships between different affected regions in AD progression? METHODS: To address these questions, we conducted a longitudinal MRI study to investigate the gray matter (GM) changes in AD progression. Abnormal brain regions were localized by a standard voxel-based morphometry method, and the absolute atrophy rate in these regions was calculated using a robust regression method. Primary foci of atrophy were identified in the hippocampus and middle temporal gyrus (MTG). A model based upon the Granger causality approach was developed to investigate the cause-effect relationship over time between these regions based on GM concentration. RESULTS: Results show that in the earlier stages of AD, primary pathological foci are in the hippocampus and entorhinal cortex. Subsequently, atrophy appears to subsume the MTG. CONCLUSION: The causality results show that there is in fact little difference between AD and age-matched healthy control in terms of hippocampus atrophy, but there are larger differences in MTG, suggesting that local pathology in MTG is the predominant progressive abnormality during intermediate stages of AD development.


Assuntos
Envelhecimento/patologia , Doença de Alzheimer/patologia , Encéfalo/patologia , Progressão da Doença , Imageamento por Ressonância Magnética , Idoso , Idoso de 80 Anos ou mais , Atrofia , Estudos de Casos e Controles , Feminino , Hipocampo/patologia , Humanos , Processamento de Imagem Assistida por Computador , Estudos Longitudinais , Masculino
5.
Neuroimage ; 52(4): 1390-400, 2010 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-20472078

RESUMO

This paper presents a new regression method for functional magnetic resonance imaging (fMRI) activation detection. Unlike general linear models (GLM), this method is based on selecting models for activation detection adaptively which overcomes the limitation of requiring a predefined design matrix in GLM. This limitation is because GLM designs assume that the response of the neuron populations will be the same for the same stimuli, which is often not the case. In this work, the fMRI hemodynamic response model is selected from a series of models constructed online by the least angle regression (LARS) method. The slow drift terms in the design matrix for the activation detection are determined adaptively according to the fMRI response in order to achieve the best fit for each fMRI response. The LARS method is then applied along with the Moore-Penrose pseudoinverse (PINV) and fast orthogonal search (FOS) algorithm for implementation of the selected model to include the drift effects in the design matrix. Comparisons with GLM were made using 11 normal subjects to test method superiority. This paper found that GLM with fixed design matrix was inferior compared to the described LARS method for fMRI activation detection in a phased-encoded experimental design. In addition, the proposed method has the advantage of increasing the degrees of freedom in the regression analysis. We conclude that the method described provides a new and novel approach to the detection of fMRI activation which is better than GLM based analyses.


Assuntos
Algoritmos , Mapeamento Encefálico/métodos , Encéfalo/fisiologia , Potenciais Evocados/fisiologia , Interpretação de Imagem Assistida por Computador/métodos , Armazenamento e Recuperação da Informação/métodos , Imageamento por Ressonância Magnética/métodos , Interpretação Estatística de Dados , Humanos , Aumento da Imagem/métodos , Análise de Regressão , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
6.
Neurosci Lett ; 450(2): 85-9, 2009 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-19071194

RESUMO

Hippocampus displayed progressively gender-associated damage in Alzheimer's disease. However, gender effects have been largely neglected in studies of amnestic type mild cognitive impairment (aMCI) patients who were believed to represent an early stage of this disease. The goal of this study was to use in vivo neuroimaging techniques to determine whether there were any evidences of gender differences in hippocampal atrophy in aMCI. A region of interest-based magnetic resonance imaging approach was used to compare hippocampal volume between aMCI patients (22 male, 17 female) and normal aging controls (12 male, 11 female). Independent of group, male hippocampal volumes were larger than female volumes and right hippocampal volumes were typically smaller than left volumes. Hippocampal volumes were significantly reduced in the clinical group but no gender differences were noted in terms of degree of atrophy present. However, female patients showed more impaired cognitive function than male patients despite this apparent equivalence in atrophy. The absence of a gender difference suggested that early neuropathological progression might be independent of gender. However, the data also suggested female aMCI patients had an increased vulnerability to cognitive impairment earlier in the illness course.


Assuntos
Amnésia/patologia , Transtornos Cognitivos/patologia , Hipocampo/patologia , Caracteres Sexuais , Idoso , Amnésia/complicações , Atrofia , Transtornos Cognitivos/complicações , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Testes Neuropsicológicos
7.
J Neurol Sci ; 278(1-2): 102-6, 2009 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-19162279

RESUMO

The association fiber tracts integrity of the inter-hemispheric and within-hemispheric communication was poor understood in amnestic type mild cognitive impairment (aMCI) patients by diffusion tensor imaging (DTI). A region of interest-based DTI approach was applied to explore fiber tract differences between 22 aMCI patients and 22 well-matched normal aging. Correlations were also sought between fractional anisotropy (FA) values and the cognitive performance scores in the aMCI patients. Extensive impairment of association fiber tracts integrity was observed in aMCI patients, including bilateral inferior fronto-occipital fascicles, the genu of corpus callosum, bilateral cingulate bundles and bilateral superior longitudinal fascicles II (SLE II) subcomponent. In addition, the FA value of right SLE II was significantly negatively correlated to the performance of Trail Making Test A and B, whilst the values of right posterior cingulate bundle was significantly positive correlation with MMSE score. As aMCI is a putative prodromal syndrome to Alzheimer's disease (AD), this study suggested that investigation of association fiber tracts between remote cortexes may yield important new data to predict whether a patient will eventually develop AD.


Assuntos
Encéfalo/patologia , Transtornos Cognitivos/patologia , Idoso , Anisotropia , Mapeamento Encefálico , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Vias Neurais/patologia , Testes Neuropsicológicos , Estatísticas não Paramétricas
8.
Auton Neurosci ; 217: 41-48, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30704974

RESUMO

Generalized anxiety disorder (GAD) is associated with both autonomic dysfunction, notably decreased vagally-mediated heart rate variability (vmHRV), and neurostructural abnormalities. Regional differences in brain morphometry correlate with vmHRV in healthy individuals. Here, we tested the hypothesis that specific focal abnormalities in cortical structure in GAD underpin decreased vmHRV. Adult female patients with GAD (n = 17) and matched controls (n = 18) underwent structural magnetic resonance imaging after characterization of symptoms and quantification of resting vmHRV derived from continuous pulse oximetry. Cortical reconstruction was performed using the FreeSurfer image analysis suite. A priori analysis was conducted only within brain regions involved in vagal control of heart rate. Compared to controls, patients with GAD showed cortical thinning of the (i) left rostral anterior cingulate cortex, (ii) left medial orbitofrontal cortex, and (iii) right isthmus cingulate gyrus. Significant negative relationships were identified between the severity of anxiety symptoms and cortical thickness of the left medial orbitofrontal cortex and right isthmus cingulate gyrus. Compared to controls, patients with GAD showed decreased vmHRV at rest. In controls only, cortical thickness of the left caudal anterior cingulate cortex correlated positively with resting vmHRV. These results extend evidence in GAD for structural abnormalities within cortical areas implicated in emotion regulation and cognition. In addition, these findings may implicate abnormal integrity of anterior cingulate cortex in the psychophysiological expression of GAD and suggest that interventional targeting of this region may normalize autonomic function in GAD.


Assuntos
Transtornos de Ansiedade/patologia , Transtornos de Ansiedade/fisiopatologia , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Giro do Cíngulo/patologia , Córtex Pré-Frontal/patologia , Adulto , Transtornos de Ansiedade/diagnóstico por imagem , Regulação Emocional/fisiologia , Feminino , Giro do Cíngulo/diagnóstico por imagem , Frequência Cardíaca/fisiologia , Humanos , Imageamento por Ressonância Magnética , Córtex Pré-Frontal/diagnóstico por imagem
9.
Psychiatry Res Neuroimaging ; 281: 107-116, 2018 11 30.
Artigo em Inglês | MEDLINE | ID: mdl-30290286

RESUMO

Generalized anxiety disorder (GAD) has excessive anxiety and uncontrollable worry as core symptoms. Abnormal cerebral functioning underpins the expression and perhaps pathogenesis of GAD:. Studies implicate impaired communication between the amygdala and the pre-frontal cortex (PFC). Our aim was to longitudinally investigate whether such network abnormalities are spatially restricted to this circuit or if the integrity of functional brain networks is globally disrupted in GAD. We acquired resting-state functional magnetic resonance imaging data from 16 GAD patients and 16 matched controls at baseline and after 1 year. Using network modeling and graph-theory, whole-brain connectivity was characterized from local and global perspectives. Overall lower global efficiency, indicating sub-optimal brain-wide organization and integration, was present in patients with GAD compared to controls. The amygdala and midline cortices showed higher betweenness centrality, reflecting functional dominance of these brain structures. Third, lower betweenness centrality and lower degree emerged for PFC, suggesting weakened inhibitory control. Overall, network organization showed impairments consistent with neurobiological models of GAD (involving amygdala, PFC, and cingulate cortex) and further pointed to an involvement of temporal regions. Such impairments tended to progress over time and predict anxiety symptoms. A graph-analytic approach represents a powerful approach to deepen our understanding of GAD.


Assuntos
Tonsila do Cerebelo/diagnóstico por imagem , Transtornos de Ansiedade/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Adulto , Tonsila do Cerebelo/fisiopatologia , Transtornos de Ansiedade/fisiopatologia , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Mapeamento Encefálico/métodos , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiopatologia , Feminino , Lobo Frontal/fisiopatologia , Giro do Cíngulo/diagnóstico por imagem , Giro do Cíngulo/fisiopatologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiopatologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/fisiopatologia
10.
Neuroimage Clin ; 17: 882-892, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29527493

RESUMO

Background: The Cognitive Avoidance Theory of Worry argues that worry is a cognitive strategy adopted to control the physiological arousal associated with anxiety. According to this theory, pathological worry, as in Generalized Anxiety Disorder (GAD), is verbal in nature, negative and abstract, rather than concrete. Neuroimaging studies link the expression of worry to characteristic modes of brain functional connectivity, especially in relation to the amygdala. However, the distinctive features of worry (verbal, abstract, negative), and their relationship to physiological arousal, have not so far been mapped to brain function. Methods: We addressed this omission by undertaking a resting-state functional magnetic resonance neuroimaging study of 19 patients with GAD and 21 controls, before and after induction of perseverative cognitions, while measuring emotional bodily arousal from heart rate (HR). Seed-based analyses quantified brain changes in whole brain functional connectivity from the amygdala. Results: In GAD, the induction increased negative thoughts and their verbal content. In line with predictions, the verbal expression of worry in GAD was associated with higher HR at baseline and attenuated HR increases after induction of perseverative cognitions. Within brain, the increased use of words during worry, and the associated dampening of HR after induction were mediated by the strength of functional connectivity between the amygdala and default mode network 'hubs' and the opercular cortex. The negative content of worry was further related to functional communication between amygdala and cingulo-opercular and temporal cortices. Conclusions: Findings provide a neurobiological basis for the impact of verbal worry on HR in GAD.


Assuntos
Transtornos de Ansiedade/diagnóstico por imagem , Transtornos de Ansiedade/fisiopatologia , Encéfalo/fisiopatologia , Emoções/fisiologia , Comportamento Verbal/fisiologia , Adulto , Transtornos de Ansiedade/psicologia , Encéfalo/diagnóstico por imagem , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Oxigênio/sangue , Escalas de Graduação Psiquiátrica , Estatísticas não Paramétricas , Inquéritos e Questionários , Vocabulário , Adulto Jovem
11.
Sci Rep ; 8(1): 9136, 2018 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-29904123

RESUMO

Motor actions can be facilitated or hindered by psychophysiological states of readiness, to guide rapid adaptive action. Cardiovascular arousal is communicated by cardiac signals conveying the timing and strength of individual heartbeats. Here, we tested how these interoceptive signals facilitate control of motor impulsivity. Participants performed a stop signal task, in which stop cues were delivered at different time points within the cardiac cycle: at systole when the heart contracts (T-wave peak, approximately 300 ms following the R-wave), or at diastole between heartbeats (R-wave peak). Response inhibition was better at systole, indexed by a shorter stop signal reaction time (SSRT), and longer stop signal delay (SSD). Furthermore, parasympathetic control of cardiovascular tone, and subjective sensitivity to interoceptive states, predicted response inhibition efficiency, although these cardiovascular and interoceptive correlations did not survive correction for multiple comparisons. This suggests that response inhibition capacity is influenced by interoceptive physiological cues, such that people are more likely to express impulsive actions during putative states of lower cardiovascular arousal, when frequency and strength of cardiac afferent signalling is reduced.


Assuntos
Nível de Alerta/fisiologia , Diástole/fisiologia , Frequência Cardíaca/fisiologia , Sístole/fisiologia , Adolescente , Adulto , Feminino , Humanos , Masculino
12.
Neuropsychopharmacology ; 31(7): 1519-25, 2006 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-16319909

RESUMO

Rapid tryptophan (Trp) depletion (RTD) has been reported to cause deterioration in the quality of decision making and impaired reversal learning, while leaving attentional set shifting relatively unimpaired. These findings have been attributed to a more powerful neuromodulatory effect of reduced 5-HT on ventral prefrontal cortex (PFC) than on dorsolateral PFC. In view of the limited number of reports, the aim of this study was to independently replicate these findings using the same test paradigms. Healthy human subjects without a personal or family history of affective disorder were assessed using a computerized decision making/gambling task and the CANTAB ID/ED attentional set-shifting task under Trp-depleted (n=17; nine males and eight females) or control (n=15; seven males and eight females) conditions, in a double-blind, randomized, parallel-group design. There was no significant effect of RTD on set shifting, reversal learning, risk taking, impulsivity, or subjective mood. However, RTD significantly altered decision making such that depleted subjects chose the more likely of two possible outcomes significantly more often than controls. This is in direct contrast to the previous report that subjects chose the more likely outcome significantly less often following RTD. In the terminology of that report, our result may be interpreted as improvement in the quality of decision making following RTD. This contrast between studies highlights the variability in the cognitive effects of RTD between apparently similar groups of healthy subjects, and suggests the need for future RTD studies to control for a range of personality, family history, and genetic factors that may be associated with 5-HT function.


Assuntos
Atenção/fisiologia , Cognição/fisiologia , Tomada de Decisões/fisiologia , Dieta , Reversão de Aprendizagem/fisiologia , Triptofano/deficiência , Adolescente , Adulto , Análise de Variância , Estudos Cross-Over , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tempo de Reação/fisiologia
13.
Soc Cogn Affect Neurosci ; 11(11): 1719-1728, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27369066

RESUMO

Generalized anxiety disorder (GAD) is characterized by excessive worry, autonomic dysregulation and functional amygdala dysconnectivity, yet these illness markers have rarely been considered together, nor their interrelationship tested longitudinally. We hypothesized that an individual's capacity for emotion regulation predicts longer-term changes in amygdala functional connectivity, supporting the modification of GAD core symptoms. Sixteen patients with GAD (14 women) and individually matched controls were studied at two time points separated by 1 year. Resting-state fMRI data and concurrent measurement of vagally mediated heart rate variability were obtained before and after the induction of perseverative cognition. A greater rise in levels of worry following the induction predicted a stronger reduction in connectivity between right amygdala and ventromedial prefrontal cortex, and enhanced coupling between left amygdala and ventral tegmental area at follow-up. Similarly, amplified physiological responses to the induction predicted increased connectivity between right amygdala and thalamus. Longitudinal shifts in a distinct set of functional connectivity scores were associated with concomitant changes in GAD symptomatology over the course of the year. Results highlight the prognostic value of indices of emotional dysregulation and emphasize the integral role of the amygdala as a critical hub in functional neural circuitry underlying the progression of GAD symptomatology.


Assuntos
Tonsila do Cerebelo/fisiopatologia , Transtornos de Ansiedade/fisiopatologia , Rede Nervosa/fisiopatologia , Córtex Pré-Frontal/fisiopatologia , Adulto , Transtornos de Ansiedade/diagnóstico , Transtornos de Ansiedade/psicologia , Nível de Alerta/fisiologia , Sistema Nervoso Autônomo/fisiopatologia , Progressão da Doença , Dominância Cerebral/fisiologia , Emoções/fisiologia , Feminino , Humanos , Estudos Longitudinais , Imageamento por Ressonância Magnética/métodos , Masculino , Adulto Jovem
14.
Biol Psychiatry ; 80(10): 786-795, 2016 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-26682467

RESUMO

BACKGROUND: Generalized anxiety disorder (GAD) is characterized by the core symptom of uncontrollable worry. Functional magnetic resonance imaging studies link this symptom to aberrant functional connectivity between the amygdala and prefrontal cortex. Patients with GAD also display a characteristic pattern of autonomic dysregulation. Although frontolimbic circuitry is implicated in the regulation of autonomic arousal, no previous study to our knowledge combined functional magnetic resonance imaging with peripheral physiologic monitoring in these patients to test the hypothesis that core symptoms of worry and autonomic dysregulation in GAD arise from a shared underlying neural mechanism. METHODS: We used resting-state functional magnetic resonance imaging and the measurement of parasympathetic autonomic function (heart rate variability) in 19 patients with GAD and 21 control subjects to define neural correlates of autonomic and cognitive responses before and after induction of perseverative cognition. Seed-based analyses were conducted to quantify brain changes in functional connectivity with the right and left amygdala. RESULTS: Before induction, patients showed relatively lower connectivity between the right amygdala and right superior frontal gyrus, right paracingulate/anterior cingulate cortex, and right supramarginal gyrus than control subjects. After induction, such connectivity patterns increased in patients with GAD and decreased in control subjects, and these changes tracked increases in state perseverative cognition. Moreover, decreases in functional connectivity between the left amygdala and subgenual cingulate cortex and between the right amygdala and caudate nucleus predicted the magnitude of reduction in heart rate variability after induction. CONCLUSIONS: Our results link functional brain mechanisms underlying worry and rumination to autonomic dyscontrol, highlighting overlapping neural substrates associated with cognitive and autonomic responses to the induction of perseverative cognitions in patients with GAD.


Assuntos
Tonsila do Cerebelo/fisiopatologia , Transtornos de Ansiedade/fisiopatologia , Doenças do Sistema Nervoso Autônomo/fisiopatologia , Conectoma , Frequência Cardíaca/fisiologia , Córtex Pré-Frontal/fisiopatologia , Adulto , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Adulto Jovem
15.
Neuroimage Clin ; 10: 172-81, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26759791

RESUMO

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.


Assuntos
Sintomas Afetivos/patologia , Sintomas Afetivos/fisiopatologia , Transtornos de Ansiedade/patologia , Transtornos de Ansiedade/fisiopatologia , Encéfalo/patologia , Adulto , Sintomas Afetivos/complicações , Transtornos de Ansiedade/complicações , Atenção/fisiologia , Sistema Nervoso Autônomo , Feminino , Substância Cinzenta/patologia , Frequência Cardíaca , Humanos , Imageamento por Ressonância Magnética , Masculino , Entrevista Psiquiátrica Padronizada , Adulto Jovem
16.
Biol Psychol ; 119: 31-41, 2016 09.
Artigo em Inglês | MEDLINE | ID: mdl-27345596

RESUMO

Generalized anxiety disorder (GAD) is characterized by difficulties in inhibiting both perseverative thoughts (worry and rumination) and autonomic arousal. We investigated the neurobiological substrates of such abnormal inhibitory processes, hypothesizing aberrant functional coupling within 'default mode' (DMN) and autonomic brain networks. Functional imaging and heart rate variability (HRV) data were acquired from GAD patients and controls during performance of three tracking tasks interspersed with a perseverative cognition (PC) induction. After detection of infrequent target stimuli, activity within putative DMN hubs was suppressed, consistent with a redirection of attentional resources from internal to external focus. This magnitude of activity change was attenuated in patients and individuals with higher trait PC, but was predicted by individual differences in HRV. Following the induction of PC in controls, this pattern of neural reactivity became closer to that of GAD patients. Results support, at a neural level, the association between cognitive inflexibility and autonomic rigidity.


Assuntos
Transtornos de Ansiedade/fisiopatologia , Sistema Nervoso Autônomo/fisiopatologia , Cognição/fisiologia , Inibição Psicológica , Análise e Desempenho de Tarefas , Adulto , Transtornos de Ansiedade/psicologia , Nível de Alerta/fisiologia , Atenção/fisiologia , Encéfalo/fisiopatologia , Estudos de Casos e Controles , Feminino , Frequência Cardíaca/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino
17.
Front Hum Neurosci ; 10: 553, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27853428

RESUMO

Excessive and uncontrollable worry is a defining feature of Generalized Anxiety Disorder (GAD). An important endeavor in the treatment of pathological worry is to understand why some people are unable to stop worrying once they have started. Worry perseveration is associated with a tendency to deploy goal-directed worry rules (known as "as many as can" worry rules; AMA). These require attention to the goal of the worry task and continuation of worry until the aims of the "worry bout" are achieved. This study examined the association between the tendency to use AMA worry rules and neural and autonomic responses to a perseverative cognition induction. To differentiate processes underlying the AMA worry rule use from trait worry, we also examined the relationship between scores on the Penn State Worry Questionnaire (PSWQ) and neural and autonomic responses following the same induction. We used resting-state functional magnetic resonance brain imaging (fMRI) while measuring emotional bodily arousal from heart rate variability (where decreased HRV indicates stress-related parasympathetic withdrawal) in 19 patients with GAD and 21 control participants. Seed-based analyses were conducted to quantify brain changes in functional connectivity (FC) with the amygdala. The tendency to adopt an AMA worry rule was associated with validated measures of worry, anxiety, depression and rumination. AMA worry rule endorsement predicted a stronger decrease in HRV and was positively associated with increased connectivity between right amygdala and locus coeruleus (LC), a brainstem noradrenergic projection nucleus. Higher AMA scores were also associated with increased connectivity between amygdala and rostral superior frontal gyrus. Higher PSWQ scores amplified decreases in FC between right amygdala and subcallosal cortex, bilateral inferior frontal gyrus, middle frontal gyrus, and areas of parietal cortex. Our results identify neural mechanisms underlying the deployment of AMA worry rules. We propose that the relationship between AMA worry rules and increased connectivity between the amygdala and prefrontal cortex (PFC) represents attempts by high worriers to maintain arousal and distress levels in order to feel prepared for future threats. Furthermore, we suggest that neural mechanisms associated with the PSWQ represent effortful inhibitory control during worry. These findings provide unique information about the neurobiological processes that underpin worry perseveration.

18.
Curr Alzheimer Res ; 9(8): 944-52, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21592057

RESUMO

Brain task-negative networks (default mode network, DMN) and task-positive networks appear to operate largely in opposition, such that task-negative networks show activation during resting states, whilst task-positive networks are deactivated with the reverse being true during goal-oriented behavior. Altered DMN and task-positive network activity has been observed in amnestic mild cognitive impairment (aMCI) subjects. However, no study has directly linked the patterns of between-state differences in the same aMCI cohort regarding these two types of functional networks. The spatial and temporal characteristics of intrinsic, low frequency BOLD signal fluctuations both during resting state and episodic memory fMRI task were assessed in 28 aMCI subjects and 23 matched healthy controls, using a posterior cingulate cortex- based temporal correlation analysis. aMCI subjects showed impaired attenuation in the DMN between rest and task state, and greater cognitive impairment was associated with decreased ability to attenuate DMN during task engagement. Moreover, more redistributed resource from DMN appeared to be required in aMCI to maintain the similar task performance possibly to offset their inability to engage task-positive networks. In order to complete a given task, mobilized and redistributed resources of DMN appeared to replace task-positive network function to some degrees in aMCI subjects. This may represent an inability to control the switching of functional modes between these types of network.


Assuntos
Amnésia/fisiopatologia , Mapeamento Encefálico , Encéfalo/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Vias Neurais/fisiopatologia , Idoso , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Imageamento por Ressonância Magnética , Masculino , Descanso/fisiologia
19.
Clin Neurophysiol ; 123(9): 1789-97, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22425484

RESUMO

OBJECTIVES: The goal of this research was to investigate sub-band modulations in the mu domain in dyads performing different social coordination tasks. METHODS: Dyads of subjects performed rhythmic finger movement under three different task conditions: intrinsic - maintain self-produced movement while ignoring their partner's movement; in-phase - synchronize with partner; and anti-phase - maintain syncopation with partner. Movement profiles of the dyads were used to estimate a synchronization index (SI) to verify differences in coordination according to each task. EEG was recorded during task performance and at baseline (partner's actions hidden from view). Log power ratios of mu band activity (active against baseline) were used to assess the relative levels of synchronization/de-synchronization in both the upper and lower mu bands. RESULTS: Results confirm a functional dissociation of lower (8-10 Hz) and upper (10-12 Hz) mu bands in social coordination tasks. Lower mu band activity was independent of specific modulations across tasks and hemispheric preferences. Upper mu band activity was sensitive to coordination tasks and exhibited marked differences between the hemispheres. Accentuated de-synchronization of right relative to left hemisphere in the anti-phase task appeared related to the greater demand of perceptual-motor discrimination. Left hemisphere de-synchronization in both in-phase and anti-phase coordination was interpreted in terms of successful production of imitation. Right hemisphere synchronization in the intrinsic task was interpreted as inhibition of an imitative response tendency. CONCLUSIONS: Functional dissociation of lower and upper mu band and hemispheric preferences exists in real-time social coordination. SIGNIFICANCE: This research attests to the merit of analyzing sub-band activity in the alpha-mu domain in order to identify neural correlates of social coordination. Such 'neuromarkers' may be relevant for brain disorders such as apraxia and autism.


Assuntos
Mapeamento Encefálico , Encéfalo/fisiologia , Movimento/fisiologia , Periodicidade , Desempenho Psicomotor/fisiologia , Comportamento Social , Adulto , Análise de Variância , Eletroencefalografia , Feminino , Dedos/inervação , Lateralidade Funcional , Humanos , Masculino , Análise Espectral , Adulto Jovem
20.
Brain Imaging Behav ; 6(1): 49-60, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22045236

RESUMO

Hippocampus and amygdala changes have been implicated in the pathophysiology and symptomatology of both schizophrenia (SCZ) and bipolar disorder (BD). However relationships between illness course, neuropathological changes and variations in symptomatology remain unclear. This investigation examined the associations between hippocampus and amygdala volumes and symptom dimensions in schizophrenia and bipolar disorder patients after their first episode of psychosis. Symptom severity was associated with decreases in hippocampus/amygdala complex volume across groups. In keeping with previous work bilateral hippocampus and amygdala volume reductions were also identified in the SCZ patients while in BD patients only evidence of amygdala inflation reached significance. The study concludes that there appear to be important relationships between volume changes in the hippocampus and amygdala and dimensions and severity of symptomatology in psychosis. Structural alterations are apparent in both SCZ and BD after first episode of psychosis but present differently in each illness and are more severe in SCZ.


Assuntos
Tonsila do Cerebelo/patologia , Transtorno Bipolar/patologia , Hipocampo/patologia , Transtornos Psicóticos/patologia , Esquizofrenia/patologia , Adulto , Tonsila do Cerebelo/fisiopatologia , Transtorno Bipolar/fisiopatologia , Feminino , Hipocampo/fisiopatologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia , Adulto Jovem
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