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Neural Abnormalities Associated with Generalized Anxiety Disorder: A Meta-Analysis of Functional Magnetic Resonance Imaging Activation Studies

Published online by Cambridge University Press:  19 July 2023

S. K. Kahlon ,
Z. Ali ,
E. Pritchard ,
S. Saravia ,
C. Baten ,
A. M. Klassen ,
J. H. Shepherd ,
G. Zamora ,
J. Jordan  and
M. Duran
...Show all authors
S. K. Kahlon*
Affiliation:
Department of Biology, Department of Psychology
Z. Ali
Affiliation:
Department of Psychology, California State University, Fresno
E. Pritchard
Affiliation:
Department of Psychology, California State University, Fresno
S. Saravia
Affiliation:
Department of Psychology, California State University, Fresno
C. Baten
Affiliation:
Department of Psychology, California State University, Fresno
A. M. Klassen
Affiliation:
Department of Psychology, California State University, Fresno
J. H. Shepherd
Affiliation:
Department of Psychology, California State University, Fresno
G. Zamora
Affiliation:
Department of Psychology, California State University, Fresno
J. Jordan
Affiliation:
Department of Biology, Department of Psychology
M. Duran
Affiliation:
Department of Psychology, California State University, Fresno
S. L. Santos
Affiliation:
Department of Psychology, California State University, Fresno
D. W. Hedges
Affiliation:
Department of Psychology, Brigham Young University, Provo, United States
J. P. Hamilton
Affiliation:
Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
M. D. Sacchet
Affiliation:
Meditation Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, United States
C. H. Miller
Affiliation:
Department of Psychology, California State University, Fresno
*
*Corresponding author.

Abstract

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Introduction

Generalized anxiety disorder (GAD) is a highly prevalent mental illness that is associated with clinically significant distress, functional impairment, and poor emotional regulation. Primary functional magnetic resonance imaging (fMRI) studies of GAD report neural abnormalities in comparison to healthy controls. However, many of these findings in the primary literature are inconsistent, and it is unclear whether they are specific to GAD or shared transdiagnostically across related disorders.

Objectives

This meta-analysis seeks to establish the most reliable neural abnormalities observed in individuals with GAD, as reported in the primary fMRI activation literature.

Methods

We conducted an exhaustive literature search in PubMed to identify primary studies that met our pre-specified inclusion criteria and then extracted relevant data from primary, whole-brain fMRI activation studies of GAD that reported coordinates in Talairach or MNI space. We then used multilevel kernel density analysis (MKDA) with ensemble thresholding to examine the differences between adults with GAD and healthy controls in order to identify brain regions that reached statistical significance across primary studies.

Results

Patients with GAD showed statistically significant (α=0.05–0.0001; family-wise-error-rate corrected) neural activation in various regions of the cerebral cortex and basal ganglia across a variety of experimental tasks.

Conclusions

These results inform our understanding of the neural basis of GAD and are interpreted using a frontolimbic model of anxiety as well as specific clinical symptoms of this disorder and its relation to other mood and anxiety disorders. These results also suggest possible novel targets for emerging neurostimulation therapies (e.g., transcranial magnetic stimulation) and may be used to advance our understanding of the effects of current pharmaceutical treatments and ways to improve treatment selection and symptom-targeting for patients diagnosed with GAD.

Disclosure of Interest

None Declared

Type
Abstract
Information
European Psychiatry , Volume 66 , Special Issue S1: Abstracts of the 31st European Congress of Psychiatry , March 2023 , pp. S452
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of the European Psychiatric Association
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