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Cortical morphometric predictors of autonomic dysfunction in generalized anxiety disorder.

  • Carnevali L Stress Physiology Lab, Department of Chemistry, Life Sciences and Environmental Sustainability, University of Parma, Italy.
  • Mancini M Centre for Medical Image Computing, University College London, London, UK.
  • Koenig J Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
  • Makovac E Centre for Neuroimaging Science, King's College London, London, UK.
  • Watson DR Clinical Imaging Sciences Centre, Brighton and Sussex Medical School, University of Sussex, Falmer, UK.
  • Meeten F School of Psychology, University of Sussex, Falmer, UK.
  • Critchley HD Psychiatry, BSMS Department of Neuroscience, Brighton and Sussex Medical School (BSMS), University of Sussex, Falmer, UK.
  • Ottaviani C Department of Psychology, Sapienza University of Rome, Italy; Neuroimaging Laboratory, Santa Lucia Foundation, Rome, Italy. Electronic address: cristina.ottaviani@uniroma1.it.
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  • 2019-02-02
Published in:
  • Autonomic neuroscience : basic & clinical. - 2019
Autonomic function
Cortical thickness
Generalized anxiety disorder
Heart rate variability
Adult
Anxiety Disorders
Autonomic Nervous System Diseases
Emotional Regulation
Female
Gyrus Cinguli
Heart Rate
Humans
Magnetic Resonance Imaging
Prefrontal Cortex
English 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.
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  • English
Open access status
green
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https://sonar.ch/global/documents/278773
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