TY - JOUR
T1 - Anxiety Patients Show Reduced Working Memory Related dlPFC Activation During Safety and Threat
AU - Balderston, Nicholas L.
AU - Vytal, Katherine E.
AU - O'Connell, Katherine
AU - Torrisi, Salvatore
AU - Letkiewicz, Allison
AU - Ernst, Monique
AU - Grillon, Christian
N1 - Funding Information:
The authors report no conflicts of interest. Financial support of this study was provided by the Intramural Research Program of the National Institute of Mental Health, ZIAMH002798 (ClinicalTrial.gov Identifier: NCT00047853: Protocol ID 02-M-0321).
Publisher Copyright:
© 2016 Wiley Periodicals, Inc.
PY - 2017/1/1
Y1 - 2017/1/1
N2 - Background: Anxiety patients exhibit deficits in cognitive tasks that require prefrontal control of attention, including those that tap working memory (WM). However, it is unclear whether these deficits reflect threat-related processes or symptoms of the disorder. Here, we distinguish between these hypotheses by determining the effect of shock threat versus safety on the neural substrates of WM performance in anxiety patients and healthy controls. Methods: Patients, diagnosed with generalized and/or social anxiety disorder, and controls performed blocks of an N-back WM task during periods of safety and threat of shock. We recorded blood-oxygen-level dependent (BOLD) activity during the task, and investigated the effect of clinical anxiety (patients vs. controls) and threat on WM load-related BOLD activation. Results: Behaviorally, patients showed an overall impairment in both accuracy and reaction time compared to controls, independent of threat. At the neural level, patients showed less WM load-related activation in the dorsolateral prefrontal cortex, a region critical for cognitive control. In addition, patients showed less WM load-related deactivation in the ventromedial prefrontal cortex and posterior cingulate cortex, which are regions of the default mode network. Most importantly, these effects were not modulated by threat. Conclusions: This work suggests that the cognitive deficits seen in anxiety patients may represent a key component of clinical anxiety, rather than a consequence of threat.
AB - Background: Anxiety patients exhibit deficits in cognitive tasks that require prefrontal control of attention, including those that tap working memory (WM). However, it is unclear whether these deficits reflect threat-related processes or symptoms of the disorder. Here, we distinguish between these hypotheses by determining the effect of shock threat versus safety on the neural substrates of WM performance in anxiety patients and healthy controls. Methods: Patients, diagnosed with generalized and/or social anxiety disorder, and controls performed blocks of an N-back WM task during periods of safety and threat of shock. We recorded blood-oxygen-level dependent (BOLD) activity during the task, and investigated the effect of clinical anxiety (patients vs. controls) and threat on WM load-related BOLD activation. Results: Behaviorally, patients showed an overall impairment in both accuracy and reaction time compared to controls, independent of threat. At the neural level, patients showed less WM load-related activation in the dorsolateral prefrontal cortex, a region critical for cognitive control. In addition, patients showed less WM load-related deactivation in the ventromedial prefrontal cortex and posterior cingulate cortex, which are regions of the default mode network. Most importantly, these effects were not modulated by threat. Conclusions: This work suggests that the cognitive deficits seen in anxiety patients may represent a key component of clinical anxiety, rather than a consequence of threat.
KW - GAD/generalized anxiety disorder
KW - anxiety/anxiety disorders
KW - cognition
KW - functional MRI
KW - stress
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U2 - 10.1002/da.22518
DO - 10.1002/da.22518
M3 - Article
C2 - 27110997
AN - SCOPUS:84968645219
SN - 1091-4269
VL - 34
SP - 25
EP - 36
JO - Depression and anxiety
JF - Depression and anxiety
IS - 1
ER -