Cortical morphometric predictors of autonomic dysfunction in generalized anxiety disorder

Carnevali, Luca, Mancini, Matteo, Koenig, Julian, Makovac, Elena, Watson, David R, Meeten, Frances, Critchley, Hugo D and Ottaviani, Cristina (2019) Cortical morphometric predictors of autonomic dysfunction in generalized anxiety disorder. Autonomic Neuroscience: Basic and Clinical, 217. pp. 41-48. ISSN 1566-0702

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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.

Item Type: Article
Keywords: Autonomic function, Cortical thickness, Generalized anxiety disorder, Heart rate variability
Schools and Departments: Brighton and Sussex Medical School > Neuroscience
School of Psychology > Psychology
Research Centres and Groups: Sackler Centre for Consciousness Science
Subjects: Q Science > QZ Psychology
R Medicine > RZ Other systems of medicine > RZ0400 Mental healing
Related URLs:
Depositing User: Hugo Critchley
Date Deposited: 19 Feb 2019 14:29
Last Modified: 02 Jul 2019 12:56

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Project NameSussex Project NumberFunderFunder Ref
Restless mindsUnsetItalian Ministry of HealthGR2010-2312442 / GR2011-02348232