title: Striatal functional alteration during incentive anticipation in pediatric anxiety disorders.
abstract: OBJECTIVE
  Behavioral inhibition is an early childhood temperament recently associated with altered striatal response in adolescence to incentives of increasing magnitudes. Since early childhood behavioral inhibition is also associated with risk for adolescent social phobia, a similar pattern of striatal activation may manifest in social phobia. The present study compares striatal function in healthy adolescents, adolescents with social phobia, and adolescents with generalized anxiety disorder.
  
  
  METHODS
  Blood-oxygen-level-dependent signal in striatal regions was examined in 58 medication-free adolescents—14 with social phobia, 18 with generalized anxiety disorder but not social phobia, and 26 with no psychiatric disorder—matched on sex, age, puberty, IQ, and socioeconomic status. During functional magnetic resonance imaging, participants responded to incentive cues depicting potential monetary gains or losses of varying magnitudes.
  
  
  RESULTS
  While anticipating incentives of increasing magnitude, adolescents with social phobia showed increasingly heightened caudate and putamen activation at a level greater than that seen in the healthy comparison and generalized anxiety disorder groups. The generalized anxiety disorder group showed a unique valence-specific putamen response relative to the healthy comparison or social phobia group. Both patient groups displayed more complex patterns in the nucleus accumbens than in the caudate or putamen.
  
  
  CONCLUSIONS
  Caudate and putamen hypersensitivity to incentives of increasing magnitudes characterizes adolescent social phobia, relative to activation in this region in adolescents with generalized anxiety disorder as well as healthy adolescents. Thus, these findings resemble the pattern previously found in adolescents with early childhood behavioral inhibition, thereby implicating similar neural responses to anticipation of incentives in both early childhood behavioral inhibition and adolescent social phobia.
authors.affiliation: Department of Human and Community Development, Center for Mind and Brain, University of California Davis, Davis, CA, USA. aeguyer@ucdavis.edu
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Guyer
authors.forename: Victoria R
authors.initials: VR
authors.lastname: Choate
authors.forename: Allison
authors.initials: A
authors.lastname: Detloff
authors.forename: Brenda
authors.initials: B
authors.lastname: Benson
authors.forename: Eric E
authors.initials: EE
authors.lastname: Nelson
authors.forename: Koraly
authors.initials: K
authors.lastname: Perez-Edgar
authors.forename: Nathan A
authors.initials: NA
authors.lastname: Fox
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Pine
authors.forename: Monique
authors.initials: M
authors.lastname: Ernst
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000503:physiopathology; D002421:Caudate Nucleus / Q000503:physiopathology*; D002648:Child; D002652:Child Behavior / Q000502:physiology; D059907:Functional Neuroimaging / Q000379:methods; D006801:Humans; D007266:Inhibition, Psychological; D008279:Magnetic Resonance Imaging / Q000379:methods*; D011699:Putamen / Q000503:physiopathology*; D012107:Research Design; D012307:Risk Factors