title: Functional neuroanatomy on the working memory under emotional distraction in patients with generalized anxiety disorder.
abstract: OBJECTIVE
  Patients with generalized anxiety disorder (GAD) suffer the symptoms of psychological distress, including excessive and uncontrollable anxiety. Until now, the functional neuroanatomy for working memory (WM) in conjunction with the major anxiety symptoms in GAD patients has not yet been clearly identified. This study investigated the neural activation patterns associated with the effect of neutral and anxiety-inducing distractors during the delayed-response WM task in GAD patients.
  
  
  METHODS
  Eighteen patients with GAD and 18 age-matched healthy controls participated in this study. The functional magnetic resonance images were obtained while the subjects performed a delayed-response WM task with neutral and anxiety-inducing distractors.
  
  
  RESULTS
  During the neutral distractor, GAD patients compared to controls showed significantly lower activities in the fusiform gyrus, superior parietal gyrus, precuneus, superior occipital gyrus, lingual gyrus, cuneus, calcarine gyrus, parahippocampal gyrus and cerebellar cortex. During the anxiety-inducing distractor, GAD patients showed significantly higher activity in the hippocampus, whereas they showed lower activities in the dorsolateral prefrontal cortex, fusiform gyrus, superior parietal gyrus, precuneus, superior occipital gyrus and cerebellar cortex. The blood-oxygen-level dependent signal changes in the dorsolateral prefrontal cortex in GAD patients during the anxiety-inducing distractor were negatively correlated with Anxiety Sensitivity Index-Revised scores.
  
  
  CONCLUSIONS
  This study identified the specific brain areas associated with the interaction between emotional regulation and cognitive function associated with neutral and anxiety-inducing distractors during WM maintenance in GAD patients. These findings will be helpful for understanding the neural mechanism on the WM-related cognitive deficits and emotional dysfunction with typical anxiety symptoms in GAD.
authors.affiliation: Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Chung-Man
authors.initials: CM
authors.lastname: Moon
authors.affiliation: Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea.|Department of Radiology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Gwang-Woo
authors.initials: GW
authors.lastname: Jeong
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000503:physiopathology*; D001288:Attention / Q000502:physiology*; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D008875:Middle Aged
keywords: distractor; functional magnetic resonance imaging; generalized anxiety disorder; neuroanatomy; working memory