title: Working memory dysfunction associated with brain functional deficits and cellular metabolic changes in patients with generalized anxiety disorder.
abstract: Generalized anxiety disorder (GAD) is associated with brain functional and morphological changes in connected with emotional dysregulation and cognitive deficit. This study dealt with the neural functional deficits and metabolic abnormalities in working memory (WM) task with emotion-inducing distractors in patients with GAD. Fourteen patients with GAD and 14 healthy controls underwent functional magnetic resonance imaging (fMRI) and proton magnetic resonance spectroscopy ((1)H-MRS) at 3T. In response to the emotional distractors in WM tasks, the patients concurrently showed higher activity in the hippocampus and lower activities in the superior occipital gyrus, superior parietal gyrus, dorsolateral prefrontal cortex (DLPFC) and precentral gyrus compared to the controls. MRS revealed significantly lower choline/creatine (Cho/Cr) and choline/N-acetylaspartate (Cho/NAA) ratios in the DLPFC. In particular, the Cho ratios were positively correlated with the brain activities based on blood oxygenation level-dependent signal change in the DLPFC. This study provides the first evidence for the association between the metabolic alterations and functional deficit in WM processing with emotion-inducing distractors in GAD. These findings will be helpful to understand the neural dysfunction in connection with WM impairment 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: Department of Radiology, Rajah Muthiah Medical College Hospital, Annamalai University, Annamalai Nagar, Chidambaram, India.
authors.forename: Thirunavukkarasu
authors.initials: T
authors.lastname: Sundaram
authors.affiliation: Department of Radiology, DongShin University, Naju, Republic of Korea.
authors.forename: Nam-Gil
authors.initials: NG
authors.lastname: Choi
authors.affiliation: Research Institute for Medical Imaging, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Radiology, Chonnam National University Hospital, Chonnam Natioanl University Medical School, Gwangju, Republic of Korea. Electronic address: gwjeong@jnu.ac.kr.
authors.forename: Gwang-Woo
authors.initials: GW
authors.lastname: Jeong
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology; D001931:Brain Mapping; D016022:Case-Control Studies; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004644:Emotions; D005260:Female; D005625:Frontal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008569:Memory Disorders / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000503:physiopathology / Q000523:psychology; D008570:Memory, Short-Term / Q000502:physiology*; D008875:Middle Aged; D010296:Parietal Lobe / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D017397:Prefrontal Cortex / Q000000981:diagnostic imaging / Q000378:metabolism / Q000503:physiopathology; D066244:Proton Magnetic Resonance Spectroscopy
chemical_list: D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline
keywords: Functional magnetic resonance imaging (fMRI); Generalized anxiety disorder (GAD); Proton magnetic resonance spectroscopy ((1)H-MRS); Working memory