title: Specifically altered brain responses to threat in generalized anxiety disorder relative to social anxiety disorder and panic disorder.
abstract: Despite considerable effort, the neurobiological underpinnings of hyper-responsive threat processing specific to patients suffering from generalized anxiety disorder (GAD) remain poorly understood. The current functional magnetic resonance imaging (fMRI) study aims to delineate GAD-specific brain activity during immediate threat processing by comparing GAD patients to healthy controls (HC), to social anxiety disorder (SAD) and to panic disorder (PD) patients.
  
  
  
  Brain activation and functional connectivity patterns to threat vs. neutral pictures were investigated using event-related fMRI. The sample consisted of 21 GAD, 21 PD, 21 SAD and 21 HC.
  
  
  
  GAD-specific elevated activity to threat vs. neutral pictures was found in cingulate cortex, dorsal anterior insula/frontal operculum (daI/FO) and posterior dorsolateral prefrontal cortex (dlPFC). Defining these effects as seed regions, we detected GAD-specific increased functional connectivity to threat vs. neutral pictures between posterior dlPFC and ventrolateral prefrontal cortex, between cingulate cortex and amygdala, between cingulate cortex and anterior insula, as well as decreased functional connectivity between daI/FO and mid-dlPFC.
  
  
  
  The findings present the first evidence for GAD-specific neural correlates of hyper-responsive threat processing, possibly reflecting exaggerated threat sensitivity, maladaptive appraisal and attention-allocation processes.
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany.
authors.forename: Christine
authors.initials: C
authors.lastname: Buff
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany.
authors.forename: Leonie
authors.initials: L
authors.lastname: Brinkmann
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany.
authors.forename: Paula
authors.initials: P
authors.lastname: Neumeister
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Feldker
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany.
authors.forename: Carina
authors.initials: C
authors.lastname: Heitmann
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany.
authors.forename: Bettina
authors.initials: B
authors.lastname: Gathmann
authors.affiliation: Institute of Psychology, University of Muenster, Fliednerstr. 21, 48149 Muenster, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Andor
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, 48149 Muenster, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Straube
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000503:physiopathology* / Q000523:psychology; D001288:Attention / Q000502:physiology; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016584:Panic Disorder / Q000503:physiopathology* / Q000523:psychology; D000072861:Phobia, Social / Q000503:physiopathology* / Q000523:psychology; D055815:Young Adult
keywords: Anterior insula; Cingulate cortex; Prefrontal cortex; RDoC; Threat processing