1. The unique face of comorbid anxiety and depression: Increased frontal, insula and cingulate cortex response during Pavlovian fear-conditioning.
- Author
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Poplin T, Ironside M, Kuplicki R, Aupperle RL, Guinjoan SM, Khalsa SS, Stewart JL, Victor TA, Paulus MP, and Kirlic N
- Subjects
- Humans, Male, Female, Adult, Insular Cortex physiopathology, Insular Cortex diagnostic imaging, Middle Aged, Comorbidity, Frontal Lobe physiopathology, Frontal Lobe diagnostic imaging, Young Adult, Cerebral Cortex physiopathology, Cerebral Cortex diagnostic imaging, Anxiety physiopathology, Anxiety psychology, Fear physiology, Gyrus Cinguli physiopathology, Gyrus Cinguli diagnostic imaging, Depressive Disorder, Major physiopathology, Depressive Disorder, Major diagnostic imaging, Magnetic Resonance Imaging, Conditioning, Classical physiology, Anxiety Disorders physiopathology, Anxiety Disorders epidemiology
- Abstract
Background: Dysregulation of fear processing through altered sensitivity to threat is thought to contribute to the development of anxiety disorders and major depressive disorder (MDD). However, fewer studies have examined fear processing in MDD than in anxiety disorders. The current study used propensity matching to examine the hypothesis that comorbid MDD and anxiety (AnxMDD) shows greater neural correlates of fear processing than MDD, suggesting that the co-occurrence of AnxMDD is exemplified by exaggerated defense related processes., Methods: 195 individuals with MDD (N = 65) or AnxMDD (N = 130) were recruited from the community and completed multi-level assessments, including a Pavlovian fear learning task during functional imaging. Visual images paired with threat (conditioned stimuli: CS+) were compared to stimuli not paired with threat (CS-)., Results: MDD and AnxMDD showed significantly different patterns of activation for CS+ vs CS- in the dorsal anterior insula/inferior frontal gyrus (partial eta squared; ηp
2 = 0.02), dorsolateral prefrontal cortex (ηp2 = 0.01) and dorsal anterior/mid cingulate cortex (ηp2 = 0.01). These differences were driven by greater activation to the CS+ in AnxMDD versus MDD., Limitations: Limitations include the cross-sectional design, a scream US rather than shock and half the number of MDD as AnxMDD participants., Conclusions: AnxMDD showed a pattern of increased activation in regions identified with fear processing. Effects were consistently driven by threat, further suggesting fear signaling as the emergent target process. Differences emerged in regions associated with salience processing, attentional orienting/conflict, self-relevant processing and executive functioning in comorbid anxiety and depression, thereby highlighting potential treatment targets for this prevalent and treatment resistant group., Competing Interests: Declaration of competing interest This work has been supported in part by The William K. Warren Foundation and the National Institute of General Medical Sciences center grant award number P20GM121312. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Maria Ironside, Rayus Kuplicki, Jennifer Stewart, Robin Aupperle, and Martin Paulus receive funding from the National Institute of General Medical Sciences (NIGMS) center grant P20GM121312; Maria Ironside has additional funding from National Institute of Mental Health (NIMH; R01MH132565). Sahib Khalsa has grant funding from the NIMH (K23MH112949, R01MH127225); Robin Aupperle has additional grant funding from NIMH (K23MH108707; R01MH123691); Jennifer Stewart has additional grant funding from the National Institute of Drug Abuse (NIDA) (R01DA050677), Rayus Kuplicki has additional funding from NIDA (R01DA050677); and Martin Paulus has additional grant funding from the NIDA (U01DA041089, R01DA050677)., (Copyright © 2024. Published by Elsevier B.V.)- Published
- 2024
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