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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Altered cerebral blood flow patterns associated with pathologic worry in the elderly.

Carmen Andreescu1, James J Gross, Eric Lenze

  • 1Department of Psychiatry, University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic,3811 O’Hara Street, Pittsburgh, PA, USA. Andreescuc@upmc.edu

Depression and Anxiety
|March 12, 2011
PubMed
Summary
This summary is machine-generated.

Elderly individuals with generalized anxiety disorder (GAD) show impaired brain activity in emotion regulation areas, specifically failing to engage the prefrontal cortex (PFC) during worry suppression. This suggests potential targets for new GAD treatments.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Psychiatry

Background:

  • Generalized anxiety disorder (GAD) is common in the elderly, causing significant functional and cognitive issues.
  • Late-life GAD is understudied, particularly its neuroanatomical basis.
  • Previous research in younger adults links anxiety disorders to emotion regulation system abnormalities.

Purpose of the Study:

  • To investigate the neural mechanisms of emotion regulation in elderly individuals with GAD.
  • To identify differences in brain activity between elderly GAD patients and non-anxious controls during emotion regulation tasks.

Main Methods:

  • Used functional MRI (fMRI) with pulsed arterial spin labeling perfusion to measure regional cerebral blood flow (rCBF).
  • Compared 7 elderly GAD subjects with 10 elderly non-anxious controls.
  • Measured rCBF at rest and during worry induction and suppression paradigms.

Main Results:

  • Non-anxious controls showed increased rCBF in the insula, amygdala, and temporooccipital areas during worry induction.
  • GAD subjects showed increased rCBF in temporooccipital areas but not insula or amygdala during worry induction.
  • Non-anxious controls activated prefrontal cortex (PFC) and dorsal ACC during worry suppression, while GAD subjects did not show PFC activation.

Conclusions:

  • Elderly GAD patients exhibit a failure to engage prefrontal regions crucial for downregulating negative emotions.
  • This impaired prefrontal cortex activation during worry suppression in late-life GAD may inform personalized treatment strategies.
  • Findings highlight neurobiological differences in emotion regulation for elderly GAD, distinct from younger populations.