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A Novel Cognitive Training Program Targets Stimulus-Driven Attention to Alter Symptoms, Behavior, and Neural
Andrew T Drysdale1,2, Michael J Myers3, Jennifer C Harper3
1Molecular Imaging and Neuropathology, New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, New York, USA.
Insights
This study shows that attention training can reduce anxiety in children by improving their attention control and decreasing activity in a specific brain region. This approach offers a new way to treat pediatric anxiety disorders.
Area of Science:
- Neuroscience
- Developmental Psychology
- Clinical Psychology
Background:
- Pediatric anxiety is linked to heightened stimulus-driven attention (SDA), an involuntary focus on stimuli.
- This increased SDA correlates with greater activity in the right ventrolateral prefrontal cortex (rVLPFC), particularly the ventral attention network (VAN).
Purpose of the Study:
- To evaluate a novel attention training program designed to reduce pediatric anxiety.
- The program aimed to decrease stimulus-driven attention (SDA) and associated right ventrolateral prefrontal cortex (rVLPFC) activity.
Main Methods:
- Eight sessions of attention training over 4 weeks for 18 children (ages 8-12) with anxiety disorders.
- Assessed clinical anxiety, SDA, goal-oriented attention, and threat bias via cognitive tasks.
- Utilized neuroimaging (fMRI) in a subset of 12 participants to examine rVLPFC activity pre- and post-training.
Main Results:
- Significant reductions in parent, child, and clinician-rated anxiety were observed.
- Attention training successfully altered stimulus-driven attention (SDA).
- Reduced activity in the cingulo-opercular network (CON) portion of the rVLPFC correlated with decreased anxiety post-training.
Conclusions:
- Attention training is a promising intervention for pediatric anxiety.
- Modulating SDA and rVLPFC activity represents a potential therapeutic target for anxiety disorders.
- The findings suggest that targeting attention mechanisms can alleviate anxiety symptoms and alter relevant neural circuitry.
Abstract:
Objective: Pediatric anxiety disorders are associated with increased stimulus-driven attention (SDA), the involuntary capture of attention by salient stimuli. Increased SDA is linked to increased activity in the right ventrolateral prefrontal cortex (rVLPFC), especially in the portion corresponding to the ventral attention network (VAN). In this study, we present a small clinical trial using a novel attention training program designed to treat pediatric anxiety by decreasing SDA and activity in the rVLPFC. Methods: Children ages 8-12 with anxiety disorders (n = 18) participated in eight sessions of attention training over a 4-week period. At baseline and after completing training, participants completed clinical anxiety measures and a battery of cognitive tasks designed to measure three different aspects of attention: SDA, goal-oriented attention, and threat bias. A subset of participants (n = 12) underwent baseline and post-training neuroimaging while engaged in an SDA task. Brain analyses focused on activity within the rVLPFC. Results: Parent (p < 0.001)-, child (p < 0.002)-, and clinician-rated (p < 0.02) anxiety improved significantly over the course of training. Training significantly altered SDA [F(1,92) = 8.88, corrected p-value (pcor) < 0.012, uncorrected p-value (puncor) < 0.004]. Anxiety improvement correlated with improvements in goal-directed attention [r(10) = 0.60, pcor < 0.12 puncor < 0.04]. Within an area of the rVLPFC corresponding to the cingulo-opercular network (CON), there was a main effect of training [F(1,20) = 6.75, pcor < 0.16, puncor < 0.02], with decreasing signal across training. There was a significant interaction between training and anxiety on this region's activity [F(1,20) = 9.48, pcor < 0.048, puncor < 0.006]. Post hoc testing revealed that post-training activity within this CON area correlated with residual anxiety [r(10) = 0.68, p < 0.02]. Conclusions: SDA and rVLPFC neural activity may be novel therapeutic targets in pediatric anxiety. After undergoing a training paradigm aimed at modifying this aspect of attention and its underlying neural circuitry, patients showed lower anxiety, changes in SDA and goal-oriented attention, and decreased activity in the CON portion of the rVLPFC.
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