Heterogeneous Brain Atrophy Sites in Anxiety Disorders Map to a Common Brain Network

Area of Science:

• Neuroimaging
• Psychiatry
• Medical Research

Background:

• Anxiety disorder research presents inconsistent findings, hindering understanding of its pathophysiology and treatment development.
• Structural MRI studies in anxiety disorders have yielded heterogeneous results.
• A unified understanding of anxiety disorder mechanisms is needed for targeted therapies.

Purpose of the Study:

• To identify a common network in anxiety disorders using structural MRI data.
• To determine if this network has therapeutic significance for anxiety.
• To investigate the potential of this network as a therapeutic target.

Main Methods:

• Systematic literature review to identify gray matter atrophy coordinates in anxiety disorder patients.
• Mapping atrophy coordinates onto an anxiety network derived from resting-state fMRI data.
• Validating the network and testing its causal link to anxiety symptoms using brain lesion data and assessing therapeutic efficacy of network-targeted rTMS.

Main Results:

• Analysis of 16 studies (453 patients) revealed a common anxiety network with the amygdala as a key hub.
• Brain lesions linked to anxiety showed increased connectivity within this network.
• Connectivity strength in the network correlated with symptom improvement after network-targeted repetitive transcranial magnetic stimulation (rTMS).

Conclusions:

• Gray matter atrophy in anxiety disorders converges on a specific network.
• This identified anxiety network may serve as a viable therapeutic target.
• Network-targeted interventions show promise for treating anxiety disorders.