Anxiety disorders alter cognitive-motor integration during visuomotor adaptation and retention

Anxiety disorders are associated with prefrontal dysfunction, yet their impact on neural mechanisms underlying skilled motor learning remains poorly understood. We examined movement-readiness potentials (MRPs) using electroencephalography during a visuomotor adaptation task in 31 young adults (13 with clinically diagnosed anxiety disorders, 18 controls). MRPs were analyzed across three temporal components: early motor preparation (- 1500 to - 500 ms), late motor preparation (- 500 to - 100 ms), and movement execution (- 100 to + 100 ms). Individuals with anxiety disorders showed significantly reduced MRP amplitudes during late motor preparation (p = 0.033) and movement execution (p = 0.047) compared to controls, while early motor preparation remained intact. Despite these neural alterations, both groups demonstrated equivalent behavioral performance, with similar learning and retention of a visuomotor rotation task. Anxiety disorders selectively disrupt late-stage cognitive-motor integration processes during movement preparation and execution. The dissociation between impaired neural activity and preserved behavioral performance suggests compensatory mechanisms that maintain motor learning despite underlying neural inefficiencies. These findings reveal that anxiety affects integrated systems of cognition and action, providing new insights into their functional neurophysiological impact.