Prefrontal Reactivity to Social Signals of Threat as a Predictor of Treatment Response in Anxious Youth
Autor: | K. Luan Phan, Gregory L. Hanna, James E. Swain, Kate D. Fitzgerald, Elizabeth Koschmann, David Simpson, Christopher S. Monk, Autumn Kujawa, Sucheta Connolly |
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Rok vydání: | 2015 |
Předmět: |
Male
medicine.medical_specialty Ventrolateral prefrontal cortex Adolescent medicine.medical_treatment Prefrontal Cortex Anger behavioral disciplines and activities Young Adult 03 medical and health sciences 0302 clinical medicine Anxiety Separation Sertraline medicine Humans Child Prefrontal cortex Psychiatry Pharmacology Brain Mapping Cognitive Behavioral Therapy medicine.diagnostic_test Separation anxiety disorder Brain Phobia Social Fear medicine.disease Magnetic Resonance Imaging 030227 psychiatry Facial Expression Dorsolateral prefrontal cortex Cognitive behavioral therapy Psychiatry and Mental health Treatment Outcome medicine.anatomical_structure Social Perception Schizophrenia Anxiety Female Original Article medicine.symptom Psychology Functional magnetic resonance imaging Facial Recognition Selective Serotonin Reuptake Inhibitors 030217 neurology & neurosurgery Clinical psychology |
Zdroj: | Neuropsychopharmacology. 41:1983-1990 |
ISSN: | 1740-634X 0893-133X |
Popis: | Neuroimaging has shown promise as a tool to predict likelihood of treatment response in adult anxiety disorders, with potential implications for clinical decision-making. Despite the relatively high prevalence and emergence of anxiety disorders in youth, very little work has evaluated neural predictors of response to treatment. The goal of the current study was to examine brain function during emotional face processing as a predictor of response to treatment in children and adolescents (age 7–19 years; N=41) with generalized, social, and/or separation anxiety disorder. Prior to beginning treatment with the selective serotonin reuptake inhibitor (SSRI) sertraline or cognitive behavior therapy (CBT), participants completed an emotional faces matching task during functional magnetic resonance imaging (fMRI). Whole brain responses to threatening (ie, angry and fearful) and happy faces were examined as predictors of change in anxiety severity following treatment. Greater activation in inferior and superior frontal gyri, including dorsolateral prefrontal cortex and ventrolateral prefrontal cortex, as well as precentral/postcentral gyri during processing of threatening faces predicted greater response to CBT and SSRI treatment. For processing of happy faces, activation in postcentral gyrus was a significant predictor of treatment response. Post-hoc analyses indicated that effects were not significantly moderated by type of treatment. Findings suggest that greater activation in prefrontal regions involved in appraising and regulating responses to social signals of threat predict better response to SSRI and CBT treatment in anxious youth and that neuroimaging may be a useful tool for predicting how youth will respond to treatment. |
Databáze: | OpenAIRE |
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