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
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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