The functional neuroanatomy of anxiety: A study of three disorders using positron emission tomography and symptom provocation

Scott L. Rauch, Cary R. Savage, Nathaniel M. Alpert, Alan J. Fischman, Michael A. Jenike

Research output: Contribution to journalArticle

271 Citations (Scopus)

Abstract

Previous neuroimaging research has contributed insights regarding the neural substrates of specific psychiatric disorders. The purpose of this study was to determine the shared mediating neuroanatomy of anxiety symptoms across three different anxiety disorders. Data were pooled from 23 right- handed adult outpatients meeting criteria for obsessive-compulsive disorder, simple phobia, or posttraumatic stress disorder. Relative regional cerebral blood flow (rCBF) was measured using positron emission tomography in the context of symptom provocation paradigms. Symptom severity was measured via self-reports. The analysis of pooled imaging data indicated activation in right inferior frontal cortex, right posterior medial orbitofrontal cortex, bilateral insular cortex, bilateral lenticulate nuclei, and bilateral brain stem foci during the symptomatic versus control conditions. A positive correlation was found between rCBF at one brain stem locus and subjective anxiety scores (r = .744, p < .001). These findings suggest that elements of the paralimbic belt together with right inferior frontal cortex and subcortical nuclei mediate symptoms across different anxiety disorders. In addition, activation at one brain stem locus appears to be associated with the subjective severity of anxiety. Further studies are warranted to determine whether these same brain systems mediate normal anxiety states as well.

Original languageEnglish (US)
Pages (from-to)446-452
Number of pages7
JournalBiological Psychiatry
Volume42
Issue number6
DOIs
StatePublished - Sep 15 1997

Fingerprint

Neuroanatomy
Positron-Emission Tomography
Cerebrovascular Circulation
Anxiety
Brain Stem
Regional Blood Flow
Frontal Lobe
Anxiety Disorders
Obsessive-Compulsive Disorder
Post-Traumatic Stress Disorders
Prefrontal Cortex
Neuroimaging
Cerebral Cortex
Self Report
Psychiatry
Outpatients
Brain
Research

Keywords

  • Anxiety
  • Limbic system
  • Obsessive-compulsive disorder
  • Phobia
  • Positron emission tomography
  • Posttraumatic stress disorder

ASJC Scopus subject areas

  • Biological Psychiatry

Cite this

The functional neuroanatomy of anxiety : A study of three disorders using positron emission tomography and symptom provocation. / Rauch, Scott L.; Savage, Cary R.; Alpert, Nathaniel M.; Fischman, Alan J.; Jenike, Michael A.

In: Biological Psychiatry, Vol. 42, No. 6, 15.09.1997, p. 446-452.

Research output: Contribution to journalArticle

Rauch, Scott L. ; Savage, Cary R. ; Alpert, Nathaniel M. ; Fischman, Alan J. ; Jenike, Michael A. / The functional neuroanatomy of anxiety : A study of three disorders using positron emission tomography and symptom provocation. In: Biological Psychiatry. 1997 ; Vol. 42, No. 6. pp. 446-452.
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