White matter integrity alterations in first episode, treatment-naive generalized anxiety disorder

2013 ◽  
Vol 148 (2-3) ◽  
pp. 196-201 ◽  
Author(s):  
Yan Zhang ◽  
Lingjiang Li ◽  
Rongjun Yu ◽  
Jun Liu ◽  
Jinsong Tang ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
White Matter ◽  
Generalized Anxiety Disorder ◽  
White Matter Integrity ◽  
First Episode ◽  
Generalized Anxiety ◽  
Treatment Naïve

scholarly journals Disorder- and emotional context-specific neurofunctional alterations during inhibitory control in generalized anxiety disorder and major depressive disorder

2020 ◽  
Author(s):  
Congcong Liu ◽  
Jing Dai ◽  
Yuanshu Chen ◽  
Ziyu Qi ◽  
Fei Xin ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Inhibitory Control ◽  
First Episode ◽  
Generalized Anxiety ◽  
Major Depressive ◽  
Emotional Context ◽  
Dorsolateral Prefrontal ◽  
Treatment Naïve ◽  
Context Specific

AbstractBackgroundMajor Depressive (MDD) and Generalized Anxiety Disorder (GAD) are highly debilitating and often co-morbid disorders. The disorders exhibit partly overlapping dysregulations on the behavioral and neurofunctional level, and the determination of disorder-specific alterations may promote neuro-mechanistic and diagnostic specificity.MethodsIn order to determine disorder-specific alterations in the domain of emotion-cognition interactions the present study examined emotional context-specific inhibitory control in treatment-naïve, first-episode MDD (n = 37) and GAD (n = 35) patients and healthy controls (n = 35) by employing a validated affective go/no-go fMRI paradigm.FindingsOn the behavioral level MDD but not GAD patients exhibited impaired inhibitory control irrespective of emotional context. On the neural level, no alterations were observed during the positive context, yet specifically MDD patients demonstrated attenuated recruitment of a broad bilateral network encompassing inferior/medial parietal, posterior frontal, and mid-cingulate regions during inhibitory control in the negative context. GAD patients exhibited a stronger engagement of the left dorsolateral prefrontal cortex relative to MDD patients and within the GAD group better inhibitory control in negative contexts was associated with higher recruitment of this region.InterpretationFindings from the present study suggest disorder- and emotional context-specific behavioral and neurofunctional deficits in inhibitory control in MDD in negative emotional contexts and may point to a depression-specific neuropathological and diagnostic marker. In contrast, GAD patients may maintain intact inhibitory performance via compensatory recruitment of prefrontal regulatory regions.

scholarly journals Genes in immune pathways associated with abnormal white matter integrity in first-episode and treatment-naïve patients with schizophrenia

2019 ◽  
Vol 214 (5) ◽  
pp. 281-287
Author(s):  
Bo Xiang ◽  
Qiang Wang ◽  
Wei Lei ◽  
Mingli Li ◽  
Yinfei Li ◽  
...  
Keyword(s):  
White Matter ◽  
Anterior Cingulate Cortex ◽  
Genetic Variants ◽  
Rare Variants ◽  
Cingulate Cortex ◽  
Anterior Cingulate ◽  
White Matter Integrity ◽  
First Episode ◽  
Treatment Naïve ◽  
Left And Right

BackgroundPrevious studies have inferred a strong genetic component in schizophrenia. However, the genetic variants involved in the susceptibility to schizophrenia remain unclear.AimsTo detect potential gene pathways and networks associated with schizophrenia, and to explore the relationship between common and rare variants in these pathways and abnormal white matter integrity in schizophrenia.MethodThe analysis included 100 first-episode treatment-naïve patients with schizophrenia and 140 healthy controls. A network-based analysis was carried out on the data collected from the Psychiatric Genomics Consortium Phase I (PGC-I). Based on our genome-wide association study and whole-exome sequencing data-sets, we performed a gene-set analysis to detect associations between the combining effects of common and rare genetic variants and abnormal white matter integrity in schizophrenia.ResultsPatients had significantly reduced functional anisotropy in the left and right anterior cingulate cortex, left and right precuneus and extra-nuclear (t = 4.61–5.10, PFDR < 0.01), compared with controls. Generated from co-expression network analysis of the PGC-1 summary statistics of schizophrenia, a subnetwork of 207 genes associated with schizophrenia was identified (P < 0.01), and 176 genes were co-expressed in four gene modules. Functional enrichment analysis for genes in each module revealed that the yellow module was enriched with highly co-expressed, innate immune response genes. Furthermore, rare variants of enriched genes in the yellow module were associated with reduced functional anisotropy in the left anterior cingulate cortex (P = 0.006; Padjusted = 0.024) in patients only.ConclusionsThe pathogenesis of schizophrenia may be substantially influenced by genes involved in the immune system, via both pathway and network.Declaration of interestsNone.

Efficacy and Safety of Lesopitron in Outpatients with Generalized Anxiety Disorder

2000 ◽  
Vol 34 (2) ◽  
pp. 147-153 ◽  
Author(s):  
Anna Fresquet ◽  
Mariano Sust ◽  
Antonio Lloret ◽  
Michael F Murphy ◽  
Frederick J Carter ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Generalized Anxiety Disorder ◽  
Rating Scale ◽  
Fixed Dose ◽  
First Episode ◽  
Generalized Anxiety ◽  
Efficacy And Safety ◽  
Clinical Patient ◽  
Not Otherwise Specified ◽  
History Of

OBJECTIVE: To compare the relative efficacy and safety of lesopitron 40–80 mg/d versus lorazepam 2–4 mg/d and placebo in a subgroup of patients with anxiety history taken from a larger study of patients with a primary diagnosis of generalized anxiety disorder (GAD). DESIGN: Six-week, randomized, double-blind, parallel, placebo and lorazepam-controlled, Phase II, single-center, outpatient study. SETTING: Outpatient clinic. PATIENTS: One hundred sixty-one patients with GAD were randomized in the main study; 68 with a documented history of GAD or anxiety disorder not otherwise specified were included in the subgroup. METHODS: After a one-week placebo lead-in, patients were randomized to receive placebo, lesopitron, or lorazepam twice daily for six weeks, followed by a one-week taper period. Efficacy was assessed using the Hamilton Rating Scale for Anxiety (HAM-A) and the Clinical Global Impressions scale. Safety was assessed through physical examinations, monitoring of vital signs, 12-lead electrocardiograms, laboratory analyses, and adverse event monitoring. RESULTS: An overall mean improvement in the HAM-A total score between baseline and end point for all three treatment groups was seen, with mean changes of 3.4 (95% CI 2.0 to 4.8), 6.1 (95% CI 4.1 to 8.1), and 6.1 (95% CI 4.6 to 7.6) for the placebo, lesopitron, and lorazepam groups, respectively (omnibus p = 0.044, uncorrected). Positive treatment effects were also observed in the subgroup population on several other measures and suggest that additional therapeutic trials may be warranted. Future trials could be stratified on the basis of referral status (symptomatic volunteer vs. clinical patient with preexisting illness) or previous exposure to anxiolytics, and use a fixed-dose rather than flexible-fixed-dose design. CONCLUSIONS: The subgroup analysis represents a comparison of treatment outcome in GAD patients presenting with a history of previous episodes of GAD or anxiety disorder not otherwise specified compared with those who were experiencing their first episode of GAD and reported no anxiety history. Although the overall study analysis was equivocal, for the approximately 40% of patients with recurrent anxiety disorder, beneficial effects for both lesopitron and lorazepam are suggested.

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