Neural structures, functioning and connectivity in Generalized Anxiety Disorder and interaction with neuroendocrine systems: A systematic review

Abstract Background Research on the neurobiological basis of Generalized Anxiety Disorder (GAD) has considerably expanded in recent years. However, many studies investigated different domains and used different methods and paradigms. Therefore, this review aims to integrate the findings to date and...

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Bibliographic Details
Published in:Journal of affective disorders 2014-04, Vol.158, p.114-126
Main Authors: Hilbert, Kevin, Lueken, Ulrike, Beesdo-Baum, Katja
Format: Article
Language:English
Subjects:
Adult and adolescent clinical studies
Amygdala - physiopathology
Anxiety disorder
Anxiety Disorders - physiopathology
Anxiety disorders. Neuroses
Biological and medical sciences
Case-Control Studies
Connectivity
Cortex
Cortisol
Diagnostic and Statistical Manual of Mental Disorders
Endocrinology
fMRI
Functional connectivity
Generalized Anxiety Disorder
Generalized anxiety disorders
Gray Matter - pathology
Gray Matter - physiopathology
Humans
Medical sciences
Miscellaneous
Mood disorders
Neuroimaging
Neurosecretory Systems - physiopathology
Organ Size
Perpetuation
Prefrontal Cortex - physiopathology
Psychiatry
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Reactivity
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Summary:Abstract Background Research on the neurobiological basis of Generalized Anxiety Disorder (GAD) has considerably expanded in recent years. However, many studies investigated different domains and used different methods and paradigms. Therefore, this review aims to integrate the findings to date and to identify the core correlates of neurobiological underpinnings of GAD discovered so far. Methods We conducted a systematic review of original papers investigating neural correlates, connectivity, or structural changes as well as reporting changes in the serotonergic system, noradrenergic system and cortisol levels in DSM-IV-defined GAD samples until December 2013. Results Studies have identified abnormal amygdala and prefrontal cortex activation in patients and decreased functional connectivity between these areas. Furthermore, studies showed increased gray matter volume and decreased structural connectivity between these structures. Neuroendocrine findings are less consistent, but increased reactivity of the noradrenergic system and perpetuations in the cortisol secretion have been reported. Limitations Only studies on DSM-IV defined Generalized Anxiety Disorder which employed a group comparison were included. Conclusions Current research suggests a distinct set of neurobiological alterations in Generalized Anxiety Disorder. However, future research on the interaction between these structures and systems and on the specificity of these findings in relation to other mental disorders is urgently needed.
ISSN:0165-0327
1573-2517
DOI:10.1016/j.jad.2014.01.022