Disruption of functional and structural networks in first-episode, drug-naïve adolescents with generalized anxiety disorder.

BACKGROUND: Individuals with generalized anxiety disorder (GAD) tend to worry exaggeratedly and uncontrollably about various daily routines. Previous studies have demonstrated that the GAD patients exhibited widespread alternations in both functional networks (FN) and structural networks (SN). However, the simultaneous alternations of the topological organization of FN, SN, as well as their couplings in GAD still remain unknown. METHODS: Using multimodal approach, we constructed FN from resting-state functional magnetic imaging (R-fMRI) data and SN from diffusion magnetic resonance imaging (dMRI) data of 32 adolescent GAD patients and 25 healthy controls (HC). Graph theory analysis was employed to investigate the topological properties of FN, SN, and FN-SN coupling. RESULTS: Compared to HC, the GAD patients showed disruptions in global (i.e., decreased clustering coefficient, global, and local efficiency) and subnetwork (i.e., reduced intermodular connections, rich club, and feeder connections) levels in FN. Abnormal global level properties (i.e., increased characteristic path length and reduced global efficiency) were also observed in SN. Altered FN-SN couplings in normalized characteristic path length and feeder connections were identified in the GAD patients. The identified network measures were correlated with anxiety severity in the GAD patients. LIMITATIONS: The sample size of the current study is small and the cross-sectional nature can not infer causal relationship. CONCLUSIONS: Our findings identified GAD-related topological alternations in both FN and SN, together with the couplings between FN and SN, providing us with a novel perspective for understanding the pathophysiological mechanisms of GAD.

The Relationship Between Symptoms of Anxiety and Somatic Symptoms in Health Professionals During the Coronavirus Disease 2019 Pandemic.

BACKGROUND: The pandemic of coronavirus disease 2019 (COVID-19) has posed a threat to global health. Increasing studies have shown that the mental health status of health professionals is very poor during the COVID-19 epidemic. At present, the relationship between somatic symptoms and symptoms of anxiety of health professionals during the COVID-19 has not been reported. The purpose of this study was to explore the frequency of somatic symptoms and its related factors in health professionals with symptoms of anxiety during COVID-19 in China. METHODS: A total of 606 health professionals were assessed online with the Chinese version of the 7-item Generalized Anxiety Disorder (GAD-7) scale, 7-item Insomnia Severity Index (ISI) and the somatization subscale of Symptom Checklist 90 (SCL-90). RESULTS: The percentage of symptoms of anxiety, somatic symptoms and insomnia in all health professionals was 45.4%, 12.0%, and 32%, respectively. The frequency of somatic symptoms in health professionals with symptoms of anxiety was 22.9%. The SCL-90 somatization subscale score was significantly positively correlated with history of somatic diseases, GAD-7 score and ISI score in participants with symptoms of anxiety. CONCLUSION: During the COVID-19, symptoms of anxiety, insomnia, and somatic symptoms are commonly observed in health professionals. Insomnia and symptoms of anxiety are independently associated with somatic symptoms of health professionals with symptoms of anxiety.

White matter structural network disturbances in first-episode, drug-naïve adolescents with generalized anxiety disorder.

BACKGROUND: Previous studies have suggested that individuals with generalized anxiety disorder (GAD) would show inefficient whole-brain communication and dysconnectivity in the fronto-parietal-subcortical sub-networks in the white matter (WM) structural network. However, these hypotheses have yet to be tested. METHODS: Individual WM structural networks were constructed based on diffusion MRI data and deterministic tractography in 34 first-episode, medication-naïve adolescents with GAD and 27 healthy controls (HCs). Graph theory was applied to investigate the topological organization alterations of the structural network. RESULTS: GAD patients showed disrupted small-world configurations (i.e., increased path length and decreased clustering coefficient) and hub organization (i.e., less connection strength in the feeder and local connections). A decreased connection strength was found in a GAD-related sub-network (mainly involving the frontal-subcortical circuits), which was able to distinguish GAD patients from HCs with higher accuracy (area under the curve of 0.96, sensitivity of 94%, specificity of 89%) than clinical scores and other topological alternations. LIMITATIONS: The current study just compared GAD patients with HCs based on a small sample, leaving whether the alternations found here are specific to GAD still an open question. Future studies are recommended to recruit patients with other anxiety disorders (e.g., social anxiety disorder) and/or comorbid mood disorders to identify the GAD-specific WM alterations using a larger sample. CONCLUSIONS: Our findings highlight the disruption of the topological organization of the whole-brain WM structural network (especially the frontal-subcortical circuits) in GAD, and suggest the potential of using structural connectivity of the GAD-related sub-network as a biomarker for GAD patients.

Decreased Intrinsic Functional Connectivity in First-Episode, Drug-Naive Adolescents With Generalized Anxiety Disorder.

Generalized anxiety disorder (GAD) is characterized by excessive and uncontrollable worry about everyday life. Prior neuroimaging studies have demonstrated that GAD is associated with disruptions in specific brain regions; however, little is known about the global functional connectivity maps in adolescents with GAD. Here, first-episode, medication-naive, adolescent GAD patients (N = 36) and healthy controls (N = 28) (HCs) underwent resting-state functional MRI (R-fMRI) and completed a package of questionnaires to assess clinical symptoms. Functional connectivity strength and seed-based functional connectivity were employed to investigate the functional connectivity architecture. GAD patients showed reduced functional connectivity strength in right supramarginal gyrus (SMG) and right superior parietal gyrus (SPG) compared with HCs. Further seed-based functional connectivity analysis revealed that GAD patients displayed decreased functional connectivity between right SMG and left fusiform gyrus, inferior temporal gyrus, parahippocampal gyrus, bilateral precuneus and cuneus, and between right SPG and bilateral supplementary motor area and middle cingulate gyrus, as well as between the SMG-based network and the SPG-based network. Moreover, the disrupted intra-network connectivity (i.e., the SMG-based network and the SPG-based network) and inter-network connectivity between the SMG-based network and the SPG-based network accounted for 25.5% variance of the State and Trait Anxiety Inventory (STAI) and 39.5% variance of the trait subscale of STAI. Our findings highlight the abnormal functional architecture in the SMG-based network and the SPG-based network in GAD, providing novel insights into the pathological mechanisms of this disorder.