Karim HT, et al. - This study encompassed an elucidation of the distinct components of the ‘neural phenomenology’ of worry: Induction, maintenance, severity and reappraisal, with the aid of a personalized, in-scanner worry script. A distinct correlation was brought to light between severe worry and increased cerebral blood flow (CBF) in several neocortical regulatory regions. New findings were disclosed supporting the view of worry as a complex process, engaging multiple regions in the initiation, maintenance and reappraisal of worry.

Methods

• The eligible candidates consisted of 20 older, non-anxious participants and twenty late-life generalized anxiety disorder (GAD) individuals.
• Whole-brain axial pseudo-continuous arterial spin-labeling scans were collected.
• A voxel-wise two-way ANOVA inspected the group-by-block interaction.

Results

• A link was found between worry induction with greater cerebral blood flow (CBF) in the visual cortex, thalamus, caudate and medial frontal cortex compared with the rest. Reappraisal correlated with greater CBF in similar regions.
• On the other hand, the orbital frontal gyrus displayed lower CBF relative to rest.
• Relative to non-anxious participants, GAD demonstrated greater CBF in multiple regions during worry induction (visual and parietal cortex, middle and superior frontal) and lower CBF during reappraisal in the supplemental motor area, middle cingulate gyrus, insula and putamen.
• No variation was seen in CBF throughout the five blocks of worry induction and reappraisal, with the exception of the thalamus.