The Emotional Stroop Task In Generalized Anxiety Disorder And Panic Disorder And The Functional Magnetic Resonance Imaging Study Of Its Neural Basis

Part Ⅰ Emotional Stroop task in patients with generalizedanxiety disorder and panic disorderObjective:Use emotional Stroop task to investigate the attentional bias inpatients with generalzied anxiety disorder and panic disorder.Methods:Forty-two patients with generalzied anxiety disorder (GAD),34patients with panic disorder (PD), who confirmed with Structural Clinical Interviewfor Diagnostic and Statistical Manual of Mental Disorders, Fourth edition, textrevision (DSM-Ⅳ-TR), and46healthy controls performed emotional Stroop task.Stimuli were of four kinds:GAD-related words, panic-related words, words withneutral valence, and words with positive valence.Results:1. We didn’t found significant difference in total wrong numbersbetween patients and controls (χ2=0.722, df=2, P=0.697). Repeated measuresanalysis of variance showed an effect of word type (F3,357=4.864, P=0.002,η2=0.039), the wrong number of words with positive valence was lower than otherthree kinds words.2. The total reaction time of three groups were significantlydifferent (χ2=13.513, df=2, P=0.001).3. There were significant effects of word type(f3,357=76.181, P<0.001,η2=0.390) and group (F2,119=7.876, P=0.001,η2=0.117).The interaction of word type and group was significant (F6,357=2.197, P=0.043,η2=0.036). In patients with PD, reaction time of panic-related words was longer thanneutral words, reaction time of positive words was slower than neutral words(F3)99=35.499, P<0.001,η2=0.518). It was similar with controls (F3,135=19.954,P<0.001,72=0.307). In patients with GAD, reaction time of GAD-related words andpanic-related words were both longer than neutral words, reaction time of positivewords was slower than neutral words (F3,123=29.741, P<0.001,η2=0.408).Conclusions:Different attention biases were observed in GAD patients. Part Ⅱ The emotional Stroop:pre and post treatmentObjective:To investigate the attentional bias pre and post treatment in patients with GAD and PD.Methods:twenty-three patients with GAD,20patients with panic disorder performed emotional Stroop task before and after8weeks of treatment. Symptoms were assessed by self-rating anxiety scale (SAS), self-rating depression scale (SDS), Hamilton anxiety scale (HAMA), Hamilton depression scale-17(HAMD17), and Panic Disorder Severity Scale (PDSS).Results:1. Symptoms were reduced after treatment in two groups.2. There were no significant differences of total wrong numbers (PD:t=0.559, P=0.579; GAD: z=-1.355, P=0.176) and total reaction time (PD:z=0.570, P=0.583; GAD: t=0.692, P=0.493) before and after treatment.3. The interaction between word type and treatment was not significant in two groups for wrong numbers (PD:F3,57=0.238, P=0.870, η2=0.012; GAD:F3,66=0.804, P=0.506, η2=0.108) and reaction time (PD: F3,57=0.352, P=0.788,η2=0.059; GAD:F3,66=1.068, P=0.369, η2=0.046).3. The interference of the emotional Stroop task was not reduced after treatment in both group (PD:F1,19=0.130, P=0.732, η2=0.007; GAD:F1,22=0.573, P=0.457,η2=0.025).Conclusions:Treatment can not change the attentional bias in patients with GAD and PD. Part III Functional Magnetic Resonance Imaging study of emotional Stroop task in patient with generalized anxiety disorder and panic disorderObjective:To investigate brain function during emotional Stroop task in patients with GAD and PD.Methods:Ten patients with PD,5patients with GAD, and9controls were taken fMRI scan when performing emotional Stroop task. The activation areas in brain involved in emotional Stroop task were analyzed with Statistical Parametric Mapping8.Results:1. Compared with control subjects, patients with PD showed increased activation in hippocampus, right parahippocampa gyrus, left cingulate gyrus, caudate, right cerebellum tuber and decreased activation in right superior frontal gyrus, right inferior gyrus, right paracentral lobule, supramarginal gyrus, left postcentral gyrus, right superior parietal lobule, right inferior parietal lobule when color naming GAD-related words (vs neutral words); showed decreased activation in precentral gyrus, left middle frontal gyrus, left inferior frontal gyrus, superior temporal gyrus, right postcentral gyrus, left inferior parietal lobule, left parietal lobe precuneus, left fusiform gyrus, insula, left caudate, left cerebellum declive when color naming PD-related words (vs neutral words); showed increased activation in insula and decreased activation in right inferior parietal lobule, left inferior frontal gyrus, right middle frontal gyrus when color naming positive words (vs neutral words).2. Compared with control subjects, patients with GAD showed increases activation in right caudate, right thalamus, right pons, right cerebellum anterior lobe, right cerebellum tuber, left cerebellum declive, left cerebellum culmen and decreased activation in left superior frontal gyrus when color naming GAD-related words (vs neutral words); showed increased activation in left cerebellum anterior lobe when color naming PD-related words (vs neutral words); showed increased activation in right precentral gyrus, postcentral gyrus, right inferior parietal lobule, right precuneus, left occipital lobe cuneus, left lingual gyrus, right middle temporal gyrus, putamen, left thalamus, left cingulate gyrus, right caudate, right pons, right cerebellar tonsil when color naming positive words (vs neutral words).3. Compared with PD patients, patients with GAD showed increased activation in right parietal lobule and decreased activation in precentral gyrus, putamen, left insula when color naming GAD-related words (vs neutral words); showed increased activation in left middle frontal gyrus, right medial frontal gyrus, right precentral gyrus, postcentral gyrus, left middle occipital gyrus, left cingulate gyrus, insula, left putamen, right cerebellum culmen, right cerebellum declive when color naming PD-related words (vs neutral words); showed increased activation in right precentral gyrus, right middle frontal gyrus, right superior frontal gyrus, supramarginal gyrus, right postcentral gyrus, right middle occipital gyrus, lingual gyrus, cingulate gyrus, left ventral posterior lateral nucleus of thalamus, right medial globus pallidus, right cerebellum tuber, right cerebellum declive, left cerebellum culmen, rignt pons when color naming positive words (vs neutral words).Conclusion:1. Patients with PD showed decreased recruitment of labor control mechanism during distracting from threat-related stimuli.2. Patients with PD and GAD both showed decreased recruitment of labor control and augmented sub-labor evaluation mechanism during distracting from GAD-related stimuli.3. Patients with PD showed decreased labor function during processing positive stimuli, while Patients with GAD showed increased labor and sub-labor function compared to control subjects.