Selective reduction in amygdala volume in pediatric anxiety disorders: A voxel-based morphometry investigation

doi:10.1016/j.biopsych.2005.01.038

Biological Psychiatry

Volume 57, Issue 9, 1 May 2005, Pages 961-966

https://doi.org/10.1016/j.biopsych.2005.01.038 Get rights and content

Background

Significant controversy has emerged concerning pediatric anxiety disorders. Some researchers question the justification for diagnosing and treating pediatric anxiety disorders, owing to concerns about the inappropriate medicalization of social problems. Others note the importance of diagnosis and treatment, given that pediatric anxiety disorders represent a strong risk factor for serious adult mental disorders. We examine the neural correlates of pediatric anxiety disorders, to consider the validity of the categorization scheme used in recent treatment studies.

Methods

Using inclusion criteria derived from recent treatment trials, we compared gray matter volume throughout the brain in children with and without anxiety. Morphometric analyses used optimized voxel-based morphometry, an automated method for examining structural changes throughout the brain.

Results

Reductions in left amygdala gray matter volume were noted for patients with anxiety disorders relative to comparison subjects.

Conclusions

We discuss implications of these findings for current controversies.

Section snippets

Participants

We studied two groups: 17 patients with an anxiety disorder and 34 comparison subjects. Groups were matched (1:2 patient/comparison subject ratio) on age (anxiety: 12.9 ± 2.3 years; control subjects: 12.4 ± 2.2 years), gender (anxiety: 9 female, 8 male; control subjects: 18 female, 16 male), and intelligence quotient (IQ) (patients: 112 ± 12; comparison subjects: 113 ± 12). Of 17 patients, 9 met criteria for social phobia, 3 for separation anxiety disorder, and 13 for GAD. Comparison subjects

Results

Our primary analysis contrasted the amygdala in anxiety patients and comparison subjects. Voxelwise comparison of PVEs revealed a statistically significant reduction in gray matter volume centered in the left amygdala (t = 4.04; p < .006, corrected; x = −21, y = −2, z = −18) (see Figure 1). No additional differences were noted; however, there was a corresponding reduction in gray matter volume within the right amygdala, (t = 2.13, p < .05, uncorrected, x = 24, y = −8, z = −8). This right-sided

Discussion

Using inclusion criteria from treatment studies, this study demonstrated morphometric abnormalities within the amygdala, a region commonly implicated in mediating emotional responses. More specifically, VBM analyses demonstrated significant gray matter volume reductions within the left amygdala in pediatric anxiety disorders. These findings are consistent with predictions from animal models.

Recent questions have arisen concerning both the validity and clinical application of diagnostic criteria

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Original articlesSelective reduction in amygdala volume in pediatric anxiety disorders: A voxel-based morphometry investigation

Background

Methods

Results

Conclusions

Section snippets

Participants

Results

Discussion

Biol Psychiatry

Neuroimage

J Am Acad Child Adolesc Psychiatry

Neuroimage

Biol Psychiatry

Biol Psychiatry

Biol Psychiatry

Neuroimage

Neuroimage

Med Image Anal

J Am Acad Child Adolesc Psychiatry

Biol Psychiatry

Neuroimage

The Pediatric Anxiety Rating Scale (PARS)Cevelopment and psychometric properties

J Am Acad Child Adolesc Psychiatry

Cognitive-behavioral treatment of anxiety disorders in childrenLong-term (6-year) follow-up

J Consult Clin Psychol

Drug treatment of anxiety disorders in children

N Engl J Med

Neural systems supporting interoceptive awareness

Nat Neurosci

Dysfunction in the neural circuitry of emotion regulation—a possible prelude to violence

Science

Original articles
Selective reduction in amygdala volume in pediatric anxiety disorders: A voxel-based morphometry investigation