The mental simulation of state/psychological stimuli in anxiety disorders: A 3T fMRI study

Mental imagery plays an important role in cognitive and emotional processes, therefore it might contribute to psychopathology in affective disorders. Distressive intrusive imagery is a core feature of anxiety disorders, but the underlying neurobiology remains unexplored. Here, we examined the functional brain mechanisms involved in state/psychological imagery in individuals with anxiety disorders.Functional Magnetic Resonance Imaging (fMRI) was used to assess the brain circuits involved in state/psychological (vs. action) imagery controlled by letter detection on the same stimuli in 33 individuals with anxiety disorders relative to 33 healthy controls.Patients were faster than controls in processing state/psychological stimuli and in general in the imagery task. We found that the left superior frontal gyrus was differentially activated by the state/psychological (vs. action) imagery (vs. letter detection) in the anxious individuals vs. healthy controls.We suggest that this area, which is involved in processing of state/psychological semantic information, appears deregulated during imagery in subjects with anxiety disorders. Our study provided the first evidence of both behavioral and brain functional alterations during imagery, highlighting a key role of the left superior frontal gyrus.