A neuroscience perspective on anxiety and its treatment: Sex differences, serotonergic pathways and genetic factors

Time period: 2010-09-01 to 2016-08-31

Project leader: Tomas Furmark

Funder: Swedish Research Council

Type of award: Project grant

Total fundning: 1 000 000 SEK

Anxiety disorders like social anxiety disorder (SAD) are very common. The aim of this project is to examine underlying neurobiological processes in anxiety and its treatment with focus on 1) Women´s increased proneness to anxiety, 2) Serotonergic imbalances, and 3) Genetic factors. Brain imaging and molecular genetic techniques will be used to examine serotonin synthesis, serotonin reuptake efficiency, anxiety related polymorphisms, and the brains´ fear network in 48 patients with SAD and 48 healthy controls. All patients will be reassessed after 9 weeks of treatment with cognitive-behavior therapy (CBT) combined with escitalopram or placebo. Positron emission tomography (PET) will be used to assess differences in serotonin signaling pathways. All participants will undergo functional and structural magnetic resonance imaging. Functional connectivity analyses based on Bayesian inference will enable comprehensive evaluation of neural networks responding to emotional stimuli. Anxiety-related abnormalities in gray matter volume and white matter tracts will be explored. Acquisition and extinction of fear conditioning will also be studied and neurobiological measures will be related to allelic variation in the serotonin transporter and tryptophan hydroxylase-2 genes. A separate study will relate gene polymorphisms to differential outcome of Internet-delivered CBT in SAD, panic disorder and depression. The goal is to develop better therapies and prevention of anxiety.