Error-Specific Cognitive Control Alterations in Generalized Anxiety Disorder.

BACKGROUND: Trait anxiety is reliably associated with enhanced neural responses following errors: meta analyses have described how the electrophysiological response to errors known as the Error-Related Negativity (ERN) is increased in anxious individuals, particularly in relation to worry. The ERN has been related to a broader class of control signals, particularly via a common theta band denominator, but it is unknown whether worry relates to these alternative medial frontal metrics. Moreover, it is unclear if increased ERN in anxiety relates to altered cognitive control.

METHODS: In this report we examine EEG activities in Generalized Anxiety Disorder (GAD, N=39) and control (CTL: N=52) participants during an executive control task. We leveraged a previously defined theta-band network to examine if an altered control signal in GAD underlies a differential implementation of cognitive control.

RESULTS: GAD and CTL groups were reliably dissociated by both error- and conflict- related neural activity, in both the time and frequency (i.e. theta band) domains. Moreover, we demonstrate that ERN, error-related theta power, and the single trial correlation between theta and response time were unique predictors of GAD status. Overall, we were able to account for nearly 1/4 of the group variance and successfully classify GAD from control participants with 2/3 accuracy.

CONCLUSIONS: Collectively, these findings suggest that multiple neural metrics of error processing may uniquely distinguish clinical anxiety from healthy individuals, and that mechanisms of control also differ in GAD; finally, these error-related neural measures have the potential to be sensitive and specific bio-signatures of anxiety.