Journal of Affective Disorders Reports (Dec 2023)
Default mode intranetwork resting-state functional connectivity is correlated with increased symptom severity in common anxiety disorders: A systematic review and meta-analysis
Abstract
Background: No study has yet to simultaneously compare generalized anxiety disorder (GAD), panic disorder (PD), and social anxiety disorder (SAD) with respect to restingstate functional connectivity (rsFC) and anxiety symptom severity. Methods: We collected articles from PubMed, PsycINFO, and ScienceDirect and subjected articles to seven eligibility criteria to be considered for inclusion. Included articles were screened using the QUADAS-2 to assess article quality. Articles were also subjected to a forest plot, activation likelihood estimation (ALE) meta-analysis, and a multiple regression to measure the effect of anxiety symptom severity and rsFC between conditions. We also subjected our sample to a funnel plot with Egger's test to determine publication bias. Results: Our initial search yielded 1022 studies. After eligibility criteria we retained 30 articles. Quality assessment indicated no major issues with bias or applicability. Our forest plot indicated that all conditions showed a robust effect on anxiety symptom severity when compared with controls. Our ALE meta-analysis showed convergent intranetwork rsFC within the default mode network (DMN) across conditions. Our multiple regression indicated that all conditions exhibited very strong correlations between DMN connectivity and anxiety symptom severity. Funnel plot and Egger's test indicated no presence of publication bias. Limitations: Our sample was limited by the following: No longitudinal data, no specific time series neuroimaging data, some biased demographic data, and the possibility that some studies might have been missed during review. Conclusion: GAD, PD, and SAD appear to exhibit increased intranetwork connectivity in the DMN which correlates with increased severity of anxiety symptoms.