Common and disorder-specific neural activity and connectivity in generalized anxiety, panic, and social anxiety disorders.

Understanding the distinct and shared neural mechanisms of generalized anxiety disorder, panic disorder, and social anxiety disorder could help address critical gaps in anxiety disorder diagnosis and treatment. This study aimed to explore common and disorder-specific brain activity and connectivity in patients with generalized anxiety disorder, panic disorder, and social anxiety disorder using resting-state functional magnetic resonance imaging. A total of 127 adults (33 with generalized anxiety disorder, 26 with panic disorder, 36 with social anxiety disorder, and 32 healthy controls) were recruited. We found that all individuals with generalized anxiety disorder, social anxiety disorder, and panic disorder showed abnormal activity in the prefrontal-limbic-cerebellar circuit and default mode network regions. Patients with panic disorder showed unique hypoconnectivity between the default mode network and sensory-motor network, whereas patients with social anxiety disorder showed unique extensive hyperconnectivity between the default mode network and other networks. In addition, increased activity in the left orbital inferior frontal gyrus was associated with depression and anxiety symptom severity, decreased activity in the left superior temporal gyrus was associated with panic symptom severity, and decreased activity in the right fusiform gyrus was correlated with social anxiety symptom severity. These findings provide valuable implications for understanding the neuropathology, diagnosing, and developing targeted therapeutic interventions for different subtypes of anxiety disorders.