Archival ReportError-Specific Cognitive Control Alterations in Generalized Anxiety Disorder

BackgroundTrait anxiety is reliably associated with enhanced neural responses following errors: meta-analyses have described how the electrophysiological response to errors known as error-related negativity (ERN) is increased in anxious individuals, particularly in relation to worry. 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.MethodsWe examined electroencephalogram activities in subjects with generalized anxiety disorder (GAD) (n = 39) and control subjects (n = 52) 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.ResultsGAD and control groups were reliably dissociated by error-related and conflict-related neural activity in both time and frequency (i.e., theta band) domains. Moreover, we demonstrated 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 a quarter of the group variance and successfully classify GAD from control participants with two-thirds accuracy.ConclusionsCollectively, these findings suggest that multiple neural metrics of error processing may uniquely distinguish individuals with 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 biosignatures of anxiety.