Neuroimaging

Structural and functional neuroimaging studies have been used to investigate the human neuroanatomy and neurocircuitry of specific anxiety disorders.11'15 Structural neuroimaging techniques include morphometric magnetic resonance imaging (mMRI), which allows for accurate assessment of brain structure volumes, and magnetic resonance diffusion tensor imaging, which allows for determination of white matter tract orientations. Functional imaging techniques focus on acquisition of data that reflect regional brain activity. These include positron emission tomography (PET) with tracers that measure blood flow (15O-carbon dioxide or water) or glucose metabolism (18F-fluorodeoxyglucose), single photon emission computed tomography (SPECT) with tracers that measure correlates of blood flow, and functional magnetic resonance imaging (fMRI), which measures blood oxygenation level-dependent (BOLD) signal changes. Functional imaging studies can be performed using several paradigms.11 Neutral state paradigms image subjects in a resting state while performing a nonspecific continuous task, symptom provocation paradigms image subjects in a neutral state and then again when an anxious state is induced behaviorally or pharmacologically, and cognitive activation paradigms image subjects while performing cognitive tasks.

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