Trial reportBrain and behavior2018
Neural functional architecture and modulation during decision making under uncertainty in individuals with generalized anxiety disorder.
Trial report in Brain and behavior, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- The medial prefrontal cortex as a proposed regulatory structure in the relationship between anxiety and perceived social support: a review.BMC psychology · 2025Pooled it
- Does non-invasive brain stimulation modulate emotional stress reactivity?Social cognitive and affective neuroscience · 2020Pooled it
- Effectiveness of noninvasive brain stimulation in the treatment of anxiety disorders: a meta-analysis of sham or behaviour-controlled studies.Journal of psychiatry & neuroscience : JPNPooled it
- Neural functional architecture and modulation during decision making under uncertainty in individuals with generalized anxiety disorder.Brain and behavior · 2018Trial
- Neural Correlates of Uncertainty Processing During Decision-Making in Individuals with Different Levels of Worry Proneness.Behavioral sciences (Basel, Switzerland) · 2026Article
- Severe bradycardia triggered by repetitive transcranial magnetic stimulation in a patient with major depressive disorder and premature ventricular contractions: a case report.BMC psychiatry · 2025Article
- Beyond Pharmacology: A Narrative Review of Alternative Therapies for Anxiety Disorders.Diseases (Basel, Switzerland) · 2024Review
- Effects of repetitive transcranial magnetic stimulation and their underlying neural mechanisms evaluated with magnetic resonance imaging-based brain connectivity network analyses.European journal of radiology open · 2023Review
- ENIGMA-anxiety working group: Rationale for and organization of large-scale neuroimaging studies of anxiety disorders.Human brain mapping · 2022Review
- Brain network effects by continuous theta burst stimulation in mal de débarquement syndrome: simultaneous EEG and fMRI study.Journal of neural engineering · 2021Article
- Cortical and subcortical brain structure in generalized anxiety disorder: findings from 28 research sites in the ENIGMA-Anxiety Working Group.Translational psychiatry · 2021Article
- Toward a neurocircuit-based taxonomy to guide treatment of obsessive-compulsive disorder.Molecular psychiatry · 2021Review
- Reduced neural differentiation of rewards and punishment during passive avoidance learning in adolescents with generalized anxiety disorder.Depression and anxiety · 2021Article
- The electrophysiology correlation of the cognitive bias in anxiety under uncertainty.Scientific reports · 2020Observational
- Efficacy and safety of repetitive transcranial magnetic stimulation for generalised anxiety disorder: A meta-analysis.General psychiatry · 2019Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRecent evidence suggests that repetitive transcranial magnetic stimulation (rTMS) might be effective in treating generalized anxiety disorder (GAD). Cognitive models of GAD highlight the role of intolerance of uncertainty (IU) in precipitating and maintaining worry, and it has been hypothesized that patients with GAD exhibit decision-making deficits under uncertain conditions. Improving understanding of the neural mechanisms underlying cognitive deficits associated with IU may lead to the identification of novel rTMS treatment targets and optimization of treatment parameters. The current report describes two interrelated studies designed to identify and verify a potential neural target for rTMS treatment of GAD.
methodsStudy I explored the integrity of prefrontal cortex (PFC) and amygdala neural networks, which underlie decision making under conditions of uncertainty, in GAD. Individuals diagnosed with GAD (n = 31) and healthy controls (n = 20) completed a functional magnetic resonance imaging (fMRI) gambling task that manipulated uncertainty using high versus low error rates. In a subsequent randomized-controlled trial (Study II), a subset of the GAD sample (n = 16) completed the fMRI gambling task again after 30 sessions of active versus sham rTMS (1 Hz, right dorsolateral prefrontal cortex) to investigate the modulation of functional networks and symptoms.
resultsIn Study I, participants with GAD demonstrated impairments in PFC-PFC and PFC-amygdala functional connectivity (FC) mostly during the high uncertainty condition. In Study II, one region of interest pair, dorsal anterior cingulate (ACC) - subgenual ACC, showed "normalization" of FC following active, but not sham, rTMS, and neural changes were associated with improvement in worry symptoms.
conclusionsThese results outline a possible treatment mechanism of rTMS in GAD, and pave the way for future studies of treatment optimization.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.