ArticleThe American journal of psychiatry2026
Reduced Threat-Related Neural Efficiency: A Possible Biomarker for Pediatric Anxiety Disorders.
Article in The American journal of psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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4 citing papers in PubMed.
- A large-scale heterogeneous 3D magnetic resonance brain imaging dataset for self-supervised learning.Scientific data · 2026Article
- Personality Heterogeneity Shapes the Neural Organization of Conditioned Threat Learning.Research square · 2026Article
- Developmental stability of task-rest neural efficiency in youth using a threat and cognitive control task.Frontiers in human neuroscience · 2026Article
- Neural Efficiency as a Brain-Wide Signature of Pediatric Anxiety and a Biomarker for Treatment Response.The American journal of psychiatry · 2026Article
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11 authors.
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Abstract
objectivePediatric anxiety disorders are common and predict adult psychopathology, yet current treatments, such as cognitive-behavioral therapy (CBT), produce lasting remission in less than 50% of affected youths. To support the search for improved, mechanistically grounded interventions, this study evaluated neural efficiency, defined as similarity in functional connectivity between a threat task and rest, as a potential biomarker. The study evaluated neural efficiency in relation to anxiety diagnosis and treatment response.
methodsThe authors compared 103 youths with an anxiety disorder diagnosis (mean age, 12.5 years [SD=2.91], 62% female) to 103 youths with no psychiatric diagnosis (mean age, 13.4 years [SD=2.58], 53% female). Participants completed functional MRI while resting and during a dot-probe task with threatening faces. Neural efficiency was calculated as partial correlations between intrinsic and task-related functional connectivity patterns across the whole brain. Four-month test-retest reliability as well as relationships with anxiety and response to exposure-based CBT were examined.
resultsNeural efficiency demonstrated satisfactory test-retest reliability (intraclass correlation coefficient=0.65) in healthy youths over a period of 11 to 18 weeks. Neural efficiency was significantly negatively related to anxiety as both a diagnostic category (t=2.62, d=0.29) and a symptom dimension (r=-0.18). Although it did not change after CBT, lower neural efficiency at baseline was significantly associated with poorer treatment response in a subset of 80 anxious youths who underwent CBT (β=-11.88, χ
conclusionsNeural efficiency, measured as network reconfiguration between rest and task, holds promise as a biomarker in pediatric anxiety. Its association with CBT response suggests that it might aid in patient stratification and offer a target for interventions aimed at enhancing CBT efficacy.
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