In a new study from the Laureate Institute for Brain Research, researchers found an abnormal link between the heart and brain in women with a generalized anxiety disorder (GAD).
They tested 58 adult female participants (29 with GAD and 29 matching healthy comparisons).
During the study they stimulated the heart system using a medicine called isoproterenol, which mimics the effects of adrenaline but, unlike adrenaline, cannot cross the blood-brain barrier to directly impact brain activity.
The team found that women with GAD differed strongly from healthy participants on several variables, but only during the lower of two dosages of isoproterenol.
Specifically, they perceived their heartbeats to be more intense and had relatively higher heart rates and lower neural activity in the ventromedial prefrontal cortex, a brain area known to regulate the autonomic nervous system and to facilitate feelings of fear or safety.
Self-reported anxiety was much higher only for those with GAD compared to healthy participants in response to either dose.
The team says administering isoproterenol allowed them to provide causal evidence that an abnormally sensitive cardiovascular system and an abnormally insensitive frontal cortex in GAD patients lower their ability to regulate bodily arousal.
This could help to explain why they experience anxiety so frequently and in a wide variety of contexts.
The authors hope that their study prompts further research into the ventromedial prefrontal cortex as a therapeutic target for novel treatments helping individuals with GAD to regulate physiological and emotional responses to stress.
Beyond the novel link revealed by this study, it is noteworthy that cardiovascular hypersensitivity was observed for GAD patients at all.
This is because the Diagnostic and Statistical Manual of Mental Disorders (DSM–5), the standard classification system used by mental health professionals in the United States, describes autonomic symptoms such as sweating, rapid heart rate, or shortness of breath, as being less prominent in GAD than other anxiety disorders, such as panic disorder.
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The study is published in JAMA Psychiatry and was conducted by Adam Teed et al.
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