Neural Connectivity Subtypes Predict Discrete Attentional Bias Profiles Among Heterogeneous Anxiety Patients

Clin Psychol Sci. 2020 May 1;8(3):491-505. doi: 10.1177/2167702620906149. Epub 2020 Apr 22.

Abstract

On average, anxious patients show altered attention to threat-including early vigilance towards threat and later avoidance of threat-accompanied by altered functional connectivity across brain regions. However, substantial heterogeneity within clinical, neural, and attentional features of anxiety is overlooked in typical group-level comparisons. We used a well-validated method for data-driven parsing of neural connectivity to reveal connectivity-based subgroups among 60 adults with transdiagnostic anxiety. Subgroups were externally compared on attentional patterns derived from independent behavioral measures. Two subgroups emerged. Subgroup A (68% of patients) showed stronger executive network influences on sensory processing regions and a paradigmatic "vigilance-avoidance" pattern on external behavioral measures. Subgroup B was defined by a larger number of limbic influences on sensory regions and exhibited a more atypical and inconsistent attentional profile. Neural connectivity-based categorization revealed an atypical, limbic-driven pattern of connectivity in a subset of anxious patients that generalized to atypical patterns of selective attention.

Keywords: anxiety; attentional bias; community detection; fMRI; individual-level functional connectivity.