Regional cerebral metabolism associated with anxiety symptoms in affective disorder patients

Background: We studied the relationship between regional cerebral metabolism and the severity of anxiety in mood disorder patients, controlling for depression severity. Methods: Fifty-two medication-free patients with unipolar or bipolar illness underwent positron emission tomography with [F-18]-fluorodeoxyglucose. Hamilton Depression Rating Scale and Spielberger Anxiety-Stare Scale scores were obtained for the week of the scan. Analyses were performed on globally normalized images and were corrected for multiple comparisons. Results: After covarying for depression scores, age, and gender, Spielberger Anxiety-Stare Scale scores correlated directly with regional cerebral metabolism in the right parahippocampal and left anterior cingulate regions, and inversely with metabolism in the cerebellum, left fusiform, left superior temporal, left angular gyrus, and left insula. in contrast, covarying for anxiety scores, age, and gender, Hamilton Depression Rating Scale scores correlated directly with regional cerebral metabolism in the bilateral medial frontal, right anterior cingulate, and right dorsolateral prefrontal cortices. Conclusions: Comorbid anxiety symptoms are associated with specific cerebral metabolic correlates that partially overlap with those in the primary anxiety disorders and differ from those associated with depression severity. (C) 2000 Society of Biological Psychiatry.