Neural efficiency may predict anxiety disorder in children

A recent study has shown the potential of neural efficiency as a biomarker in paediatric anxiety disorder.

“Its association with CBT response suggests that it might aid in patient stratification and offer a target for interventions aimed at enhancing cognitive behavioural therapy (CBT) efficacy,” the investigators said.

Neural efficiency exhibited acceptable test-retest reliability (intraclass correlation coefficient, 0.65) in healthy children over 11 to 18 weeks and showed a significantly negative association with anxiety as both a diagnostic category (t=2.62; d=0.29) and a symptom dimension (r=‒0.18).

In a subset of 80 children with anxiety who underwent CBT, lower neural efficiency at baseline did not change after CBT and significantly correlated with poorer treatment response (β, ‒11.88; χ², 9.20).

This study compared 103 paediatric patients with an anxiety disorder diagnosis (mean age 12.5 years, 62 percent female) to 103 counterparts with no psychiatric diagnosis (mean age 13.4 years, 53 percent female). Participants underwent functional MRI while resting and during a dot-probe task with threatening faces.

The investigators calculated neural efficiency as partial correlations between intrinsic and task-related functional connectivity patterns across the whole brain. They also assessed the 4-month test-retest reliability, as well as associations with anxiety and response to exposure-based CBT.

Neural efficiency is defined as “similarity in functional connectivity between a threat task and rest,” according to the investigators.

“Paediatric anxiety disorders are common and predict adult psychopathology, yet current treatments, such as CBT, produce lasting remission in less than 50 percent of affected youths,” they noted.