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The neural circuitry of anticipated aversion, fear, and anxiety is thought to involve the amygdala, insula, anterior cingulate cortex, and prefrontal cortex. In a functional MRI study, investigators examined this circuitry in 14 patients with generalized anxiety disorder (GAD) and in 12 age- and sex-matched controls. Patients, who were carefully screened to exclude other axis I diagnoses, then entered an 8-week, open-treatment phase involving extended-release venlafaxine.
During fMRI, participants received visual cues alerting them to whether, within a few seconds, they would see neutral pictures of household items or aversive photos, such as images of mutilated bodies. Compared with controls, patients showed significantly more activation in…