Left orbital frontal activation in pathological anxiety

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Abstract
Twelve patients with anxiety disorder were studied with respect to regional cerebral blood flow (rCBF) using a 32-detector system with the 133 Xe inhalation technique. Measurements were taken during a rest condition and during anxiety induction. Anxiety relevant to the patient's psychological disorder was induced with a projective test, the meta-contrast technique (MCT). Increased blood flow in the orbital frontal region of the left hemisphere was observed in each of the 11 subjects who showed evidence of experiencing anxiety during the procedure. In a second study four additional anxiety patients were studied with a high-resolution (254-detector)Xe rCBF system. In addition to the anxiety and resting conditions, a neutral verbalization condition was added to control for the verbal aspects of the anxiety induction procedure. The results again showed the experience of anxiety to be accompanied by increased blood flow in the left orbital frontal region, with the patients showing this flow increase to be greater in the posterior, paralimbic, areas of the region. These results are consistent with previous suggestions of left hemisphere involvement in anxiety. They also suggest that imaging methods may allow research into what appears to be exaggerated corticolimbic activity in this disorder.