The Startle-Evoked Potential: Negative Affect and Severity of Pathology in Anxiety/Mood Disorders

Biol Psychiatry Cogn Neurosci Neuroimaging. 2018 Jul;3(7):626-634. doi: 10.1016/j.bpsc.2017.07.006. Epub 2017 Aug 8.

Abstract

Background: The National Institute of Mental Health Research Domain Criteria initiative encourages a search for dimensional biological measures of psychopathology unconstrained by current diagnostic categories. Consistent with this aim, the presented research studies a large sample of anxiety and mood disorder patients, assessing differences in principal diagnoses and comorbidity patterns, clinicians' ratings, and questionnaire measures of negative affect and life dysfunction as they relate to a potential brain marker of pathology: the amplitude of the event-related potential (ERP) elicited by a startle-evoking stimulus.

Methods: Patients seeking evaluation or treatment for anxiety and mood disorders (N = 208) participated in two tasks at the University of Florida (Gainesville, FL): 1) imagining emotional and neutral events and 2) viewing emotional and neutral pictures while acoustic startle probes were presented and the ERP was recorded. For a comparison patient group (N = 120), startle probes were administered and ERPs recorded at the University of Greifswald (Greifswald, Germany) while performing the same imagery task.

Results: Reduced positive amplitude of a centroparietal startle-evoked ERP (156-352 ms after onset) significantly predicted higher questionnaire scores of anxiety/depression, reports of increased life dysfunction, greater comorbidity, and clinician ratings of heightened severity and poorer prognosis. The effect was general across principal diagnoses, found for both the Florida and German samples, and consistent in pattern despite differences in the tasks administered.

Conclusions: The startle-evoked ERP reliably predicts severity and breadth of psychopathology, independent of task context. It is a potential significant contributor to a needed array of biological measures that might improve classification of anxiety and mood disorders.

Keywords: Anxiety disorders; Comorbidity; ERP; Mood disorders; RDoC; Startle reflex.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety Disorders / physiopathology*
  • Auditory Perception / physiology
  • Cerebral Cortex / physiopathology*
  • Electroencephalography
  • Evoked Potentials / physiology*
  • Female
  • Humans
  • Male
  • Mood Disorders / physiopathology*
  • Pattern Recognition, Visual / physiology
  • Reflex, Startle / physiology*
  • Severity of Illness Index*