Anxious individuals struggle with emotional behavior control, hindering exposure-based learning due to excessive avoidance. This study investigates the lateral frontopolar cortex (FPI), a key region for emotional action control, in highly anxious individuals. Using MRS, DWI, and fMRI, researchers found that anxious participants exhibit overexcitable FPI (higher GABA/glutamate ratio) and stronger amygdalofugal projections. However, during emotional action control, they failed to recruit FPI, instead relying on dorsolateral and medial prefrontal areas. This shift is proportional to FPI excitability and amygdala connection strength, revealing circuit-level vulnerabilities and a neural bottleneck in emotional action control.

Bob Bramson, Sjoerd Meijer, Annelies van Nuland, Ivan Toni, Karin Roelofs