Enhanced Early Posterior Negativity to Fearful Faces in Patients with Anxiety Disorder.

Patients with anxiety disorders (AnDs) have distinct patterns of threat-related emotional processing compared to healthy controls (HCs). The current study investigated the temporal course of emotional processing in AnDs by examining Event-related potential (ERP) components. Twenty-three AnDs and twenty-four age- and gender-matched HCs viewed emotional (fearful, happy) and neutral faces while their electroencephalograms were recorded. Early (P100, N170), middle (early posterior negativity; EPN), and late ERP components late positive potential were analyzed. To localize ERP source activity, standardized low-resolution brain electromagnetic tomography (sLORETA) was used. AnDs displayed significantly enhanced mean amplitude of the EPN compared to HCs when fearful faces were presented. In addition, the EPN's mean amplitude elicited by fearful faces was more pronounced than for happy and neutral faces in AnDs, whereas in HCs the EPN elicited by fearful faces was only augmented compared to neutral faces. Finally, sLORETA analysis revealed that the source activity of the EPN (fearful minus happy face condition) was increased in the cuneus and precuneus in AnDs compared to HCs. Our results indicate that the EPN is a distinct ERP component modulated by facial emotional processing in AnDs. Furthermore, the results show that anxiety symptoms enhance selective attention for fearful faces. Finally, it revealed that the cuneus and precuneus are involved in fearful face processing in AnDs.