School of Medicine Publications and Presentations

A systematic review and meta-analysis of resting-state fMRI in anxiety disorders: Need for data sharing to move the field forward

Document Type


Publication Date




  • There are numerous studies investigating rs-fMRI and anxiety; however, the methodologies are inconsistent.

  • Anxiety patients show hypoconnectivity between the amygdala and the medial prefrontal cortex.

  • This finding is not robust against possible publication bias. Thus, no strong findings manifest in available literature.

  • More studies are needed with standardized methods and larger sample sizes.


Anxiety disorders are among the most prevalent psychiatric disorders. Neuroimaging findings remain uncertain, and resting state functional magnetic resonance (rs-fMRI) connectivity is of particular interest since it is a scalable functional imaging modality. Given heterogeneous past findings for rs-fMRI in anxious individuals, we characterize patterns across anxiety disorders by conducting a systematic review and meta-analysis. Studies were included if they contained at the time of scanning both a healthy group and a patient group. Due to insufficient study numbers, the quantitative meta-analysis only included seed-based studies. We performed an activation likelihood estimation (ALE) analysis that compared patients and healthy volunteers. All analyses were corrected for family-wise error with a cluster-level threshold of p < .05. Patients exhibited hypo-connectivity between the amygdala and the medial frontal gyrus, anterior cingulate cortex, and cingulate gyrus. This finding, however, was not robust to potential file-drawer effects. Though limited by strict inclusion criteria, our results highlight the heterogeneous nature of reported findings. This underscores the need for data sharing when attempting to detect reliable patterns of disruption in brain activity across anxiety disorders.


Original published version available at

Publication Title

Journal of anxiety disorders



Academic Level


Mentor/PI Department

Office of Human Genetics