Analysis of Altered Brain Dynamics During Episodic Recall and Detection of Generalized Anxiety Disorder.

Numerous blood oxygenation level-dependent (BOLD) imaging studies have shown that generalized anxiety disorder (GAD) can lead to abnormal activation of specific brain regions in patients. However, these methods lack sufficient temporal resolution to explain the underlying brain dynamics of GAD. The electroencephalogram (EEG) microstate allows us to explore brain dynamics at the subsecond level. We performed microstate analysis and source localization on the EEG data of 15 GADs and 14 healthy controls (HCs). We found two kinds of noncanonical microstate topologies (MS-4 and MS-5) in the episodic recall tasks. Compared with HCs, the duration and coverage of MS-5 were significantly reduced in GADs and positively correlated with the GAD-7 scores. The results of source localization showed obvious activation in the prefrontal lobe, parietal lobe, temporal lobe, and fusiform gyri. Moreover, we propose an improved capsule network to capture EEG spatial features and combine them with temporal parameters of microstates for more reliable GAD detection. The sensor-level EEG data and the source-level EEG data obtained by source reconstruction are used as input to the model. The optimal configuration combined the spatial features of source-level data with microstate features and achieved the highest classification accuracy. Collectively, the statistical results indicated remarkable differences in dynamic brain parameters between the two groups, and patients with GAD may have abnormalities in their higher sensory cortex that affect the processing of anxiety signals. Furthermore, our proposed fusion framework provides a reliable method for GAD automatic detection.