The effect of parietal glutamate/GABA balance on test anxiety levels in early childhood in a cross-sectional and longitudinal study.

George Zacharopoulos,Roi Cohen Kadosh,Uzay Emir,Kathrin Cohen Kadosh,Francesco Sella

doi:10.1093/cercor/bhab412

Abstract

The increased prevalence of test anxiety in our competitive society makes it a health issue of public concern. However, its neurobiological basis, especially during the years of formal education, is currently scant. Previous research has highlighted the association between neural excitation/inhibition balance and psychopathology and disease. We examined whether the glutamate/GABA profile tracks test anxiety levels in development, using a cross-sectional and longitudinal design in a cohort spanning from early childhood to early adulthood (N = 289), reassessed approximately 21 months later (N = 194). We used magnetic resonance spectroscopy to noninvasively quantify glutamate and gamma-Aminobutyric acid (GABA) levels in the intraparietal sulcus (IPS) and the middle frontal gyrus. We show that the glutamate/GABA balance within the IPS relates to current individual variation in test anxiety levels and predict future test anxiety approximately 21 months later. Critically, this relationship was observed during early childhood but not during the later developmental stages. Our results extend the use of the excitation/inhibition balance framework to characterize the psychopathology mechanisms of test anxiety, an underexplored yet widespread and debilitating condition that can impact early child development. Our findings provide a better understanding of the neurotransmitter basis underlying the emergence of anxiety disorders during development.

Highlights

Anxiety disorders are a class of mental-health disorders characterized by excessive worry, which typically cause clinically significant distress or impairments in social, occupational, or other vital areas of functioning (American Psychiatric Association 2013)
We found that the intraparietal sulcus (IPS) glutamate/gamma-Aminobutyric acid (GABA) is a significant predictor of TA during early childhood only (β = −0.5, t(249) = −2.01, SE = 0.22, P = 0.022, 95% CI = [−0.93, −0.08]
We showed that IPS glutamate/GABA balance predicted future TA in early childhood

Summary

Introduction

Anxiety disorders are a class of mental-health disorders characterized by excessive worry, which typically cause clinically significant distress or impairments in social, occupational, or other vital areas of functioning (American Psychiatric Association 2013). High TA has a debilitating effect on learning and academic performance, including standardized tests, university entrance exams, and grade point average (Mandler and Sarason 1952; Sarason and Mandler 1952; Hembree 1988; Bedell and Marlowe 1995; von der Embse et al 2018). The negative consequences of TA extend beyond the academic setting, including fear of negative evaluation, low selfesteem, blame assignment, and subsequent risk for anxiety and depression (Hembree 1988; Leadbeater et al 2012). TA’s prevalence is increasing due to the pressure and demands of increased testing (McDonald 2001). There is a pressing need for characterizing the underlying roots that give rise to TA during human development (Allen et al 2020)

Objectives

Methods

Results

Conclusion