ArticlePsychology research and behavior management2026
Altered Bilateral Motor Cortex Excitability and Peripheral Glutamate/GABA Imbalance in Generalized Anxiety Disorder: A TMS Investigation.
Article in Psychology research and behavior management, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: Generalized anxiety disorder (GAD) imposes a substantial burden on individuals and society, yet its underlying neurophysiological mechanisms remain unclear. This study aimed to investigate whether GAD is associated with abnormalities in bilateral motor cortex excitability and peripheral neurochemical balance. Methods: This case-control study compared 30 unmedicated GAD patients with 30 age- and gender-matched healthy controls. Cortical excitability indices-including resting motor threshold (rMT), motor evoked potential amplitude (MEP-A) and latency (MEP-L), and cortical silent period (CSP)-were assessed using single-pulse transcranial magnetic stimulation (spTMS). Peripheral serum levels of glutamate (Glu) and gamma-aminobutyric acid (GABA) were also measured. Results: Key findings revealed a pathological imbalance in bilateral motor cortex excitability in GAD patients. This was characterized by a significant increase in left rMT (the corrected Conclusion: These results demonstrate that GAD involves systemic dysregulation across neurophysiological and neurochemical domains, featuring left-lateralized cortical hypoexcitability and right-lateralized hyperexcitability, coupled with altered peripheral glutamate-GABA balance. The combined use of TMS-derived excitability metrics and peripheral neurochemical markers may offer novel objective indicators to supplement clinical assessment in GAD. Further research is needed to establish the diagnostic specificity of these biomarkers. This study was registered with the Chinese Clinical Trial Registry (ChiCTR2200066311).
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