Pre-stress functional brain connectivity is associated with subsequent anxiety during war-related stress

Individuals exposed to major real-world stressors show markedly different psychological outcomes, but whether this heterogeneity is associated with pre-existing neural characteristics remains unclear because neuroimaging is rarely performed beforehand. We acquired resting-state fMRI in healthy adults before the unforeseen onset of war-related stress. Approximately 13 months later, during ongoing war-related stress, participants (n = 31) were assessed for anxiety, depressive symptoms, perceived stress and post-traumatic stress symptoms. Among 144 associations spanning 36 predefined corticolimbic and reward-related connections and four outcomes, lower baseline functional connectivity between the right nucleus accumbens and right amygdala was associated with greater subsequent anxiety. This association survived permutation-based family-wise error correction and adjustment for baseline depressive symptoms, age and sex. These findings provide preliminary prospective evidence that pre-existing functional organization of threat- and reward-related circuitry is associated with individual differences in anxiety during prolonged adversity.