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Background: Little is known about the functional neuroanatomy underlying the processing of emotional stimuli in social phobia. Objectives: To investigate specific brain activation that is associated with the processing of threat and safety signals in social phobics. Methods: Using functional magnetic resonance imaging, brain activation was measured in social phobic and nonphobic subjects during the presentation of angry, happy and neutral facial expressions under free viewing conditions. Results: Compared to controls, phobics showed increased activation of extrastriate visual cortex regardless of facial expression. Angry, but not neutral or happy, faces elicited greater insula responses in phobics. In contrast, both angry and happy faces led to increased amygdala activation in phobics. Conclusions: The results support the hypothesis that the amygdala is involved in the processing of negative and positive stimuli. Furthermore, social phobics respond sensitively not only to threatening but also to accepting faces and common and distinct neural mechanisms appear to be associated with the processing of threat versus safety signals.

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The role of the right hemisphere for language processing and successful therapeutic interventions in aphasic patients is a matter of debate. This study explored brain activation in right-hemispheric areas and left-hemispheric perilesional areas in response to language tasks in chronic non-fluent aphasic patients before and after constraint-induced aphasia therapy (CIAT). In particular, we analysed the relation between brain responses and therapy outcome. Using functional magnetic resonance imaging (fMRI), brain activation was measured during word-reading (REA) and word-stem completion (COM) in 16 chronic non-fluent aphasic and 8 healthy subjects. Before therapy, activation in right inferior frontal gyrus/insula (IFG/IC) was stronger in aphasics compared to controls during REA and in precentral gyrus (PCG) during COM. Therapeutic intervention per se did not change brain activation for either task across all aphasic subjects. However, therapeutic success correlated with a relative decrease of activation in right-hemispheric areas, including the IFG/IC. Most importantly, initial activation in right IFG/IC and other right-hemispheric areas correlated positively with subsequent therapy success. Thus, right-hemispheric activation prior to aphasia therapy strongly predicts therapeutic success, suggesting that brain activation in chronic aphasia indicates the patients' potential for further language improvement.