A functional MRI study of amygdala responses to angry schematic faces in social anxiety disorder

Abstract

Neuroimaging studies using angry or contemptuous human facial photographic stimuli have suggested amygdala hyper-responsivity in social anxiety disorder (SAD). We sought to determine if an angry "schematic face" (simple line drawing) would evoke exaggerated amygdalar responses in SAD patients compared with healthy control (HC) subjects. Angry, happy, and neutral schematic faces were overtly presented to matched cohorts of 11 SAD and 11 HC subjects for passive viewing, whereas brain functional magnetic resonance imaging signal was measured at 1.5 Tesla. Voxel-wise analyses were performed using a random effects model in SPM99. Compared with HC subjects, SAD patients exhibited exaggerated responses in the right amygdala for the Angry versus Neutral contrast. The findings of exaggerated amygdala responses to angry schematic faces in SAD converge with results from earlier neuroimaging studies and illustrate the potential utility of schematic faces for probing amygdala function in psychiatric disorders. One prospective advantage of schematic faces is that they may minimize confounds related to gender, age, or race effects. However, extending earlier findings in healthy subjects, schematic faces appear more effective for probing amygdala responses to arousal-based (Angry versus Neutral) as opposed to valence-based (Angry versus Happy) contrasts.

Reduced Anterior Temporal and Hippocampal Functional Connectivity During Face Processing Discriminates Individuals with Social Anxiety Disorder from Healthy Controls and Panic Disorder, and Increases Following Treatment

“…Unless future studies with larger, multiracial samples confirm that these findings are robust across gender and race/ethnicity, race/ethnicity of the facial stimuli could pose an obstacle in eventually translating the current findings and methodology toward clinical use. In this case, use of schematic face stimuli could be explored to preclude any confounds due to racial bias (Evans et al, 2008).…”

Resting-State Neuroimaging Studies: A New Way of Identifying Differences and Similarities among the Anxiety Disorders?

“…These studies usually involve exposing participants to stimuli with direct diagnostic relevance to their condition. For example, pictures of spiders presented to people with a spider phobia 1 and pictures of angry faces presented to people with a social phobia 2 are common task-driven paradigms used in these research programs. Studies of this sort have shown that hyperactivation of amygdala and insula-activity strongly correlated with fear response-is common to PTSD, [3][4][5][6][7] OCD, 8 SP, [9][10][11][12] SAD, [13][14][15] and PD.…”

Hjärnan formas av psykologisk behandling

“…This suggests that the amygdala and the fear circuitry may be major players in processing emotional facial expressions, but still, the amygdala works collaboratively, and these studies suggest that amygdala couplings may also differentiate individuals with SAD from healthy controls. Interestingly, hyper-responsiveness to emotional faces differentiates SAD from other anxiety disorders (Blair et al, 2008b), and it has repeatedly been shown that social anxiety symptom severity predicts amygdala responsivity (Evans et al, 2008;Goldin, Manber, Hakimi, Canli, & Gross, 2009a;Phan, Fitzgerald, Nathan, & Tancer, 2006). Furthermore, Goldin et al (2009a) found that the differences between SAD and controls were specific to social threats (i.e., emotional faces) and that the SAD hyper-responsiveness was located in in the parahippocampal gyrus.…”

“…Typically, the participants are instructed to match two out of three faces that share a common feature, e.g., emotional valence. Such tasks are a reliable predictor of amygdala, and insula reactivity in healthy individuals (Fusar-Poli et al, 2009), and have repeatedly been shown to evoke elevated amygdala responses in SAD individuals, relative to matched healthy controls (Evans et al, 2008;Stein, Goldin, Sareen, Zorrilla, & Brown, 2002;Yoon, Fitzgerald, Angstadt, McCarron, & Phan, 2007). See also review by Schulz et al (2013).…”