Area-dependent time courses of brain activation during video-induced symptom provocation in social anxiety disorder

Abstract

BackgroundPrevious functional imaging studies using symptom provocation in patients with social anxiety disorder (SAD) reported inconsistent findings, which might be at least partially related to different time-dependent activation profiles in different brain areas. In the present functional magnetic resonance imaging study, we used a novel video-based symptom provocation design in order to investigate the magnitude and time course of activation in different brain areas in 20 SAD patients and 20 healthy controls.ResultsThe disorder-related videos induced increased anxiety in patients with SAD as compared to healthy controls. Analyses of brain activation to disorder-related versus neutral video clips revealed amygdala activation during the first but not during the second half of the clips in patients as compared to controls. In contrast, the activation in the insula showed a reversed pattern with increased activation during the second but not during the first half of the video clips. Furthermore, a cluster in the anterior dorsal anterior cingulate cortex showed a sustained response for the entire duration of the videos.ConclusionsThe present findings suggest that different regions of the fear network show differential temporal response patterns during video-induced symptom provocation in SAD. While the amygdala is involved during initial threat processing, the insula seems to be more involved during subsequent anxiety responses. In accordance with cognitive models of SAD, a medial prefrontal region engaged in emotional-cognitive interactions is generally hyperactivated.

Epigenetic modification of the oxytocin receptor gene influences the perception of anger and fear in the human brain

“…Several other studies have also proposed a strong link between the endogenous oxytocin system and dACC structure and function (44,45,49). In fact, dysfunction in this area is often implicated in developmental and psychiatric disorders (50)(51)(52). Finally, additional regions not functionally activated by this task arise in the connectivity analysis including thalamus, caudate, putamen, and precentral gyrus.…”

Imaging Studies of Anxiety Disorders

“…The insula is generally found to be hyperactivated (Boehme, Mohr, Becker, Miltner, & Straube, 2014;Boehme, Ritter, Tefikow, et al, 2013;Gentili et al, 2008;Hamilton et al, 2014;Klumpp, Angstadt, & Phan, 2012;Lorberbaum et al, 2004;Shah, Klumpp, Angstadt, Nathan, & Phan, 2009;Straube, Mentzel, & Miltner, 2005;Waugh, Hamilton, Chen, Joormann, & Gotlib, 2012), and only two studies found the opposite (Bruhl, Herwig, Delsignore, Jancke, & Rufer, 2013;Sareen et al, 2007).…”

“…Most studies reported hyperactivation of the amygdala (Blair, Geraci, Devido, et al, 2008;Blair, Shaywitz, Smith, et al, 2008;Blair et al, 2011;Boehme et al, 2013Boehme et al, , 2014Bruhl et al, 2011;Evans, Wright, Wedig, et al, 2008;Gentili et al, 2008;Klumpp, Angstadt, Nathan, & Phan, 2010;Labuschagne, Phan, Wood, et al, 2010;Lorberbaum et al, 2004;Phan, Fitzgerald, Nathan, & Tancer, 2006;Richey, Rittenberg, Hughes, et al, 2014;Schmidt et al, 2010;Schneider, Weiss, Kessler, et al, 1999;Shah et al, 2009;Sladky et al, 2012;Straube et al, 2005;Veit et al, 2002), and only one study found hypoactivation (Bruhl et al, 2013).…”

Hjärnan formas av psykologisk behandling

“…The time course of neural response has been evaluated by SAD individuals passively viewing video clips of actors attending social and non-social situations (Boehme, Mohr, Becker, Miltner, & Straube, 2014a), and the authors reported that the dACC, amygdala, and the insula, were more activated in SAD. However, it was only the dACC that showed elevated activity both early and later on while viewing such scenarios.…”

“…Along these lines, there are neuroimaging case-control studies on SAD suggesting that aberrant neural signalling alters over shorter periods of time. Boehme et al suggest that exaggerated amygdala responsivity in SAD individuals are evident early on (first half of the BOLD-fMRI experiment) while anticipating a speech (Boehme et al, 2014b) or viewing others engaging in social interactions (Boehme et al, 2014a), but not later on during the experimantal manipulation. Time-dependent activations in SAD individuals have also been observed in other extended action tasks, particularly in the prefrontal cortex (Goldin et al, 2009b;Goldin et al, 2013).…”