Insula reactivity and connectivity to anterior cingulate cortex when processing threat in generalized social anxiety disorder

Abstract

Aberrant subcortical-prefrontal connectivity may contribute to insula hyper-reactivity to threat in generalized social anxiety disorder (gSAD). A novel PsychoPhysiological Interaction (PPI) analysis was used to examine functional ‘coupling’ between the insula and prefrontal cortex in gSAD patients and healthy controls (HCs). During fMRI, 29 gSAD and 26 HC volunteers performed an Emotional Face Matching Task, involving the processing of fear, angry, and happy expressions. As expected, compared with HCs, gSAD patients exhibited greater bilateral anterior insula (aINS) reactivity for fear vs. happy faces; this group difference was less robust for angry vs. happy faces. PPI of insula connectivity when processing fearful faces revealed the gSAD group had less right aINS-dorsal anterior cingulate coupling compared to HCs. Findings indicate that aINS hyper-reactivity for fear faces in gSAD, compared to controls, involves reduced connectivity with a prefrontal region implicated in cognitive control and emotion regulation.

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

“…Although previous studies have demonstrated differences in activation and FC Liao et al, 2010;Prater et al, 2012;Hahn et al, 2011;Klumpp et al, 2012) between SAD and HCs, the current work is the first to use FC (and activation) to discriminate SAD vs HC diagnostic membership. The current approach of combining machine learning with large-scale, condition-dependent FC is more exploratory and data driven in identifying FC differences than previously used techniques such as PPI Analysis, which only assess FC with a single, a priori specified, 'seed' region at a time.…”

Food motivation circuitry hypoactivation related to hedonic and nonhedonic aspects of hunger and satiety in women with active anorexia nervosa and weight-restored women with anorexia nervosa

“…We note that, importantly, the functions of these regions are not limited to processes related to appetite and food intake regulation. These regions are also highly involved in the response to stressful stimuli in healthy controls 43 and have been implicated in anxiety disorders, including generalized anxiety disorder, 44,45 social anxiety disorder 46 and obsessive-compulsive disorder. 47,48 Although activity in the amygdala 44,46,48 and insula [45][46][47] is generally heightened in individuals with anxiety disorders (rather than hypoactive, as observed here in women with anorexia nervosa), we cannot rule out the possibility that dysfunction in these regions in women with anorexia nervosa might reflect a generalized anxiety response to food images.…”

The Neural Mechanisms Underlying Personality Disorders

“…However, some findings can be referred to the avoidant personality. Decreased insula-dorsal anterior cingulate functional connectivity was shown in social anxiety disorder, but not in avoidant personality disorder (Klumpp et al, 2012). Decreased connectivity between insula and ACC was confirmed when viewing negative pictures (Koenigsberg et al, 2014).…”