Topography of the Anxious Self: Abnormal Rest-Task Modulation in Social Anxiety Disorder

Abstract

Social anxiety disorder (SAD) is characterized by social anxiety/fear, self-attention, and interoception. Functional magnetic resonance imaging studies demonstrate increased activity during symptom-sensitive tasks in regions of the default-mode network (DMN), amygdala (AMG), and salience network (SN). What is the source of this task-unspecific symptom-sensitive hyperactivity in DMN? We address this question by probing SAD resting state (rs) changes in DMN including their relation to other regions as possible source of task-unspecific hyperactivity in the same regions. Our findings show the following: (1) rs-hypoconnectivity within-DMN regions; (2) rs-hyperconnectivity between DMN and AMG/SN; (3) task-evoked hyperactivity in the abnormal rs-regions of DMN and AMG/SN during different symptom-sensitive tasks; (4) negative relationship of rest and task changes in especially anterior DMN regions as their rs-hypoconnectivity is accompanied by task-unspecific hyperactivity; (5) abnormal top-down/bottom-up modulation between anterior DMN regions and AMG during rest and task. Findings demonstrate that rs-hypoconnectivity among DMN regions is negatively related to task-unspecific hyperactivity in DMN and AMG/SN. We propose a model of “Topography of the Anxious Self” in SAD (TAS-SAD). Abnormal DMN-AMG/SN topography during rest, as trait feature of an “unstable social self”, is abnormally aggravated during SAD-sensitive situations resulting in task-related hyperactivity in the same regions with an “anxious self” as state feature.

The nested hierarchy of self and its trauma: In search for a synchronic dynamic and topographical re-organization

“…Moreover, this study also highlights the function of the insula, which seems to represent the common denominator for each level of self processing (refer to Figure 3). This hypothesis linking the functional role of the insula and the different layers of the sense of self seems to be further confirmed by the studies on macaques (Critchley and Seth, 2012), studies on the role of the insula and emotional awareness (Gu et al, 2013) and by its relevance in severe psychopathologies, such as anorexia (Esposito et al, 2018) and anxiety disorders (Lucherini Angeletti et al, 2021).…”

Anorexia nervosa as a disorder of the subcortical–cortical interoceptive-self

“…This may suggest that decreased resting state activity in these regions prone them to react abnormally strong to external stimuli or tasks [ 91 , 92 ]. This brain dynamics does not seem to be a peculiarity of the AN condition: negative rest-task modulation has also been found in patients with social anxiety disorder (SAD) [ 93 ]. Interestingly, AN and SAD are disorders that often occur in comorbidities (55%), with the anxiety disorder tending to be already present prior to the onset of the eating disorder [ 94 ].…”

“…Even more so if at rest there is already an altered bottom-up/top-down modulation between the subcortical medial regions (involved in interoception and emotional experience) and the cortical medial regions (involved in SRP and cognitive processing), as happens similarly in anxiety disorders (Fig. 6 ) [ 93 , 106 ].…”

From Lung to Brain - Respiration Modulates Neural and Mental Activity

“…In addition, subcortical regions included the thalamus and the putamen (for individual references see supplementary table 9). Interestingly, many of these regions have been implicated in important networks responsible for the sense of self and cognition such as the default mode and salience networks (Angeletti et al, 2021, Northoff et al, 2004, Melnychuck et al, 2018, Anderson et al, 2018. This, albeit indirectly, provides evidence for possible connection of respiratory activity with neuro-mental functions like self and consciousness; that is further supported by the differential neuro-mental impact of different slow-fast respiration protocols.…”