Amygdala and insula response to emotional images in patients with generalized social anxiety disorder.
BACKGROUND
Functional brain imaging studies have demonstrated amygdala and insula hyper-reactivity to probes of social threat in participants with generalized social anxiety disorder (gSAD). The amygdala and insula are known to serve broad functions in emotional processing, including integration of affective information. However, few studies have examined brain responses in socially anxious participants during general emotional processing. We examined brain response to emotionally evocative images in patients with gSAD and matched healthy controls.


METHODS
Eleven patients with gSAD who were not taking psychotropic medications and did not have psychiatric comorbidities and 11 matched healthy controls underwent functional magnetic resonance imaging while viewing blocks of emotionally salient (positive, negative, neutral) pictures.


RESULTS
Participants with gSAD exhibited enhanced bilateral amygdala and insula reactivity to negative (v. neutral) images compared with healthy controls who did not exhibit enhanced reactivity. Within the gSAD group, the extent of amygdala activation was correlated with social anxiety severity, whereas the extent of insula activation was correlated with trait anxiety.


CONCLUSIONS
The small sample size may have limited our ability to detect group differences in other relevant brain regions and in behavioural measures.


CONCLUSIONS
In addition to prior findings of probes of social information processing, our findings suggest that the amygdala and insula responses are hyper-reactive to general emotional images with negative emotional content and that these brain regions may play divergent roles in their representation of different phenotypes.
Shah
Sabin G
SG
Department of Psychiatry, University of Michigan, Ann Arbor, Mich. 48109-2700, USA.
Klumpp
Heide
H
Angstadt
Mike
M
Nathan
Pradeep J
PJ
Phan
K Luan
KL
D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001008:Anxiety Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology; D016022:Case-Control Studies; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012720:Severity of Illness Index; D013694:Temperament / Q000502:physiology