title: Enlargement of visual processing regions in social anxiety disorder is related to symptom severity.
abstract: Social anxiety disorder (SAD) is associated with altered brain function and structure, but most structural studies include small samples and findings are mixed. This study compared regional gray matter volume between 48 SAD patients and 29 healthy controls (HC) as well as the relationship between volume and symptom severity. Structural magnetic resonance images from SAD patients and HC were evaluated using standard voxel-based morphometry (VBM) processing in the SPM8 software package. Social anxiety symptom severity was rated in SAD patients by a clinician using the Liebowitz Social Anxiety Scale (LSAS). SAD patients had greater regional gray matter volume in the lingual gyrus and lateral occipital cortex than the controls, and within the SAD group a positive correlation was found between symptom severity and regional gray matter volume in the lingual gyrus and the retrosplenial cortex. These findings replicate and extend earlier reports of enlarged visual processing areas in SAD. Increased gray matter volume in regions involved in visual processing and self-consciousness could underlie, or be the result of, abnormal emotional information processing and self-focused attention previously demonstrated in patients with SAD.
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden. Electronic address: andreas.frick@psyk.uu.se.
authors.forename: Andreas
authors.initials: A
authors.lastname: Frick
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Jonas
authors.initials: J
authors.lastname: Engman
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Iman
authors.initials: I
authors.lastname: Alaie
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Johannes
authors.initials: J
authors.lastname: Björkstrand
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden; Center for Pain and the Brain, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: Vanda
authors.initials: V
authors.lastname: Faria
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Gingnell
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Ulrika
authors.initials: U
authors.lastname: Wallenquist
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Thomas
authors.initials: T
authors.lastname: Agren
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Kurt
authors.initials: K
authors.lastname: Wahlstedt
authors.affiliation: Department of Radiology, Oncology and Radiation Sciences, Uppsala University Hospital/Uppsala University, Uppsala, Sweden.
authors.forename: Elna-Marie
authors.initials: EM
authors.lastname: Larsson
authors.affiliation: Department of Radiology, Oncology and Radiation Sciences, Uppsala University Hospital/Uppsala University, Uppsala, Sweden.
authors.forename: Arvid
authors.initials: A
authors.lastname: Morell
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Fredrikson
authors.affiliation: Department of Psychology, Uppsala University, Uppsala, Sweden.
authors.forename: Tomas
authors.initials: T
authors.lastname: Furmark
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000473:pathology* / Q000523:psychology; D016022:Case-Control Studies; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D012920:Social Behavior Disorders / Q000473:pathology* / Q000523:psychology; D014795:Visual Pathways / Q000473:pathology*; D055815:Young Adult
keywords: Anxiety; Gray matter; Social phobia; VBM; Voxel based morphometry