Of 'disgrace' and 'pain'--corticolimbic interaction patterns for disorder-relevant and emotional words in social phobia.
Limbic hyperactivation and an impaired functional interplay between the amygdala and the prefrontal cortex are discussed to go along with, or even cause, pathological anxiety. Within the multi-faceted group of anxiety disorders, the highly prevalent social phobia (SP) is characterized by excessive fear of being negatively evaluated. Although there is widespread evidence for amygdala hypersensitivity to emotional faces in SP, verbal material has rarely been used in imaging studies, in particular with an eye on disorder-specificity. Using functional magnetic resonance imaging (fMRI) and a block design consisting of (1) overall negative, (2) social-phobia related, (3) positive, and (4) neutral words, we studied 25 female patients with social phobia and 25 healthy female control subjects (HC). Results demonstrated amygdala hyperactivation to disorder-relevant but not to generally negative words in SP patients, with a positive correlation to symptom severity. A functional connectivity analysis revealed a weaker coupling between the amygdala and the left middle frontal gyrus in patients. Symptom severity was negatively related to connectivity strength between the amygdala and the ventromedial prefrontal and orbitofrontal cortex (Brodmann Area 10 and 11). The findings clearly support the view of a hypersensitive threat-detection system, combined with disorder-related alterations in amygdala-prefrontal cortex connectivity in pathological anxiety.
Department of Psychiatry, University of Münster, Münster, Germany; Institute for Psychology, University of Münster, Münster, Germany.
Inga
I
Laeger
Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany.
Christian
C
Dobel
Department of Psychiatry, University of Münster, Münster, Germany.
Britta
B
Radenz
Department of Clinical Radiology, University of Münster, Münster, Germany.
Harald
H
Kugel
Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany.
Kati
K
Keuper
Institute for Biomagnetism and Biosignalanalysis, University of Münster, Münster, Germany.
Annuschka
A
Eden
Department of Psychiatry, University of Münster, Münster, Germany.
Volker
V
Arolt
Institute for Psychology, University of Münster, Münster, Germany.
Pienie
P
Zwitserlood
Department of Psychiatry, University of Münster, Münster, Germany; Department of Psychiatry, University of Marburg, Marburg, Germany.
Udo
U
Dannlowski
Department of Psychiatry, University of Münster, Münster, Germany; kbo-Inn-Salzach-Hospital, Wasserburg am Inn, Germany.
Peter
P
Zwanzger
D000679:Amygdala / Q000503:physiopathology; D016022:Case-Control Studies; D003142:Communication; D004644:Emotions; D005260:Female; D006801:Humans; D008032:Limbic System / Q000503:physiopathology*; D008297:Male; D009415:Nerve Net / Q000503:physiopathology; D010146:Pain / Q000503:physiopathology* / Q000523:psychology; D010698:Phobic Disorders / Q000503:physiopathology* / Q000523:psychology*