title: Emotion processing in joint hypermobility: A potential link to the neural bases of anxiety and related somatic symptoms in collagen anomalies.
abstract: BACKGROUND
  Joint hypermobility syndrome (JHS) has repeatedly been associated with anxiety and anxiety disorders, fibromyalgia, irritable bowel syndrome and temporomandibular joint disorder. However, the neural underpinnings of these associations still remain unclear. This study explored brain responses to facial visual stimuli with emotional cues using fMRI techniques in general population with different ranges of hypermobility.
  
  
  METHODS
  Fifty-one non-clinical volunteers (33 women) completed state and trait anxiety questionnaire measures, were assessed with a clinical examination for hypermobility (Beighton system) and performed an emotional face processing paradigm during functional neuroimaging.
  
  
  RESULTS
  Trait anxiety scores did significantly correlate with both state anxiety and hypermobility scores. BOLD signals of the hippocampus did positively correlate with hypermobility scores for the crying faces versus neutral faces contrast in ROI analyses. No results were found for any of the other studied ROIs. Additionally, hypermobility scores were also associated with other key affective processing areas (i.e. the middle and anterior cingulate gyrus, fusiform gyrus, parahippocampal region, orbitofrontal cortex and cerebellum) in the whole brain analysis.
  
  
  CONCLUSIONS
  Hypermobility scores are associated with trait anxiety and higher brain responses to emotional faces in emotion processing brain areas (including hippocampus) described to be linked to anxiety and somatic symptoms. These findings increase our understanding of emotion processing in people bearing this heritable variant of collagen and the mechanisms through which vulnerability to anxiety and somatic symptoms arises in this population.
authors: Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Psychiatry, Psychology and Psychosomatics department, Institut Universitari Quirón Dexeus, Barcelona, Spain; Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain. Electronic address: nmallorqui@live.com.
authors: N
authors: N
authors: Mallorquí-Bagué
authors: Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Anxiety Unit, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: A
authors: A
authors: Bulbena
authors: Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain.
authors: N
authors: N
authors: Roé-Vellvé
authors: Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain; Netherlands Institute for Neuroscience, Meibergdreef 47, 1105 BA Amsterdam, The Netherlands.
authors: E
authors: E
authors: Hoekzema
authors: Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud mental, Madrid, Spain; Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain.
authors: S
authors: S
authors: Carmona
authors: Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain.
authors: E
authors: E
authors: Barba-Müller
authors: Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain; Department Psicobiologia i Metodologia de les Ciències de la Salut, Campus de la UAB, 08193 Bellaterra (Cerdanyola del Vallés), Barcelona, Spain.
authors: J
authors: J
authors: Fauquet
authors: Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Fundació IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Anxiety Unit, Institute of Neuropsychiatry and Addictions (INAD), Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain.
authors: G
authors: G
authors: Pailhez
authors: Department of Psychiatry and Forensic Medicine, School of Medicine, Campus de la Universitat Autonoma de Barcelona (UAB), Barcelona, Spain; Neuroimaging Research Group, Fundació IMIM, Doctor Aiguader, 88, 08003 Barcelona, Spain.
authors: O
authors: O
authors: Vilarroya
mesh_terms: D000328:Adult; D001007:Anxiety / Q000503:physiopathology* / Q000523:psychology; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D003094:Collagen / Q000737:chemistry; D003463:Cues; D005149:Facial Expression; D005260:Female; D006179:Gyrus Cinguli / Q000503:physiopathology*; D006801:Humans; D007593:Joint Instability / Q000503:physiopathology* / Q000523:psychology; D008279:Magnetic Resonance Imaging; D008297:Male; D014796:Visual Perception / Q000502:physiology*
chemical_list: D003094:Collagen
keywords: Anxiety; Emotion; Functional magnetic resonance imaging (fMRI); Joint hypermobility; Psychosomatics