Beyond emotions: A meta-analysis of neural response within face processing system in social anxiety.
Patients with social anxiety disorder (SAD) experience anxiety and avoidance in face-to-face interactions. We performed a meta-analysis of functional magnetic resonance imaging (fMRI) studies in SAD to provide a comprehensive understanding of the neural underpinnings of face perception in this disorder. To this purpose, we adopted an innovative approach, asking authors for unpublished data. This is a common procedure for behavioral meta-analyses, which, however has never been used in neuroimaging studies. We searched Pubmed with the key words "Social Anxiety AND faces" and "Social Phobia AND faces." Then, we selected those fMRI studies for which we were able to obtain data for the comparison between SAD and healthy controls (HC) in a face perception task, either from the published papers or from the authors themselves. In this way, we obtained 23 studies (totaling 449 SAD and 424 HC individuals). We identified significant clusters in which faces evoked a higher response in SAD in bilateral amygdala, globus pallidus, superior temporal sulcus, visual cortex, and prefrontal cortex. We also found a higher activity for HC in the lingual gyrus and in the posterior cingulate. Our findings show that altered neural response to face in SAD is not limited to emotional structures but involves a complex network. These results may have implications for the understanding of SAD pathophysiology, as they suggest that a dysfunctional face perception process may bias patient person-to-person interactions.
Clinical Psychology Branch - Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa 56126, Italy Department of General Psychology - University of Padua, Padua 35131, Italy.
Claudio
C
Gentili
Clinical Psychology Branch - Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa 56126, Italy Department of Clinical Psychology and Psychotherapy, University Babes-Bolyai, Cluj-Napoca, RO 400015, Romania.
Ioana Alina
IA
Cristea
Department of Psychiatry, University of Michigan, Ann Arbor, Michigan 48109, USA.
Mike
M
Angstadt
Department of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL 60612, USA.
Heide
H
Klumpp
Trinity College, College Green, Dublin 2, Ireland.
Leonardo
L
Tozzi
Department of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, IL 60612, USA Department Anatomy and Cell Biology and the Graduate Program in Neuroscience, Chicago, IL 60612, USA Mental Health Service Line, Jesse Brown VA Medical Center, Chicago, IL 60612, USA.
K Luan
KL
Phan
Clinical Psychology Branch - Department of Surgical, Medical and Molecular Pathology and Critical Care, University of Pisa, Pisa 56126, Italy pietro.pietrini@med.unipi.it.
Pietro
P
Pietrini
D001008:Anxiety Disorders / Q000503:physiopathology*; D001921:Brain / Q000000981:diagnostic imaging*; D000066499:Facial Recognition; D006801:Humans; D008279:Magnetic Resonance Imaging; D009474:Neurons / Q000502:physiology*; D010698:Phobic Disorders / Q000503:physiopathology*; D011859:Radiography
Face perception; amygdala; anxiety; functional magnetic resonance imaging; meta-analysis; social phobia