title: Abnormal brain activation and connectivity to standardized disorder-related visual scenes in social anxiety disorder.
abstract: Our understanding of altered emotional processing in social anxiety disorder (SAD) is hampered by a heterogeneity of findings, which is probably due to the vastly different methods and materials used so far. This is why the present functional magnetic resonance imaging (fMRI) study investigated immediate disorder-related threat processing in 30 SAD patients and 30 healthy controls (HC) with a novel, standardized set of highly ecologically valid, disorder-related complex visual scenes. SAD patients rated disorder-related as compared with neutral scenes as more unpleasant, arousing and anxiety-inducing than HC. On the neural level, disorder-related as compared with neutral scenes evoked differential responses in SAD patients in a widespread emotion processing network including (para-)limbic structures (e.g. amygdala, insula, thalamus, globus pallidus) and cortical regions (e.g. dorsomedial prefrontal cortex (dmPFC), posterior cingulate cortex (PCC), and precuneus). Functional connectivity analysis yielded an altered interplay between PCC/precuneus and paralimbic (insula) as well as cortical regions (dmPFC, precuneus) in SAD patients, which emphasizes a central role for PCC/precuneus in disorder-related scene processing. Hyperconnectivity of globus pallidus with amygdala, anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) additionally underlines the relevance of this region in socially anxious threat processing. Our findings stress the importance of specific disorder-related stimuli for the investigation of altered emotion processing in SAD. Disorder-related threat processing in SAD reveals anomalies at multiple stages of emotion processing which may be linked to increased anxiety and to dysfunctionally elevated levels of self-referential processing reported in previous studies.
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany.
authors.forename: Carina Yvonne
authors.initials: CY
authors.lastname: Heitmann
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany.
authors.forename: Katharina
authors.initials: K
authors.lastname: Feldker
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany.
authors.forename: Paula
authors.initials: P
authors.lastname: Neumeister
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany.
authors.forename: Britta Maria
authors.initials: BM
authors.lastname: Zepp
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Peterburs
authors.affiliation: Institute of Psychology, University of Muenster, Muenster, Germany.
authors.forename: Pienie
authors.initials: P
authors.lastname: Zwitserlood
authors.affiliation: Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Muenster, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Straube
mesh_terms: D000328:Adult; D001008:Anxiety Disorders / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000072861:Phobia, Social / Q000000981:diagnostic imaging / Q000503:physiopathology*; D010775:Photic Stimulation / Q000379:methods*; D010865:Pilot Projects; D011897:Random Allocation; D055815:Young Adult
keywords: amygdala; default-mode-network; globus pallidus; precuneus; psychophysiological interaction; self-referential processing; social phobia