Neural activity during self-referential working memory and the underlying role of the amygdala in social anxiety disorder.
Self-referential processing, theory of mind, and working memory are distorted in social anxiety disorder (SAD). This study aimed to investigate characteristics of altered self-referential working memory processing and resting-state functional connectivity in patients with SAD. Twenty patients and 20 healthy controls underwent functional magnetic resonance imaging at resting-state and while performing a working memory task containing faces with self-referential positive or negative comments and three memory phases (encoding, maintenance, and retrieval). Task-related results were compared between groups and tested for correlations. Resting-state connectivity between amygdala subregions and regions showing a task-related difference was also compared between groups. Patients compared to controls showed augmented memory for the negative comments, hyperactivation of the dorsomedial prefrontal cortex and temporo-parietal junction during encoding, and hypoactivation of the dorsolateral prefrontal cortex and insula during retrieval. At resting-state, increased connectivity of amygdala subregions with multiple task-related regions was found in patients. These findings suggest that the encoding process in SAD is accompanied by altered involvement of self-referential processing and theory of mind, whereas the retrieval process reflects impaired cognitive control. These memory-related processing may be affected by predisposing resting-state hyperconnectivity with the amygdala, and may underlie a hypersensitivity to negative comments and post-event reflection in SAD.
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Hyung-Jun
HJ
Yoon
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Jin Seong
JS
Kim
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Yu-Bin
YB
Shin
Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea.
Soo-Hee
SH
Choi
Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea.
Seung-Koo
SK
Lee
Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Radiology, Yonsei University College of Medicine, Seoul, Republic of Korea; Department of Psychiatry, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea. Electronic address: jaejkim@yonsei.ac.kr.
Jae-Jin
JJ
Kim
D000328:Adult; D000679:Amygdala / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology*; D011939:Mental Recall / Q000502:physiology; D000072861:Phobia, Social / Q000503:physiopathology*; D012649:Self Concept; D055815:Young Adult
Amygdala; Dorsomedial prefrontal cortex; Self-referential processing; Social anxiety; Visual working memory