Cerebellar Neural Circuits Involving Executive Control Network Predict Response to Group Cognitive Behavior Therapy in Social Anxiety Disorder.
Some intrinsic connectivity networks including the default mode network (DMN) and executive control network (ECN) may underlie social anxiety disorder (SAD). Although the cerebellum has been implicated in the pathophysiology of SAD and several networks relevant to higher-order cognition, it remains unknown whether cerebellar areas involved in DMN and ECN exhibit altered resting-state functional connectivity (rsFC) with cortical networks in SAD. Forty-six patients with SAD and 64 healthy controls (HC) were included and submitted to the baseline resting-state functional magnetic resonance imaging (fMRI). Seventeen SAD patients who completed post-treatment clinical assessments were included after group cognitive behavior therapy (CBT). RsFC of three cerebellar subregions in both groups was assessed respectively in a voxel-wise way, and these rsFC maps were compared by two-sample t tests between groups. Whole-brain voxel-wise regression was performed to examine whether cerebellar connectivity networks can predict response to CBT. Lower rsFC circuits of cerebellar subregions compared with HC at baseline (p < 0.05, corrected by false discovery rate) were revealed. The left Crus I rsFC with dorsal medial prefrontal cortex was negatively correlated with symptom severity. The clinical assessments in SAD patients were significantly decreased after CBT. Higher pretreatment cerebellar rsFC with angular gyrus and dorsal lateral frontal cortex corresponded with greater symptom improvement following CBT. Cerebellar rsFC circuits involving DMN and ECN are possible neuropathologic mechanisms of SAD. Stronger pretreatment cerebellar rsFC circuits involving ECN suggest potential neural markers to predict CBT response.
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China.
MinlanYuan
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China.|State Key Laboratory of Biotherapy, Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Yajing
Y
Meng
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China.
Yan
Y
Zhang
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China.
Xiaojing
X
Nie
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China.
Zhengjia
Z
Ren
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China.|State Key Laboratory of Biotherapy, Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Hongru
H
Zhu
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China.
Yuchen
Y
Li
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.|Radiology Department of the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.
Su
S
Lui
Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Qiyong
Q
Gong
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China. qiuchangjian18@126.com.
Changjian
C
Qiu
Mental Health Center, West China Hospital of Sichuan University, No. 37 GuoXue Xiang, Chengdu, 610041, China. weizhang27@163.com.|State Key Laboratory of Biotherapy, Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China. weizhang27@163.com.
Wei
W
Zhang
D000328:Adult; D001931:Brain Mapping / Q000379:methods; D002531:Cerebellum / Q000503:physiopathology*; D015928:Cognitive Behavioral Therapy / Q000379:methods; D056344:Executive Function; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009434:Neural Pathways / Q000503:physiopathology*; D000072861:Phobia, Social / Q000628:therapy*; D012146:Rest / Q000502:physiology; D055815:Young Adult
Cerebellar circuits; Cognitive behavioral therapy; Executive control network; Functional connectivity; Social anxiety disorder