Neural correlates of speech anticipatory anxiety in generalized social phobia

Department of Psychiatry and Center for Advanced Imaging, Medical University of South Carolina Charleston (MUSC), SC 29425, USA.
Neuroreport (Impact Factor: 1.52). 01/2005; 15(18):2701-5.
Source: PubMed


Patients with generalized social phobia fear embarrassment in most social situations. Little is known about its functional neuroanatomy. We studied BOLD-fMRI brain activity while generalized social phobics and healthy controls anticipated making public speeches. With anticipation minus rest, 8 phobics compared to 6 controls showed greater subcortical, limbic, and lateral paralimbic activity (pons, striatum, amygdala/uncus/anterior parahippocampus, insula, temporal pole)--regions important in automatic emotional processing--and less cortical activity (dorsal anterior cingulate/prefrontal cortex)--regions important in cognitive processing. Phobics may become so anxious, they cannot think clearly or vice versa.

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    • "In addition, we hypothesized that the dorsal aspect of the anterior insula (dAI), which is implicated in the processing of arousal, would be active whenever the participant's performance deviated from his/her expectations; thus especially during perceived failures or achievements (Critchley, 2005; Seeley et al., 2007). There is accumulating evidence demonstrating amygdala involvement in various negative and positive emotions (Adolphs et al., 1995; Morris et al., 1998; Phan et al., 2002), and the amygdala is particularly active in a socially evaluative context (Guyer et al., 2008; Lorberbaum et al., 2004). Additionally, meta-analyses of neuroimaging data consistently show that ventral aspects of the anterior insula (vAI), which are densely connected to the amygdala (Mesulam and Mufson, 1982), are central in human affect (Chang et al., 2013; Deen et al., 2011; Kelly et al., 2012). "
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    • "Previous PET and fMRI studies in SAD have demonstrated increased amygdala activity during speech anticipation (Tillfors et al. 2002; Lorberbaum et al. 2004; Etkin & Wager, 2007). However, cortical-amygdala connectivity in SAD during speech anticipation has not been addressed, and, more generally, the role of amygdala activity in prolonged stress states is unclear (Pruessner et al. 2008; Wager et al. 2009b; Choi et al. 2012). "
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