Enlargement of visual processing regions in social anxiety disorder is related to symptom severity

doi:10.1016/j.neulet.2014.09.033

Neuroscience Letters

Volume 583, 7 November 2014, Pages 114-119

https://doi.org/10.1016/j.neulet.2014.09.033 Get rights and content

Highlights

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Reports of structural alterations in SAD have been few and mixed.
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We found increased gray matter volume in visual areas in social anxiety disorder.
•
Social anxiety severity was positively related to regional gray matter volume.
•
Increased gray matter volume could underlie abnormal emotional processing in SAD.

Abstract

Social anxiety disorder (SAD) is associated with altered brain function and structure, but most structural studies include small samples and findings are mixed. This study compared regional gray matter volume between 48 SAD patients and 29 healthy controls (HC) as well as the relationship between volume and symptom severity. Structural magnetic resonance images from SAD patients and HC were evaluated using standard voxel-based morphometry (VBM) processing in the SPM8 software package. Social anxiety symptom severity was rated in SAD patients by a clinician using the Liebowitz Social Anxiety Scale (LSAS). SAD patients had greater regional gray matter volume in the lingual gyrus and lateral occipital cortex than the controls, and within the SAD group a positive correlation was found between symptom severity and regional gray matter volume in the lingual gyrus and the retrosplenial cortex. These findings replicate and extend earlier reports of enlarged visual processing areas in SAD. Increased gray matter volume in regions involved in visual processing and self-consciousness could underlie, or be the result of, abnormal emotional information processing and self-focused attention previously demonstrated in patients with SAD.

Section snippets

Participants

Forty-eight SAD patients and 29 HC participants were included in the study (see Table 1). SAD patients were recruited through newspaper advertisement and volunteered to participate by signing up and completing online screening questionnaires at a dedicated website. Initial screening included the Social Phobia Screening Questionnaire (SPSQ) [2] and exclusion criteria, i.e. ongoing or within 2 months discontinued psychological treatment or treatment with psychotropic medication, current drug or

Results

Relative to HC individuals, SAD participants had larger regional gray matter volume bilaterally in the occipital cortices extending into the fusiform and lingual gyri, see Table 2 and Fig. 1. Within the SAD group, total LSAS scores correlated positively with regional gray matter volume in clusters in the left lingual gyrus and bilaterally in the posterior cingulate cortex (PCC)/retrosplenial cortex, see Table 2 and Fig. 2. The area displaying a correlation between gray matter volume and

Discussion

We demonstrate increased regional gray matter volume in the lingual gyrus and lateral occipital cortex in patients with SAD relative to controls, as well as a positive relation between social anxiety symptom severity and regional gray matter volume in the lingual gyrus and the retrosplenial and posterior cingulate cortices. This replicates and extends previous findings [19], [23], including a recent study from our lab that showed increased cortical thickness in the lingual and fusiform gyri [23]

Role of funding sources

Financial support was provided through the Swedish Research Council, the Swedish Brain Foundation and the Swedish Research Council for Health, Working Life and Welfare. The study sponsors had no role in study design, data collection, data analysis, interpretation of data, writing of the report, or in the decision to submit the paper for publication.

Acknowledgment

We gratefully thank the study participants, without whom we could not have conducted this research.

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Existing studies have provided some supportive but inconsistent evidence for the effectiveness of the imaging measures. As for structural images, previous studies have reported aberrancies of gray matter volume (GMV) in the dorsal striatum (Bas-Hoogendam et al., 2017), left precuneus, right middle occipital gyrus, left putamen (Wang et al., 2018), lingual gyrus, and lateral occipital cortex (Frick et al., 2014). Other studies have reported abnormal cortical thicknesses in the left infratemporal cortex (Frick et al., 2013), the left insula, the right anterior cingulate, and the right temporal pole (Brühl et al., 2014).
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We suspect that as the disease progresses, patients gradually reduce such excessive cognitive efforts. This would make sense of the negative association between illness duration and CSA PFC. Since clinical population-based developmental research in the context of brain structure is limited, longitudinal studies will be needed to clarify whether participation of people with chronic illness will exhibit more or less CSA expansion in PFC. In addition, our failure to find significant correlations between symptom severity and neuroanatomical differences is in line with recent studies [10,27], but somewhat inconsistent with some other studies that reported significant associations between SAD symptom severity and structural alterations (in GMV or CT) [9,11,14,16–18,25,26]. This difference may perhaps be explained by method and sample differences such as sample size and characteristics.
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This study was funded by the National Natural Science Foundation of China (Grant Nos. 31700964, 31800963, 81621003, and 81820108018).

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Enlargement of visual processing regions in social anxiety disorder is related to symptom severity

Highlights

Abstract

Section snippets

Participants

Results

Discussion

Role of funding sources

Acknowledgment

Prog. Neuropsychopharmacol. Biol. Psychiatry

Biol. Psychol.

Biol. Psychiatry

Brain Res. Bull.

Biol. Psychiatry

Psychiatry Res.

Brain Res.

Biol. Psychiatry

Psychiatry Res.: Neuroimaging

Neurosci. Lett.

NeuroImage

NeuroImage

Eur. Neuropsychopharmacol.

Brain Res. Bull.

Eur. J. Radiol.

Clin. Psychol. Rev.

Biol. Psychiatry

Biol. Psychiatry

Neurobiol. Aging

Neurobiol. Aging

Diagnostic and Statistical Manual of Mental Disorders, Text Revision

Social phobia in the general population: prevalence and sociodemographic profile

Soc. Psychiatry Psychiatr. Epidemiol.

Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the national comorbidity survey replication

Arch. Gen. Psychiatry

Neuroimaging in social anxiety disorder – a meta-analytic review resulting in a new neurofunctional model

Neurosci. Biobehav. Rev.