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Corticolimbic brain reactivity to social signals of threat before and after sertraline treatment in generalized social phobia.

Abstract：

BACKGROUND:Generalized social phobia (gSP), also known as generalized social anxiety disorder, is characterized by excessive fear of scrutiny by others and pervasive avoidance of social interactions. Pathophysiologic models of gSP implicate exaggerated reactivity of the amygdala and insula in response to social evaluative threat, making them plausible targets for treatment. Although selective serotonin reuptake inhibitor (SSRI) treatment is known to be an effective treatment, little is known about the mechanism through which these agents exert their anxiolytic effects at a brain level in gSP. METHODS:We acquired functional magnetic resonance imaging data of brain response to social signals of threat (fearful/angry faces) in 21 gSP patients before and after they completed 12 weeks of open-label treatment with the SSRI sertraline. For comparison, 19 healthy control (HC) subjects also underwent two functional magnetic resonance imaging scans, 12 weeks apart. RESULTS:Whole-brain voxelwise analysis of variance revealed significant Group×Time interactions in the amygdala and the ventral medial prefrontal cortex. Follow-up analyses showed that treatment in gSP subjects reduced amygdala reactivity to fearful faces (which was exaggerated relative to HCs before treatment) and enhanced ventral medial prefrontal cortex activation to angry faces (which was attenuated relative to HCs before treatment). However, these brain changes were not significantly related to social anxiety symptom improvement. CONCLUSIONS:SSRI treatment response in gSP is associated with changes in a discrete limbic-paralimbic brain network, representing a neural mechanism through which SSRIs may exert their actions.

journal_name

Biol Psychiatry

journal_title

Biological psychiatry

authors

Phan KL,Coccaro EF,Angstadt M,Kreger KJ,Mayberg HS,Liberzon I,Stein MB

doi

10.1016/j.biopsych.2012.10.003

subject

Has Abstract

pub_date

2013-02-15 00:00:00

pages

329-36

issue

4

eissn

0006-3223

issn

1873-2402

pii

S0006-3223(12)00858-X

journal_volume

73

pub_type

杂志文章

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