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Abstract
We investigated differences in the intrinsic functional brain organization (functional connectivity) of the human reward system between healthy control participants and patients with social anxiety disorder. Functional connectivity was measured in the resting-state via functional magnetic resonance imaging (fMRI). 53 patients with social anxiety disorder and 33 healthy control participants underwent a 6-minute resting-state fMRI scan. Functional connectivity of the reward system was analyzed by calculating whole-brain temporal correlations with a bilateral nucleus accumbens seed and a ventromedial prefrontal cortex seed. Patients with social anxiety disorder, relative to the control group, had (1) decreased functional connectivity between the nucleus accumbens seed and other regions associated with reward, including ventromedial prefrontal cortex; (2) decreased functional connectivity between the ventromedial prefrontal cortex seed and lateral prefrontal regions, including the anterior and dorsolateral prefrontal cortices; and (3) increased functional connectivity between both the nucleus accumbens seed and the ventromedial prefrontal cortex seed with more posterior brain regions, including anterior cingulate cortex. Social anxiety disorder appears to be associated with widespread differences in the functional connectivity of the reward system, including markedly decreased functional connectivity between reward regions and between reward regions and lateral prefrontal cortices, and markedly increased functional connectivity between reward regions and posterior brain regions.
Highlights
The social anxiety disorder (SAD) group exhibited significant and widespread decreases in functional correlations, compared to the Control group, between the nucleus accumbens (NAcc) seed (Fig 1) and multiple regions associated with reward, value, and decisionmaking, including ventromedial prefrontal cortical (vmPFC)/BA11, bilateral medial anterior prefrontal cortex/BA10, bilateral inferior frontal gyrus, anterior regions of the dorsal anterior cingulate cortex, subgenual ACC, left temporal pole, left hippocampus, and bilateral putamen (Figs 2 & 3; Table 1)
Increased functional connectivity in the Control group compared to the SAD group was not due to loss of signal in the SAD group
Positive temporal correlations between two major components of the reward system, the NAcc and the ventral region of the vmPFC, were significantly reduced in the SAD group. Functional connectivity between both the NAcc and the vmPFC seed regions with multiple other anterior brain regions were significantly reduced in SAD, including prefrontal and anterior cingulate regions associated with decision-making
Summary
We were guided by this literature to select seeds (brain locations) in the NAcc and vmPFC regions, and compare their intrinsic functional connectivity between the SAD and control groups. The SAD group exhibited significant and widespread decreases in functional correlations (connectivity), compared to the Control group, between the NAcc seed (Fig 1) and multiple regions associated with reward, value, and decisionmaking, including vmPFC/BA11, bilateral medial anterior prefrontal cortex/BA10, bilateral inferior frontal gyrus, anterior regions of the dorsal anterior cingulate cortex (dACC), subgenual ACC, left temporal pole, left hippocampus, and bilateral putamen (Figs 2 & 3; Table 1).
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