Abstract
BackgroundAmygdala is considered as the core pathogenesis of generalized social anxiety disorder (GSAD). However, it is still unclear whether effective group cognitive behavioral therapy (CBT) could modulate the function of amygdala-related network. We aimed to examine the resting-state functional connectivity (rsFC) of the amygdala before and after group CBT.MethodsFifteen patients with GSAD were scanned on a 3T MR system before and after 8 weeks of group CBT. For comparison, nineteen healthy control participants also underwent baseline fMRI scanning. We used bilateral amygdala as seed regions and the rsFC maps of the right and left amygdala were created separately in a voxel-wise way. Clusters survived two-tailed Gaussian Random Field (GRF) correction at p <0.05 (voxel z value >2.3).ResultsCompared with baseline, patients with CBT showed significantly decreased connectivity of the left amygdala with the right putamen, the left dorsal medial prefrontal cortex (dmPFC) and the right dorsal anterior cingulate cortex (dACC). Especially, the changes of the connectivity between the left amygdala and the dACC positively correlated with changes of the anxiety symptom in patients. Furthermore, in relative to controls, patients showed higher connectivity of left amygdala with dmPFC and dACC at baseline, while normal after CBT.ConclusionsShort-term group CBT could down-regulate the abnormal higher connectivity of prefrontal-amygdala network, along with clinical improvement. This may provide a potential biomarker to monitor the treatment effect of CBT in GSAD patients.
Highlights
Amygdala is considered as the core pathogenesis of generalized social anxiety disorder (GSAD)
Further studies began to study the interaction of amygdala with other brain regions since the GSAD are attributable to the mis-communication among different brain regions in a wide network rather than a single specific brain structure [12]
These findings indicate the cognitive behavioral therapy (CBT) is effective in treatment of the symptoms of GSAD patients (Table 1)
Summary
Amygdala is considered as the core pathogenesis of generalized social anxiety disorder (GSAD). It is still unclear whether effective group cognitive behavioral therapy (CBT) could modulate the function of amygdala-related network. Evidences from animal models [4, 5] and human beings [6, 7] have indicated the role of amygdala as the core in the pathogenesis of GSAD. Neuroimaging studies have detected decreased volume of the amygdala [8] and increased functional activity of the amygdala in response to aversive and threatening social stimuli in GSAD patients [9,10,11]. A positive connectivity between amygdala and dorsal mPFC was related to anxiety, indicating hypervigilance to external stimuli [14]. Abnormal amygdala connectivity with other brain regions such as precuneus [15] and insula [16] in GSAD have been revealed
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