Abstract
Despite the fact that social anxiety disorder (SAD) is highly prevalent, there have been only a few structural imaging studies. Moreover, most of them reported about a volume reduction in amygdale, which plays a key role in the neural function of SAD. Insula is another region of interest. Its hyperactivity in regard to processing negative emotional information or interoceptive awareness has been detected in patients with SAD. Referring to these studies, we hypothesized that insular volumes might reduce in patients with SAD and made a comparison of insular volumes between 13 patients with SAD and 18 healthy controls with matched age and gender using voxel-based morphometry. As a result, we found a significant volume reduction in insula in the SAD group. Our results suggest that the patients with SAD might have an insular volume reduction apart from amygdala. Since insula plays a critical role in the pathology of SAD, more attention should be paid not only to functional study but also morphometrical study of insula.
Highlights
Social anxiety disorder (SAD), known as social phobia, is defined by excessive fear and avoidance of social situations
Confining the ROIs to bilateral insulae, we found that left anterior and right posterior insular volumes significantly reduced in the SAD group as compared to the CTL (Figure 1; Table 2)
We investigated the difference in hippocampus and amygdala according to the previous reports, which resulted in no significant differences between the groups
Summary
Social anxiety disorder (SAD), known as social phobia, is defined by excessive fear and avoidance of social situations. According to Clark and Wells [1], patients with SAD tend to have negative social cognitions in the situation in which they fear and these cognitions are enhanced by misperception of somatic symptoms. More than 15 years later, Irle et al examined hippocampal/amygdala volumes of patients with SAD with region-ofinterest (ROI) method and revealed hippocampal/amygdala volume reduction in patients with SAD [5]. They reported a negative correlation between a right hippocampal volume and Liebowitz Social Anxiety Scale (LSAS) and between a right amygdala volume and State-Trait Anxiety Inventory (STAI). Meng et al reported a volume reduction in bilateral thalami, right amygdala, and right precuneus, a negative correlation of a right amygdala
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