Neural correlates of emotional interference in social anxiety disorder.

Stephanie Boehme,Bernhard Strauss,Ulrich Stangier,Viktoria Ritter,Susan Tefikow,Thomas Straube,Wolfgang H R Miltner

doi:10.1371/journal.pone.0128608

Abstract

Disorder-relevant but task-unrelated stimuli impair cognitive performance in social anxiety disorder (SAD); however, time course and neural correlates of emotional interference are unknown. The present study investigated time course and neural basis of emotional interference in SAD using event-related functional magnetic resonance imaging (fMRI). Patients with SAD and healthy controls performed an emotional stroop task which allowed examining interference effects on the current and the succeeding trial. Reaction time data showed an emotional interference effect in the current trial, but not the succeeding trial, specifically in SAD. FMRI data showed greater activation in the left amygdala, bilateral insula, medial prefrontal cortex (mPFC), dorsal anterior cingulate cortex (ACC), and left opercular part of the inferior frontal gyrus during emotional interference of the current trial in SAD patients. Furthermore, we found a positive correlation between patients’ interference scores and activation in the mPFC, dorsal ACC and left angular/supramarginal gyrus. Taken together, results indicate a network of brain regions comprising amygdala, insula, mPFC, ACC, and areas strongly involved in language processing during the processing of task-unrelated threat in SAD. However, specifically the activation in mPFC, dorsal ACC, and left angular/supramarginal gyrus is associated with the strength of the interference effect, suggesting a cognitive network model of attentional bias in SAD. This probably comprises exceeded allocation of attentional resources to disorder-related information of the presented stimuli and increased self-referential and semantic processing of threat words in SAD.

Highlights

Individuals suffering from social anxiety disorder (SAD) showed biased processing of disorderrelated information (e.g. [1,2])
Results indicate a network of brain regions comprising amygdala, insula, medial prefrontal cortex (mPFC), anterior cingulate cortex (ACC), and areas strongly involved in language processing during the processing of task-unrelated threat in SAD
The present findings show that threat-related words induce emotional interference in patients with SAD during the current but not the subsequent trial in an emotional stroop task

Summary

Introduction

Individuals suffering from social anxiety disorder (SAD) showed biased processing of disorderrelated information (e.g. [1,2]). Neural Correlates of Emotional Interference in SAD exhibit strong sensitivity towards disorder-related cues, such as socially-threatening words or aversive facial expressions [3,4]. Along these lines, attentional bias, i.e. the capture of attention and interference by threat-related information, has been investigated in SAD patients [3]. Fast and automatic allocation of attention to and prioritized processing of disorder-related words has been suggested to interfere with the cognitive task and to cause increased reaction times Patients with anxiety disorders show increased reaction times to disorder-relates cues in emotional stroop tasks (see [8]). The relevance of fast and slow emotional interference effects in patients with anxiety disorders is completely unknown

Methods

Results

Discussion

Conclusion