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Flechsenhar A, Levine SM, Müller LE, Herpertz SC, Bertsch K. Oxytocin and social learning in socially anxious men and women. Neuropharmacology 2024; 251:109930. [PMID: 38537867 DOI: 10.1016/j.neuropharm.2024.109930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This study extended a classic self-referential learning paradigm by investigating the effects of intranasally-administered oxytocin in high and low socially anxious participants during social learning, as a function of social anxiety levels and sex. METHODS In a randomized double-blinded design, 160 participants were either given intranasal oxytocin (24 I.U.) or placebo. Subsequently, while lying in an MR scanner, participants were shown neutral faces that were paired with positively, neutrally, or negatively valenced self-referential sentences, during which we measured self-reported arousal and sympathy of the facial stimuli, pupil dilation, and changes in the brain-oxygen-level dependent signal. Four-factor mixed analyses of variance with the between-subjects factors group (high socially anxious vs. low socially anxious), substance (oxytocin vs. placebo), and sex (male vs. female) and the within-subjects factor sentence valence (positive vs. neutral vs. negative) were conducted for each measure, respectively. RESULTS Administration of intranasal oxytocin yielded an increase in sympathy ratings in high socially anxious compared to low socially anxious individuals and decreased arousal ratings for positively-conditioned faces in low socially anxious participants. As an objective physiological measure of arousal, pupil dilation mirrored the behavioral results. Oxytocin effects on neural activation in the insula interacted with anxiety levels and sex: low socially anxious individuals yielded lower activation under oxytocin than placebo; the converse was observed in high socially anxious individuals. This interaction also differed between sexes, as men yielded higher activation levels than women. These findings were more prominent for positively- and negatively-conditioned faces. Within the amygdala, high socially anxious men yielded higher activation than high socially anxious women in the left hemisphere, and low socially anxious men yielded higher activation than low socially anxious women from positively- and negatively-conditioned faces, though no influence of oxytocin was detected. CONCLUSION These results suggest oxytocin-induced behavioral, physiological, and neural changes as a function of social learning in socially low and high anxious individuals. These findings challenge the amygdalocentric view of the role of emotions in social learning, instead contributing to the growing body of findings implicating the insula therein, revealing an interaction between oxytocin, sex, and emotional valence. Such discoveries raise an interesting set of questions regarding the computational goals of regions such as the insula in emotional learning and how neural activity can play a diagnostic or prognostic role in social anxiety, potentially leading to new treatment opportunities that may combine oxytocin and neurofeedback differentially for men and women.
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Affiliation(s)
- Aleya Flechsenhar
- Department of Psychology, Ludwig-Maximilians Universität München, Germany; NeuroImaging Core Unit Munich (NICUM), University Hospital, Ludwig-Maximilians Universität München, Germany
| | - Seth M Levine
- Department of Psychology, Ludwig-Maximilians Universität München, Germany; NeuroImaging Core Unit Munich (NICUM), University Hospital, Ludwig-Maximilians Universität München, Germany
| | - Laura E Müller
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Heidelberg University, Germany
| | - Katja Bertsch
- Department of Psychology, Ludwig-Maximilians Universität München, Germany; NeuroImaging Core Unit Munich (NICUM), University Hospital, Ludwig-Maximilians Universität München, Germany; Department of Psychology, Julius-Maximilians-Universität Würzburg, Germany.
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Sheynin J, Lokshina Y, Ahrari S, Nickelsen T, Duval ER, Ben-Zion Z, Shalev AY, Hendler T, Liberzon I. Greater Early Posttrauma Activation in the Right Inferior Frontal Gyrus Predicts Recovery From Posttraumatic Stress Disorder Symptoms. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024; 9:91-100. [PMID: 37451548 PMCID: PMC10787040 DOI: 10.1016/j.bpsc.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/18/2023]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been associated with altered emotion processing and modulation in specific brain regions, i.e., the amygdala, insula, and medial prefrontal and anterior cingulate cortices. Functional alterations in these regions, recorded shortly after trauma exposure, may predict changes in PTSD symptoms. METHODS Survivors (N = 104) of a traumatic event, predominantly a motor vehicle accident, were included. Functional magnetic resonance imaging was used to assess brain activation 1, 6, and 14 months after trauma exposure (T1, T2, and T3, respectively). Participants performed the Shifted-attention Emotional Appraisal Task, which probes 3 affective processes: implicit emotional processing (of emotional faces), emotion modulation by attention shifting (away from these faces), and emotion modulation by appraisal (of the participants' own emotional response to these faces). We defined regions of interest based on task-related activations, extracted beta weights from these regions of interest, and submitted them to a series of analyses to examine relationships between neural activation and PTSD severity over the 3 time points. RESULTS At T1, a regression model containing activations in the left dorsolateral prefrontal cortex, bilateral inferior frontal gyrus (IFG), and medial prefrontal cortex during emotion modulation by appraisal significantly predicted change in PTSD symptoms. More specifically, greater right IFG activation at T1 was associated with greater reduction in symptom severity (T1-T3). Exploratory analysis also found that activation of the right IFG increased from T1 to T3. CONCLUSIONS The results suggest that greater early posttrauma activation during emotion appraisal in the right IFG, a region previously linked to cognitive control in PTSD, predicts recovery from PTSD symptoms.
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Affiliation(s)
- Jony Sheynin
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Yana Lokshina
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas; Department of Psychological & Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas
| | - Samira Ahrari
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Tetiana Nickelsen
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas
| | - Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Ziv Ben-Zion
- Departments of Comparative Medicine and Psychiatry, Yale School of Medicine, Yale University, New Haven, Connecticut; Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel; United States Department of Veterans Affairs National Center for PTSD Clinical Neuroscience Division, Veterans Affairs Connecticut Healthcare System, West Haven, Connecticut
| | - Arieh Y Shalev
- Department of Psychiatry, New York University Grossman School of Medicine, New York, New York
| | - Talma Hendler
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel; Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Israel Liberzon
- Department of Psychiatry and Behavioral Science, Texas A&M University Health Science Center, Bryan, Texas; Department of Psychological & Brain Sciences, Texas A&M University, College Station, Texas; Texas A&M Institute for Neuroscience, Texas A&M University, College Station, Texas.
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3
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Kim H, Duval ER. Social interaction anxiety and depression symptoms are differentially related in men and women. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 35789632 PMCID: PMC9243700 DOI: 10.1007/s12144-022-03245-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 11/11/2022]
Abstract
Social anxiety disorder (SAD) and major depressive disorder (MDD) are highly comorbid with each other, and comorbidity exacerbates distress and impairment. The prevalence of comorbid depression is higher in women with SAD than in men with SAD, but this is based on global depression scores and cannot speak to heterogeneous individual depression symptoms. The current study bridges this gap by examining gender differences in the relationship between social interaction anxiety and individual depression symptoms. 165 community adults (113 women, 52 men) were included in a series of bootstrapped moderation analyses to examine the main and interaction effects of social interaction anxiety and gender on total depression and individual depressive symptom scores while controlling for age and racial/ethnic background. Social interaction anxiety positively predicted total and individual depression scores. Greater social interaction anxiety predicted greater self-dislike and worthlessness in men than in women. Our findings replicate the finding that social anxiety and depression are highly comorbid with respect to total scores and extend this finding to individual symptoms. Our findings also demonstrate that the relationship between social interaction anxiety and depressive symptoms can be modulated by gender identities. Men with social interaction anxiety may be more prone to distress associated with self/identity. These findings elucidate the specific ways in which social interaction anxiety relates to the constellation of depression symptoms in men and women and highlights the need for more tailored assessment and intervention for socially anxious men and women to target individual dimensions of symptom presentations.
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Affiliation(s)
- Hanjoo Kim
- Department of Psychiatry, Michigan Medicine, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109 USA
| | - Elizabeth R. Duval
- Department of Psychiatry, Michigan Medicine, University of Michigan, 4250 Plymouth Road, Ann Arbor, MI 48109 USA
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Li Y, Jiang L. State and Trait Anxiety Share Common Network Topological Mechanisms of Human Brain. Front Neuroinform 2022; 16:859309. [PMID: 35811997 PMCID: PMC9260038 DOI: 10.3389/fninf.2022.859309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 05/04/2022] [Indexed: 12/01/2022] Open
Abstract
Anxiety is a future-oriented unpleasant and negative mental state induced by distant and potential threats. It could be subdivided into momentary state anxiety and stable trait anxiety, which play a complex and combined role in our mental and physical health. However, no studies have systematically investigated whether these two different dimensions of anxiety share a common or distinct topological mechanism of human brain network. In this study, we used macroscale human brain morphological similarity network and functional connectivity network as well as their spatial and temporal variations to explore the topological properties of state and trait anxiety. Our results showed that state and trait anxiety were both negatively correlated with the coefficient of variation of nodal efficiency in the left frontal eyes field of volume network; state and trait anxiety were both positively correlated with the median and mode of pagerank centrality distribution in the right insula for both static and dynamic functional networks. In summary, our study confirmed that state and trait anxiety shared common human brain network topological mechanisms in the insula and the frontal eyes field, which were involved in preliminary cognitive processing stage of anxiety. Our study also demonstrated that the common brain network topological mechanisms had high spatiotemporal robustness and would enhance our understanding of human brain temporal and spatial organization.
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Affiliation(s)
- Yubin Li
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Lili Jiang
- CAS Key Laboratory of Behavioral Science, Institute of Psychology, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Lili Jiang
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Kim MK, Eom H, Kwon JH, Kyeong S, Kim JJ. Neural effects of a short-term virtual reality self-training program to reduce social anxiety. Psychol Med 2022; 52:1296-1305. [PMID: 32880252 DOI: 10.1017/s0033291720003098] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Social anxiety disorder (SAD) is characterized by anxiety regarding social situations, avoidance of external social stimuli, and negative self-beliefs. Virtual reality self-training (VRS) at home may be a good interim modality for reducing social fears before formal treatment. This study aimed to find neurobiological evidence for the therapeutic effect of VRS. METHODS Fifty-two patients with SAD were randomly assigned to a VRS or waiting list (WL) group. The VRS group received an eight-session VRS program for 2 weeks, whereas the WL group received no intervention. Clinical assessments and functional magnetic resonance imaging scanning with the distress and speech evaluation tasks were repeatedly performed at baseline and after 3 weeks. RESULTS The post-VRS assessment showed significantly decreased anxiety and avoidance scores, distress index, and negative evaluation index for 'self', but no change in the negative evaluation index for 'other'. Patients showed significant responses to the distress task in various regions, including both sides of the prefrontal regions, occipital regions, insula, and thalamus, and to the speech evaluation task in the bilateral anterior cingulate cortex. Among these, significant neuronal changes after VRS were observed only in the right lingual gyrus and left thalamus. CONCLUSIONS VRS-induced improvements in the ability to pay attention to social stimuli without avoidance and even positively modulate emotional cues are based on functional changes in the visual cortices and thalamus. Based on these short-term neuronal changes, VRS can be a first intervention option for individuals with SAD who avoid society or are reluctant to receive formal treatment.
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Affiliation(s)
- Min-Kyeong Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyojung Eom
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Hee Kwon
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sunghyon Kyeong
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Jin Kim
- Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, Korea
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Rutherford S, Fraza C, Dinga R, Kia SM, Wolfers T, Zabihi M, Berthet P, Worker A, Verdi S, Andrews D, Han LKM, Bayer JMM, Dazzan P, McGuire P, Mocking RT, Schene A, Sripada C, Tso IF, Duval ER, Chang SE, Penninx BWJH, Heitzeg MM, Burt SA, Hyde LW, Amaral D, Wu Nordahl C, Andreasssen OA, Westlye LT, Zahn R, Ruhe HG, Beckmann C, Marquand AF. Charting brain growth and aging at high spatial precision. eLife 2022; 11:e72904. [PMID: 35101172 PMCID: PMC8828052 DOI: 10.7554/elife.72904] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 01/26/2022] [Indexed: 11/28/2022] Open
Abstract
Defining reference models for population variation, and the ability to study individual deviations is essential for understanding inter-individual variability and its relation to the onset and progression of medical conditions. In this work, we assembled a reference cohort of neuroimaging data from 82 sites (N=58,836; ages 2-100) and used normative modeling to characterize lifespan trajectories of cortical thickness and subcortical volume. Models are validated against a manually quality checked subset (N=24,354) and we provide an interface for transferring to new data sources. We showcase the clinical value by applying the models to a transdiagnostic psychiatric sample (N=1985), showing they can be used to quantify variability underlying multiple disorders whilst also refining case-control inferences. These models will be augmented with additional samples and imaging modalities as they become available. This provides a common reference platform to bind results from different studies and ultimately paves the way for personalized clinical decision-making.
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Affiliation(s)
- Saige Rutherford
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Cognitive Neuroscience, Radboud University Medical CenterNijmegenNetherlands
- Department of Psychiatry, University of MichiganAnn ArborUnited States
| | - Charlotte Fraza
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Cognitive Neuroscience, Radboud University Medical CenterNijmegenNetherlands
| | - Richard Dinga
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Cognitive Neuroscience, Radboud University Medical CenterNijmegenNetherlands
| | - Seyed Mostafa Kia
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Cognitive Neuroscience, Radboud University Medical CenterNijmegenNetherlands
- Department of Psychiatry, Utrecht University Medical CenterUtrechtNetherlands
| | - Thomas Wolfers
- Department of Psychology, University of OsloOsloNorway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University HospitalOsloNorway
| | - Mariam Zabihi
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Cognitive Neuroscience, Radboud University Medical CenterNijmegenNetherlands
| | - Pierre Berthet
- Department of Psychology, University of OsloOsloNorway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University HospitalOsloNorway
| | - Amanda Worker
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
| | - Serena Verdi
- Centre for Medical Image Computing, Medical Physics and Biomedical Engineering, University College LondonLondonUnited Kingdom
- Dementia Research Centre, UCL Queen Square Institute of NeurologyLondonUnited Kingdom
| | - Derek Andrews
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, DavisSacramentoUnited States
| | - Laura KM Han
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research InstituteAmsterdamNetherlands
- GGZ inGeest, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Johanna MM Bayer
- Centre for Youth Mental Health, University of MelbourneMelbourneAustralia
- Orygen Youth HealthMelbourneAustralia
| | - Paola Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College LondonLondonUnited Kingdom
- National Institute for Health Research Mental Health Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust and King’s College LondonLondonUnited Kingdom
| | - Phillip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, King’s College LondonLondonUnited Kingdom
| | - Roel T Mocking
- Department of Psychiatry, Amsterdam UMC, Location AMCAmsterdamNetherlands
| | - Aart Schene
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Psychiatry, Radboud University Medical CenterNijmegenNetherlands
| | - Chandra Sripada
- Department of Psychiatry, University of MichiganAnn ArborUnited States
| | - Ivy F Tso
- Department of Psychiatry, University of MichiganAnn ArborUnited States
| | - Elizabeth R Duval
- Department of Psychiatry, University of MichiganAnn ArborUnited States
| | - Soo-Eun Chang
- Department of Psychiatry, University of MichiganAnn ArborUnited States
| | - Brenda WJH Penninx
- Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health Research InstituteAmsterdamNetherlands
- GGZ inGeest, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Mary M Heitzeg
- Department of Psychiatry, University of MichiganAnn ArborUnited States
| | - S Alexandra Burt
- Department of Psychology, Michigan State UniversityEast LansingUnited States
| | - Luke W Hyde
- Department of Psychology, University of MichiganAnn ArborUnited States
| | - David Amaral
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, DavisSacramentoUnited States
| | - Christine Wu Nordahl
- The Medical Investigation of Neurodevelopmental Disorders (MIND) Institute and Department of Psychiatry and Behavioral Sciences, UC Davis School of Medicine, University of California, DavisSacramentoUnited States
| | - Ole A Andreasssen
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University HospitalOsloNorway
- KG Jebsen Centre for Neurodevelopmental Disorders Research, Institute of Clinical Medicine, University of OsloOsloNorway
| | - Lars T Westlye
- Department of Psychology, University of OsloOsloNorway
- Norwegian Center for Mental Disorders Research (NORMENT), University of Oslo, and Oslo University HospitalOsloNorway
- KG Jebsen Centre for Neurodevelopmental Disorders Research, Institute of Clinical Medicine, University of OsloOsloNorway
| | - Roland Zahn
- Centre for Affective Disorders at the Institute of Psychiatry, King's College LondonLondonUnited Kingdom
| | - Henricus G Ruhe
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Psychiatry, Radboud University Medical CenterNijmegenNetherlands
| | - Christian Beckmann
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Cognitive Neuroscience, Radboud University Medical CenterNijmegenNetherlands
- Centre for Functional MRI of the Brain (FMRIB), Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, University of OxfordOxfordUnited Kingdom
| | - Andre F Marquand
- Donders Institute for Brain, Cognition, and Behavior, Radboud UniversityNijmegenNetherlands
- Department of Cognitive Neuroscience, Radboud University Medical CenterNijmegenNetherlands
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Liu S, Zhang X, Wang Q, Xu Y, Huang X, Liu T, Yang Z, Xiang Z, Lu C, Chen Y, Chen J, Yang J. Increased attentional network activity in premature ejaculation patients with anxiety revealed by resting-state functional magnetic resonance imaging. Eur J Neurosci 2021; 54:5417-5426. [PMID: 34327757 DOI: 10.1111/ejn.15402] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 06/29/2021] [Accepted: 07/24/2021] [Indexed: 11/28/2022]
Abstract
Psychological account hypothesizes that premature ejaculation (PE) is a learned pattern of rapid ejaculation maintained by anxiety about sexual failure, whereas neuropsychological accounts hypothesizes that PE is the result of dysfunction of central nervous system regulating ejaculatory. However, the central neural mechanism underlying PE patients with anxiety remains unclear. Resting-state functional magnetic resonance imaging (fMRI) data were collected in 20 PE (diagnoses based on PE Guidelines drafted by the International Society for Sexual Medicine [ISSM]) patients with anxiety and 25 matched healthy controls (HCs) from January 2019 to December 2020. The values of fractional amplitude of low-frequency fluctuation (fALFF) were compared between groups. Moreover, the correlations between fALFF and the severity of PE and anxiety of patients were examined. PE patients with anxiety had increased fALFF values in the right inferior frontal gyrus (opercular part) and middle frontal gyrus. In addition, significant positive correlations were found between the scores of PE diagnostic tool (PEDT) and fALFF values of the right inferior frontal gyrus (opercular part), as well as the right middle frontal gyrus. Moreover, fALFF values of the right inferior frontal gyrus (opercular part) and middle frontal gyrus were positively correlated with the scores of self-rating anxiety scale (SAS). Our results suggested that increased attentional network activity might play a critical role in the neural basis of PE patients with anxiety.
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Affiliation(s)
- Shaowei Liu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xing Zhang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China.,Department of Andrology, Yangzhou Hospital of Chinese Medicine, Affiliated of Nanjing University of Chinese Medicine, Yangzhou, China
| | - Qing Wang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yan Xu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Xinfei Huang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Tao Liu
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhaoxu Yang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Ziliang Xiang
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Chao Lu
- Department of Radiology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Yun Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jianhuai Chen
- Department of Andrology, Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Jie Yang
- Department of Urology, Jiangsu Provincial People's Hospital, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.,Department of Urology, People's Hospital of Xinjiang Kizilsu Kirgiz Autonomous Prefecture, Xinjiang, China
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8
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Gerrans P, Murray RJ. Interoceptive active inference and self-representation in social anxiety disorder (SAD): exploring the neurocognitive traits of the SAD self. Neurosci Conscious 2020; 2020:niaa026. [PMID: 39015778 PMCID: PMC11249956 DOI: 10.1093/nc/niaa026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 07/18/2024] Open
Abstract
This article provides an interoceptive active inference (IAI) account of social anxiety disorder (SAD). Through a neurocognitive framework, we argue that the cognitive and behavioural profile of SAD is best conceived of as a form of maladaptive IAI produced by a negatively biased self-model that cannot reconcile inconsistent tendencies to approach and avoid social interaction. Anticipated future social interactions produce interoceptive prediction error (bodily states of arousal). These interoceptive states are transcribed and experienced as states of distress due to the influence of inconsistent and unstable self-models across a hierarchy of interrelated systems involved in emotional, interoceptive and affective processing. We highlight the role of the insula cortex, in concert with the striatum, amygdala and dorsal anterior cingulate in the generation and reduction of interoceptive prediction errors as well as the resolution of social approach-avoidance conflict. The novelty of our account is a shift in explanatory priority from the representation of the social world in SAD to the representation of the SAD self. In particular, we show how a high-level conceptual self-model of social vulnerability and inadequacy fails to minimize prediction errors produced by a basic drive for social affiliation combined with strong avoidant tendencies. The result is a cascade of interoceptive prediction errors whose attempted minimization through action (i.e. active inference) yields the symptom profile of SAD. We conclude this article by proposing testable hypotheses to further investigate the neurocognitive traits of the SAD self with respect to IAI.
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Affiliation(s)
- Philip Gerrans
- Department of Philosophy, University of Adelaide, Adelaide, Australia
| | - Ryan J Murray
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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9
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Duval ER, Sheynin J, King AP, Phan KL, Simon NM, Martis B, Porter KE, Norman SB, Liberzon I, Rauch SAM. Neural function during emotion processing and modulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder. Depress Anxiety 2020; 37:670-681. [PMID: 32306485 PMCID: PMC8010611 DOI: 10.1002/da.23022] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 02/19/2020] [Accepted: 03/27/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) has been associated with exaggerated threat processing and deficits in emotion modulation circuitry. It remains unknown how neural circuits are associated with response to evidence-based treatments for PTSD. METHOD We examined associations between PTSD symptoms and indicators of neural response in key emotion processing and modulation regions. Fifty-six military Veterans with PTSD were randomly assigned to one of three evidence-based treatments (prolonged exposure, sertraline, and PE plus sertraline) in a randomized clinical trial ("PROGrESS"; 2018, Contemp Clin Trials, 64, 128-138). Twenty-seven combat-exposed controls (CCs) served as a comparison group at pretreatment. Before and after PTSD treatment, functional magnetic resonance imaging was used to assess brain activation and connectivity during the validated Shifted Attention Emotion Appraisal Task (2003, J Neurosci, 23, 5627-5633; 2013, Biol Psychiatry, 73, 1045-1053). RESULTS Greater activation in emotion processing (anterior insula) and modulation (prefrontal cortex) regions and increased connectivity between attentional control (dorsolateral prefrontal cortex and superior parietal cortex) and emotion processing (amygdala) regions, at pretreatment, were associated with subsequent PTSD symptom improvement. CONCLUSIONS This study is one of the first to examine task-based activation and functional connectivity in a PTSD treatment trial, and provides evidence to suggest that activation in and connectivity between emotion processing and modulation regions are important predictors of treatment response.
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Affiliation(s)
- Elizabeth R. Duval
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Jony Sheynin
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Anthony P. King
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - K. Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University, Columbus, Ohio
| | - Naomi M. Simon
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts,Department of Psychiatry, New York University School of Medicine, New York, New York
| | - Brian Martis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Research Service, VA San Diego Healthcare System, San Diego, California,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, California
| | - Katherine E. Porter
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Sonya B. Norman
- Research Service, VA San Diego Healthcare System, San Diego, California,Department of Psychiatry, University of California, San Diego School of Medicine, La Jolla, California,Executive Division, National Center for PTSD, White River Junction, Vermont
| | - Israel Liberzon
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan,Department of Psychiatry, University of Michigan, Ann Arbor, Michigan,Department of Psychiatry, Texas A&M University Health Science Center, Bryan, Texas
| | - Sheila A. M. Rauch
- Mental Health Service Line, VA Atlanta Healthcare System, Decatur, Georgia,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
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10
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Joshi SA, Duval ER, Sheynin J, King AP, Phan KL, Martis B, Porter KE, Liberzon I, Rauch SAM. Neural correlates of emotional reactivity and regulation associated with treatment response in a randomized clinical trial for posttraumatic stress disorder. Psychiatry Res Neuroimaging 2020; 299:111062. [PMID: 32278278 PMCID: PMC8019332 DOI: 10.1016/j.pscychresns.2020.111062] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 02/27/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
Posttraumatic Stress Disorder (PTSD) is a debilitating condition often associated with difficulty in emotion regulation, including reappraising negative emotions. This study assessed neural mechanisms associated with emotion regulation in veterans prior to and following treatment for PTSD. Participants with PTSD and combat exposed controls (CC) completed diagnostic evaluation and underwent fMRI scanning while completing Emotion Regulation Task (ERT) and Emotional Faces Assessment Task (EFAT). Participants with PTSD were randomly assigned to Prolonged Exposure plus placebo (PE+PLB), Sertraline plus enhanced medication management (SERT+EMM), or PE plus SERT (PE+SERT) and repeated diagnostic evaluation and MRI scanning following treatment. The amygdala, dmPFC, and dlPFC were examined as regions of interest. On ERT, veterans with PTSD showed significantly less dmPFC activation than CCs during reappraisal vs emotional maintenance. Within the PTSD group, results demonstrated a significant association between less activation in the dmPFC during emotion reappraisal vs maintenance trials before treatment and greater reductions in symptoms from pre- to post-treatment. During the EFAT, there were no group differences between participants with PTSD and CCs in brain activation, and no relationships between brain function and PTSD symptoms. These findings suggest that less emotional reactivity might potentially reflect less need for recruitment of prefrontal regions when reappraising negative emotion, and is an individual factor associated with better treatment outcome.
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Affiliation(s)
- Sonalee A Joshi
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States; University of Michigan, Department of Psychology, 530 Church St, Ann Arbor, MI 48109, United States
| | - Elizabeth R Duval
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States
| | - Jony Sheynin
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States; Texas A&M University Health Science Center, Department of Psychiatry, 8441 Riverside Parkway, Bryan, TX 77807, United States
| | - Anthony P King
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States
| | - K Luan Phan
- Department of Psychiatry and Behavioral Health, The Ohio State University 1670 Upham Drive, Columbus, OH 43210, United States
| | - Brian Martis
- University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States; VA San Diego Healthcare System, 3350 Villa La Jolla Drive, San Diego, CA 92161, United States; University of California, San Diego, School of Medicine, 9500 Gilman Drive, La Jolla, CA 92037, United States
| | - Katherine E Porter
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; University of Michigan, Department of Psychiatry, 4250 Plymouth Road, Ann Arbor, MI 48109, United States
| | - Israel Liberzon
- VA Ann Arbor Healthcare System, 2215 Fuller Road, Ann Arbor, MI 48105, United States; Texas A&M University Health Science Center, Department of Psychiatry, 8441 Riverside Parkway, Bryan, TX 77807, United States.
| | - Sheila A M Rauch
- Atlanta VA Medical Center, 1670 Clairmont Road, Decatur, GA 30033, United States; Emory University School of Medicine, 12 Executive Park, 3rd Floor, Atlanta, GA 30029, United States
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11
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Duval ER, Lovelace CT, Filion DL. Attention allocation to subliminally presented affective faces in high and low social anxiety. Int J Psychophysiol 2020; 153:159-165. [PMID: 32389619 DOI: 10.1016/j.ijpsycho.2020.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 04/04/2020] [Accepted: 04/22/2020] [Indexed: 11/17/2022]
Abstract
Attention bias to affective stimuli, particularly threatening stimuli, has been well documented, with attention bias to affective faces often reported in populations with social anxiety (SA). However, inconsistencies exist in the literature regarding the direction of the bias, with some studies reporting a bias to attend toward social threat, and others reporting a bias to avoid social threat. This variability in the attention bias literature could be related to fluctuations in how attentional resources are allocated toward social stimuli over time. This study aimed to isolate early processing of affective faces using a backward masking paradigm in participants with high and low levels of subclinical SA. We used prepulse inhibition (PPI) of startle to index the amount of early attention allocated to masked affective faces. There was greater PPI to masked angry faces compared to neutral faces across all participants, suggesting that more attention was allocated to threatening faces. This effect was similar across face genders and participant SA levels. There was also a trend for more attention to be allocated to masked affective faces (angry and happy) compared to neutral faces across all participants. These findings demonstrate that attention bias to subliminal affect, and threat specifically, may not be modulated by subclinical levels of SA at very early stages of attention processing.
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Affiliation(s)
- Elizabeth R Duval
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA.
| | | | - Diane L Filion
- Department of Psychology, University of Missouri - Kansas City, Kansas City, MO, USA
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12
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Artificial bee colony clustering with self-adaptive crossover and stepwise search for brain functional parcellation in fMRI data. Soft comput 2019. [DOI: 10.1007/s00500-018-3467-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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13
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Ben-Zion Z, Fine NB, Keynan NJ, Admon R, Halpern P, Liberzon I, Hendler T, Shalev AY. Neurobehavioral moderators of post-traumatic stress disorder (PTSD) trajectories: study protocol of a prospective MRI study of recent trauma survivors. Eur J Psychotraumatol 2019; 10:1683941. [PMID: 31762950 PMCID: PMC6853209 DOI: 10.1080/20008198.2019.1683941] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/03/2019] [Accepted: 10/08/2019] [Indexed: 02/07/2023] Open
Abstract
Background: Post-traumatic stress disorder (PTSD) is triggered by distinct events and is therefore amenable to studies of its early pathogenesis. Longitudinal studies during the year that follows trauma exposure revealed typical symptom trajectories leading to either recovery or protracted PTSD. Thezneurobehavioral correlates of early PTSD symptoms' trajectories have not been longitudinally explored. Objective: To present the rationale and design of a longitudinal study exploring the relationship between evolving PTSD symptoms and co-occurring cognitive functioning and structural and functional brain imaging parameters. Method: Adult civilians consecutively admitted to a general hospital emergency room (ER) for traumatic injury will be screened for early PTSD symptoms suggestive of chronic PTSD risk, and consecutively evaluated 1, 6 and 14 months following the traumatic event. Consecutive assessments will include structured clinical interviews for PTSD and comorbid disorders, self-reported depression and anxiety symptoms, a web-based assessment of cognitive domains previously linked with PTSD (e.g., memory, executive functions, cognitive flexibility), high-resolution structural MRI of both grey and white matter, functional resting-state connectivity, and fMRI tasks examining emotional reactivity and regulation, as well as motivation processing and sensitivity to risk and reward. Data analyses will explore putative cognitive predictors of non-remitting PTSD, and brain structural and functional correlates of PTSD persistence or recovery. Conclusion: This work will longitudinally document patterns of brain structures, connectivity, and functioning, predictive of (or associated with) emerging PTSD during the critical first year of after the traumatic event. It will thereby inform our understanding of the disorder's pathogenesis and underlying neuropathology. Challenges to longitudinal MRI studies of recent survivors, and methodological choices used to optimize the study's design are discussed.
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Affiliation(s)
- Ziv Ben-Zion
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel
| | - Naomi B Fine
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.,School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Nimrod Jackob Keynan
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.,School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel
| | - Roee Admon
- Department of Psychology, University of Haifa, Haifa, Israel
| | - Pinchas Halpern
- Department of Emergency Medicine, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel
| | - Israel Liberzon
- Department of Psychiatry, Texas A&M Health Science Center, Austin, TX, USA
| | - Talma Hendler
- Sagol Brain Institute Tel-Aviv, Wohl Institute for Advanced Imaging, Tel Aviv Sourasky Medical Center, Tel-Aviv, Israel.,Sagol School of Neuroscience, Tel-Aviv University, Tel-Aviv, Israel.,School of Psychological Sciences, Faculty of Social Sciences, Tel-Aviv University, Tel-Aviv, Israel.,Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Arieh Y Shalev
- Department of Psychiatry, NYU Langone Medical Center, New York, NY, USA
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