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Guo X, Wang S, Lin X, Wang Z, Dou Y, Cao Y, Zhang Y, Luo X, Kang L, Yu T, Wang Z, Tan Y, Gao S, Zheng H, Zhao F, Wang H, Wang K, Xie F, Chen W, Luo X. A novel risk variant block across introns 36-45 of CACNA1C for schizophrenia: a cohort-wise replication and cerebral region-wide validation study. Psychiatr Genet 2023; 33:182-190. [PMID: 37706495 PMCID: PMC10502955 DOI: 10.1097/ypg.0000000000000344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
OBJECTIVES Numerous genome-wide association studies have identified CACNA1C as one of the top risk genes for schizophrenia. As a necessary post-genome-wide association study (GWAS) follow-up, here, we focused on this risk gene, carefully investigated its novel risk variants for schizophrenia, and explored their potential functions. METHODS We analyzed four independent samples (including three European and one African-American) comprising 5648 cases and 6936 healthy subjects to identify replicable single nucleotide polymorphism-schizophrenia associations. The potential regulatory effects of schizophrenia-risk alleles on CACNA1C mRNA expression in 16 brain regions (n = 348), gray matter volumes (GMVs) of five subcortical structures (n = 34 431), and surface areas and thickness of 34 cortical regions (n = 36 936) were also examined. RESULTS A novel 17-variant block across introns 36-45 of CACNA1C was significantly associated with schizophrenia in the same effect direction across at least two independent samples (1.8 × 10-4 ≤ P ≤ 0.049). Most risk variants within this block showed significant associations with CACNA1C mRNA expression (1.6 × 10-3 ≤ P ≤ 0.050), GMVs of subcortical structures (0.016 ≤ P ≤ 0.048), cortical surface areas (0.010 ≤ P ≤ 0.050), and thickness (0.004 ≤ P ≤ 0.050) in multiple brain regions. CONCLUSION We have identified a novel and functional risk variant block at CACNA1C for schizophrenia, providing further evidence for the important role of this gene in the pathogenesis of schizophrenia.
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Affiliation(s)
- Xiaoyun Guo
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of medicine, Shanghai 200030, China
| | - Shibin Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of medicine, Shanghai 200030, China
| | - Xiandong Lin
- Laboratory of Radiation Oncology and Radiobiology, Fujian Provincial Cancer Hospital, the Teaching Hospital of Fujian Medical University, Fuzhou, Fujian 350014, China
| | - Zuxing Wang
- Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China
| | - Yikai Dou
- Mental Health Center and Psychiatric Laboratory, the State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, China
- Huaxi Brain Research Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yuping Cao
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
| | - Yong Zhang
- Tianjin Mental Health Center, Tianjin, China
| | - Xinqun Luo
- Department of Clinical Medicine, College of Integrated Traditional Chinese and Western Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350004, China
| | - Longli Kang
- Key Laboratory for Molecular Genetic Mechanisms and Intervention Research on High Altitude Diseases of Tibet Autonomous Region, Xizang Minzu University School of Medicine, Xiangyang, Shaanxi 712082, China
| | - Ting Yu
- Beijing Huilongguan Hospital, Peking University Huilongguan School of Clinical Medicine, Beijing, China
| | - Zhiren Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan School of Clinical Medicine, Beijing, China
| | - Yunlong Tan
- Beijing Huilongguan Hospital, Peking University Huilongguan School of Clinical Medicine, Beijing, China
| | - Shenshen Gao
- Shanghai Shenkang Hospital Development Center established the Clinical Research and Development Center of Shanghai Municipal Hospitals, Shanghai, China
| | - Hangxiao Zheng
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of medicine, Shanghai 200030, China
| | - Fen Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of medicine, Shanghai 200030, China
| | - Huifen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of medicine, Shanghai 200030, China
| | - Kesheng Wang
- Department of Family and Community Health, School of Nursing, Health Sciences Center, West Virginia University, Morgantown, WV 26506, USA
| | - Fan Xie
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of medicine, Shanghai 200030, China
| | - Wenzhong Chen
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of medicine, Shanghai 200030, China
| | - Xingguang Luo
- Beijing Huilongguan Hospital, Peking University Huilongguan School of Clinical Medicine, Beijing, China
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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Fertuck EA, Stanley B, Kleshchova O, Mann JJ, Hirsch J, Ochsner K, Pilkonis P, Erbe J, Grinband J. Rejection Distress Suppresses Medial Prefrontal Cortex in Borderline Personality Disorder. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2023; 8:651-659. [PMID: 36868964 PMCID: PMC10388534 DOI: 10.1016/j.bpsc.2022.11.006] [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: 07/07/2022] [Revised: 10/25/2022] [Accepted: 11/17/2022] [Indexed: 12/10/2022]
Abstract
BACKGROUND Borderline personality disorder (BPD) is characterized by an elevated distress response to social exclusion (i.e., rejection distress), the neural mechanisms of which remain unclear. Functional magnetic resonance imaging studies of social exclusion have relied on the classic version of the Cyberball task, which is not optimized for functional magnetic resonance imaging. Our goal was to clarify the neural substrates of rejection distress in BPD using a modified version of Cyberball, which allowed us to dissociate the neural response to exclusion events from its modulation by exclusionary context. METHODS Twenty-three women with BPD and 22 healthy control participants completed a novel functional magnetic resonance imaging modification of Cyberball with 5 runs of varying exclusion probability and rated their rejection distress after each run. We tested group differences in the whole-brain response to exclusion events and in the parametric modulation of that response by rejection distress using mass univariate analysis. RESULTS Although rejection distress was higher in participants with BPD (F1,40 = 5.25, p = .027, η2 = 0.12), both groups showed similar neural responses to exclusion events. However, as rejection distress increased, the rostromedial prefrontal cortex response to exclusion events decreased in the BPD group but not in control participants. Stronger modulation of the rostromedial prefrontal cortex response by rejection distress was associated with higher trait rejection expectation, r = -0.30, p = .050. CONCLUSIONS Heightened rejection distress in BPD might stem from a failure to maintain or upregulate the activity of the rostromedial prefrontal cortex, a key node of the mentalization network. Inverse coupling between rejection distress and mentalization-related brain activity might contribute to heightened rejection expectation in BPD.
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Affiliation(s)
- Eric A Fertuck
- Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, New York; Department of Psychiatry, Columbia University, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York.
| | - Barbara Stanley
- Department of Psychiatry, Columbia University, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
| | - Olena Kleshchova
- Department of Psychology, University of Nevada Reno, Reno, Nevada
| | - J John Mann
- Department of Psychiatry, Columbia University, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
| | - Joy Hirsch
- Departments of Psychiatry, Neuroscience and Comparative Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Kevin Ochsner
- Department of Psychology, Columbia University, New York, New York
| | - Paul Pilkonis
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jeff Erbe
- Department of Psychology, Clinical Psychology Doctoral Program, The City College of the City University of New York, New York, New York; Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York
| | - Jack Grinband
- Department of Psychiatry, Columbia University, New York, New York
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Yin Y, Tong J, Huang J, Tian B, Chen S, Tan S, Wang Z, Yang F, Tong Y, Fan F, Kochunov P, Jahanshad N, Li CSR, Hong LE, Tan Y. History of suicide attempts associated with the thinning right superior temporal gyrus among individuals with schizophrenia. Brain Imaging Behav 2022; 16:1893-1901. [PMID: 35545740 PMCID: PMC10025969 DOI: 10.1007/s11682-021-00624-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2021] [Indexed: 11/02/2022]
Abstract
Individuals with schizophrenia have higher rates of suicide attempts than the general population. Specific cortical abnormalities (e.g., the cortical surface area and thickness) may be associated with a history of suicide attempts. We recruited 74 individuals with schizophrenia (37 suicide attempters were individually matched with 37 non-attempters on age, sex, phase of illness, and study center) and 37 healthy volunteers. The cortical surface area and thickness data were extracted from structural MRI and compared between the groups. Suicide attempters showed significantly smaller surface areas in the whole brain (p = .028, Cohen's d = -0.54) than non-attempters. No association was found between the cortical surface area of individual brain regions and a history of suicide attempts. The mean cortical thickness did not differ significantly between the groups; however, suicide attempters demonstrated a thinner cortex in the right superior temporal gyrus (p < .001, q = 0.037, Cohen's d = -0.88). These findings indicate that a history of suicide attempts among individuals with schizophrenia is associated with a reduction in the global cortical surface area and specific cortical thinning of the right superior temporal gyrus. The morphometric alteration of the right superior temporal gyrus may represent a biomarker of suicidal behavior in individuals with schizophrenia.
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Affiliation(s)
- Yi Yin
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Jinghui Tong
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Junchao Huang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Baopeng Tian
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Song Chen
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Shuping Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Zhiren Wang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Fude Yang
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Yongsheng Tong
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
- Beijing Suicide Research and Prevention Center, WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Fengmei Fan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China
| | - Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
| | - Neda Jahanshad
- Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - L Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, USA
| | - Yunlong Tan
- Peking University HuiLongGuan Clinical Medical School, Beijing HuiLongGuan Hospital, Beijing, People's Republic of China.
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Arioli M, Basso G, Carne I, Poggi P, Canessa N. Increased pSTS activity and decreased pSTS-mPFC connectivity when processing negative social interactions. Behav Brain Res 2020; 399:113027. [PMID: 33249070 DOI: 10.1016/j.bbr.2020.113027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022]
Abstract
We have previously shown that activity and connectivity within and between the action observation and mentalizing brain systems reflect the degree of positive dimensions expressed by social interactions such as cooperativity and affectivity, respectively. Here we aim to extend this evidence by investigating the neural bases of processing negative dimensions of observed interactions, such as competition and affective conflict, possibly representing a benchmark for different pathological conditions. In this fMRI study 34 healthy participants were shown pictures depicting interactions characterized by two crossed dimensions, i.e. positively- vs. negatively- connotated social intentions mainly expressed in terms of motor acts vs. mental states, i.e. cooperative, competitive, affective and conflicting interactions. We confirmed the involvement of the action observation and mentalizing networks in processing intentions mainly expressed through motor acts (cooperative/competitive) vs. mental states (affective/conflicting), respectively. Results highlighted the selective role of the left pSTS/TPJ in decoding social interactions, even when compared with parallel actions by non-interacting individuals. Its right-hemispheric homologue displayed stronger responses to negative than positive social intentions, regardless of their motor/mental status, and decreased connectivity with the medial prefrontal cortex (mPFC) when processing negative interactions. The resulting mPFC downregulation by negative social scenes might reflect an adaptive response to socio-affective threats, via decreased mentalizing when facing negative social stimuli. This evidence on the brain mechanisms underlying the decoding of real complex interactions represents a baseline for assessing both the neural correlates of impaired social cognition, and the effects of rehabilitative treatments, in neuro-psychiatric diseases or borderline conditions such as loneliness.
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Affiliation(s)
- Maria Arioli
- Scuola Universitaria Superiore IUSS, Pavia, 27100, Italy; Cognitive Neuroscience Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, 27100, Italy.
| | | | - Irene Carne
- Medical Physics Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, 27100, Italy.
| | - Paolo Poggi
- Radiology Unit, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, 27100, Italy.
| | - Nicola Canessa
- Scuola Universitaria Superiore IUSS, Pavia, 27100, Italy; Cognitive Neuroscience Laboratory, Istituti Clinici Scientifici Maugeri IRCCS, Pavia, 27100, Italy.
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Perceived burdensomeness and neural responses to ostracism in the Cyberball task. J Psychiatr Res 2020; 130:1-8. [PMID: 32763557 PMCID: PMC7554229 DOI: 10.1016/j.jpsychires.2020.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/09/2020] [Accepted: 06/22/2020] [Indexed: 12/23/2022]
Abstract
Previous studies have identified the brain correlates of social pain processing during ostracism. However, the affective response to ostracism may vary according to individual differences in interpersonal needs and subsequent social actions. Despite this relationship, how the neural processes underlying ostracism may be modulated by interpersonal needs to regulate prosocial behaviors remains unknown. Here, in an fMRI study of 64 adults performing the Cyberball task, we quantified ball catching and tossing response time (RT) as a behavioral measure of participants' willingness to seek and reciprocate social interactions. Neural activations to social exclusion were identified and characterized in relation to individual differences in behavioral performance and perceived burdensomeness (PB), a measure of interpersonal needs. The results showed that social exclusion elicited activity in the anterior insula, middle frontal gyrus, postcentral gyrus, and dorsomedial prefrontal cortex, replicating previous studies on ostracism. Importantly, those with higher PB also exhibited greater brain activations to exclusion as well as reduced prosocial behaviors, as reflected by slower ball catching and tossing RT in the Cyberball task. Taken together, these findings suggest that emotional distress in ostracism may increase with PB, resulting in stronger neural responses to social pain and behavioral avoidance of social interactions.
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Concurrent amygdalar and ventromedial prefrontal cortical responses during emotion processing: a meta-analysis of the effects of valence of emotion and passive exposure versus active regulation. Brain Struct Funct 2019; 225:345-363. [PMID: 31863185 DOI: 10.1007/s00429-019-02007-3] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 12/09/2019] [Indexed: 01/04/2023]
Abstract
Anatomically interconnected, the ventromedial prefrontal cortex (vmPFC) and amygdala interact in emotion processing. However, no meta-analyses have focused on studies that reported concurrent vmPFC and amygdala activities. With activation likelihood estimation (ALE) we examined 100 experiments that reported concurrent vmPFC and amygdala activities, and distinguished responses to positive vs. negative emotions and to passive exposure to vs. active regulation of emotions. We also investigated whole-brain experiments for other regional activities. ALE and contrast analyses identified convergent anterior and posterior vmPFC response to passive positive and negative emotions, respectively, and a subregion in between to mixed emotions. A smaller area in the posterior ventral vmPFC is specifically involved in regulation of negative emotion. Whereas bilateral amygdala was involved during emotional exposure, only the left amygdala showed convergent activities during active regulation of negative emotions. Whole-brain analysis showed convergent activity in left ventral striatum for passive exposure to positive emotions and downregulation of negative emotions, and in the posterior cingulate cortex and ventral precuneus for passive exposure to negative emotions. These findings highlight contrasting, valence-specific subregional vmPFC as well as other regional responses during passive exposure to emotions. The findings also suggest that hyperactivation of the vmPFC is associated with diminished right amygdala activities during regulation of negative emotions. Together, the findings extend the literature by specifying the roles of subregional vmPFC and amygdala activities in emotion processing.
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Wang W, Zhornitsky S, Chao HH, Levy I, Joormann J, Li CSR. The effects of age on cerebral responses to self-initiated actions during social interactions: An exploratory study. Behav Brain Res 2019; 378:112301. [PMID: 31644928 DOI: 10.1016/j.bbr.2019.112301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Revised: 10/11/2019] [Accepted: 10/11/2019] [Indexed: 01/10/2023]
Abstract
Self-initiated action is critical to social interaction and individuals with social anxiety find it particularly difficult to initiate social interactions. We showed earlier that social exclusion encumbered self-initiated actions in the Cyberball task in young adults. Here, we examined whether the behavioral performance and regional responses during self-initiated actions vary with age in 53 participants (21-74 years; 27 men). Behaviorally, participants were slower in tossing the ball during exclusion (EX) than during fair game (FG) sessions in both men and women. In women but not in men the reaction time (RT) burden (RT_EX - RT_FG; RT prolonged during social exclusion) of ball toss was positively correlated with age despite no observed sex difference in Social Interaction Anxiety Scale scores. The pregenual anterior cingulate cortex, thalamus, left occipital cortex (OC) and left insula/orbitofrontal cortex responded to ball toss in EX vs. FG in negative correlation with age in women but not in men. Further, the activation of left OC fully mediated the relationship between age and RT burden in women. Thus, older women are more encumbered in self-initiated action during social exclusion, although this behavioral burden is not reflected in subjective reports of social anxiety. Age-related diminution in OC activities may reflect the neural processes underlying the difficulty in initiating social interactions in women. Together, the findings identified age-sensitive behavioral and neural processes of self-initiated action in the Cyberball task and suggest the importance of considering age and sex differences in studies of social interaction.
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Affiliation(s)
- Wuyi Wang
- Department of Psychiatry, Yale University, New Haven, CT 06519, United States
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University, New Haven, CT 06519, United States
| | - Herta H Chao
- Department of Medicine, Yale University, New Haven, CT 06520, United States; VA Connecticut Healthcare System, West Haven, CT 06516, United States
| | - Ifat Levy
- Department of Comparative Medicine, Yale University, New Haven, CT 06520, United States; Department of Neuroscience, Yale University, New Haven, CT 06520, United States; Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520, United States
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT 06520, United States
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University, New Haven, CT 06519, United States; Department of Neuroscience, Yale University, New Haven, CT 06520, United States; Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520, United States.
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8
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Wang W, Zhornitsky S, Li CSP, Le TM, Joormann J, Li CSR. Social anxiety, posterior insula activation, and autonomic response during self-initiated action in a Cyberball game. J Affect Disord 2019; 255:158-167. [PMID: 31153052 PMCID: PMC6591038 DOI: 10.1016/j.jad.2019.05.046] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 05/22/2019] [Accepted: 05/27/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND An earlier study characterized the neural correlates of self-initiated actions in a Cyberball game in healthy individuals. It remains unclear how social anxiety may influence these neural processes. METHODS We examined regional activations to self-initiated actions in 25 adults with low and 25 with high social anxiety (LA and HA, respectively). Skin conductance was recorded concurrently with fMRI. We followed published routines in the analyses of imaging and skin conductance data. RESULTS We hypothesized that HA as compared to LA individuals would demonstrate increased cortical limbic activations during self-initiated actions (tossing or T > receiving or R trials, to control for motor activities) in social exclusion (EX) vs. fair game (FG) scenario. At a corrected threshold, HA as compared with LA group showed increases in bilateral posterior insula activation during T vs. R trials in EX as compared to FG. Further, HA as compared to LA showed higher skin conductance response to tossing trials during EX as compared to FG. LIMITATIONS With a limited sample size, we did not examine potential sex effects. Further, we cannot rule out the effects of depression on the findings. CONCLUSIONS Together, the results suggest that individuals with more severe social anxiety engaged the somatosensory insula to a greater extent and exhibited higher physiological arousal when initiating ball toss during social exclusion in the Cyberball game. Posterior insula response to self-initiated action may represent a biomarker of social anxiety. It remains to be investigated whether interventions to decrease physiological arousal may alleviate social anxiety.
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Affiliation(s)
- Wuyi Wang
- Department of Psychiatry, Yale University, New Haven, CT 06519, United States
| | - Simon Zhornitsky
- Department of Psychiatry, Yale University, New Haven, CT 06519, United States
| | - Clara S-P Li
- Department of Psychiatry, Yale University, New Haven, CT 06519, United States; Phillips Academy, Andover, MA 01810, United States
| | - Thang M Le
- Department of Psychiatry, Yale University, New Haven, CT 06519, United States
| | - Jutta Joormann
- Department of Psychology, Yale University, New Haven, CT 06520, United States
| | - Chiang-Shan R Li
- Department of Psychiatry, Yale University, New Haven, CT 06519, United States; Department of Neuroscience, Yale University, New Haven, CT 06520, United States; Interdepartmental Neuroscience Program, Yale University, New Haven, CT 06520, United States.
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