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Chu SY, Sakai N, Lee J, Harrison E, Tang KP, Mori K. Comparison of social anxiety between Japanese adults who stutter and non-stuttering controls. J Fluency Disord 2020; 65:105767. [PMID: 32535211 DOI: 10.1016/j.jfludis.2020.105767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 12/18/2019] [Accepted: 05/14/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE Adults who stutter (AWS) often develop social anxiety disorder. This study was to provide comparative data on the Liebowitz Social Anxiety Scale-Japanese version (LSAS-J) from AWS and non-stuttering adult controls. METHODS LSAS-J, a 24-item self-reported survey of social phobia and avoidance across various daily situations, was administered to 130 AWS (Mean Age = 41.5 years, SD = 15.8, 111 males) and 114 non-stuttering adults (Mean Age = 39.5, SD = 14.9, 53 males). The test-retest reliability and internal consistency of the LSAS-J were assessed. A between-subject multivariate analysis of variance (MANOVA) was also conducted to determine whether attitude toward social anxiety differed between AWS and AWNS, or by age (<40 and ≥ 40 years old), or sex (female and male). RESULTS AWS reported higher scores on both fear subscales of the LSAS-J. Age had no significant influence on the social anxiety levels reported by either participant group. Sex differences were found in the fear subscales, with females scoring higher on both fear subscales, although these were only marginally significant (p = .06). LSAS-J showed good test-retest reliability and high Cronbach's alpha coefficient, indicating that it is an internally consistent measure of attitudes about social anxiety. CONCLUSION Given the similarly high incidence of social anxiety in adults in Japan who stutter compared with those in other countries, social anxiety should be identified and assessed during clinical decision making and before decisions are made about stuttering treatment. LSAS-J is an easy tool to administer, and showed reliable results of social phobia and avoidance for AWS.
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Affiliation(s)
- Shin Ying Chu
- Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (H-CARE), Speech Sciences Programme, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
| | - Naomi Sakai
- National Rehabilitation Center for Persons with Disabilities, Research Institute, Department of Rehabilitation for Sensory Functions, 4-1 Namiki, Tokorozawa, Saitama, 359-8555, Japan.
| | - Jaehoon Lee
- Department of Educational Psychology and Leadership, Texas Tech University, Box 41071, Lubbock, TX, 79409-1071, USA.
| | | | - Keng Ping Tang
- Faculty of Health Sciences, Speech Sciences Programme, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, 50300, Malaysia.
| | - Koichi Mori
- National Rehabilitation Center for Persons with Disabilities, Rehabilitation Services Bureau, 4-1 Namiki, Tokorozawa, Saitama, 359-8555, Japan.
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Zhang X, Luo Q, Wang S, Qiu L, Pan N, Kuang W, Lui S, Huang X, Yang X, Kemp GJ, Gong Q. Dissociations in cortical thickness and surface area in non-comorbid never-treated patients with social anxiety disorder. EBioMedicine 2020; 58:102910. [PMID: 32739867 PMCID: PMC7393569 DOI: 10.1016/j.ebiom.2020.102910] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Abnormalities of functional activation and cortical volume in brain regions involved in the neurobiology of fear and anxiety have been implicated in the pathophysiology of social anxiety disorder (SAD). However, few studies have performed separate measurements of cortical thickness (CT) and cortical surface area (CSA) which reflect different neurobiological processes. Thus, we aimed to explore the cortical morphological anomaly separately in SAD using FreeSurfer. METHODS High-resolution structural magnetic resonance images were obtained from 32 non-comorbid never-treated adult SAD patients and 32 demography-matched healthy controls. Cortical morphometry indices including CT and CSA were separately determined by FreeSurfer and compared between the two groups via whole-brain vertex-wise analysis, while partial correlation analysis using age and gender as covariates were conducted. FINDINGS The patients with SAD showed decreased CT but increased CSA near-symmetrically in the bilateral prefrontal cortex (PFC) of the dorsolateral, dorsomedial, and ventromedial subdivisions, as well as the right lateral orbitofrontal cortex; increased CSA in the left superior temporal gyrus (STG) was also observed in SAD. The CSA in the left PFC was negatively correlated with the disease duration. INTERPRETATION As the balloon model hypothesis suggests that the tangentially stretched cortex may cause dissociations in cortical morphometry and affect the cortical capacity for information processing, our findings of dissociated morphological alterations in the PFC and cortical expansion in the STG may reflect the morphological alterations of the functional reorganization in those regions, and highlight the important role of those structures in the pathophysiology and neurobiology of SAD. FUNDING This study was funded by the National Natural Science Foundation of China (Grant Nos. 31700964, 31800963, 81621003, and 81820108018).
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Affiliation(s)
- Xun Zhang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu 610041, China
| | - Qiang Luo
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu 610041, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu 610041, China
| | - Lihua Qiu
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu 610041, China; Department of Radiology, The Second People's Hospital of Yibin, Yibin 644000, China
| | - Nanfang Pan
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu 610041, China
| | - Weihong Kuang
- Department of Psychiatry, State Key Lab of Biotherapy, West China Hospital of Sichuan University, Chengdu 610041, PR, China
| | - Su Lui
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xun Yang
- School of Public Affairs, Chongqing University, Chongqing 400044, China.
| | - Graham J Kemp
- Liverpool Magnetic Resonance Imaging Centre (LiMRIC) and Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Psychoradiology Research Unit of Chinese Academy of Medical Sciences (2018RU011), West China Hospital of Sichuan University, Chengdu 610041, China; Department of Psychology, School of Public Administration, Sichuan University, Chengdu 610041, China.
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Hofmann SG, Papini S, Carpenter JK, Otto MW, Rosenfield D, Dutcher CD, Dowd S, Lewis M, Witcraft S, Pollack MH, Smits JAJ. Effect of d-cycloserine on fear extinction training in adults with social anxiety disorder. PLoS One 2019; 14:e0223729. [PMID: 31622374 PMCID: PMC6797442 DOI: 10.1371/journal.pone.0223729] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/26/2019] [Indexed: 12/17/2022] Open
Abstract
Preclinical and clinical data have shown that D-cycloserine (DCS), a partial agonist at the N-methyl-d-aspartate receptor complex, augments the retention of fear extinction in animals and the therapeutic learning from exposure therapy in humans. However, studies with non-clinical human samples in de novo fear conditioning paradigms have demonstrated minimal to no benefit of DCS. The aim of this study was to evaluate the effects of DCS on the retention of extinction learning following de novo fear conditioning in a clinical sample. Eighty-one patients with social anxiety disorder were recruited and underwent a previously validated de novo fear conditioning and extinction paradigm over the course of three days. Of those, only 43 (53%) provided analyzable data. During conditioning on Day 1, participants viewed images of differently colored lamps, two of which were followed by with electric shock (CS+) and a third which was not (CS-). On Day 2, participants were randomly assigned to receive either 50 mg DCS or placebo, administered in a double-blind manner 1 hour prior to extinction training with a single CS+ in a distinct context. Day 3 consisted of tests of extinction recall and renewal. The primary outcome was skin conductance response to conditioned stimuli, and shock expectancy ratings were examined as a secondary outcome. Results showed greater skin conductance and expectancy ratings in response to the CS+ compared to CS- at the end of conditioning. As expected, this difference was no longer present at the end of extinction training, but returned at early recall and renewal phases on Day 3, showing evidence of return of fear. In contrast to hypotheses, DCS had no moderating influence on skin conductance response or expectancy of shock during recall or renewal phases. We did not find evidence of an effect of DCS on the retention of extinction learning in humans in this fear conditioning and extinction paradigm.
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Affiliation(s)
- Stefan G. Hofmann
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
- * E-mail:
| | - Santiago Papini
- Department of Psychology, University of Texas at Austin, Austin, Texas, United States of America
| | - Joseph K. Carpenter
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
| | - Michael W. Otto
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
| | - David Rosenfield
- Department of Psychology, Southern Methodist University, Dallas, Texas, United States of America
| | - Christina D. Dutcher
- Department of Psychology, University of Texas at Austin, Austin, Texas, United States of America
| | - Sheila Dowd
- Department of Psychiatry, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Mara Lewis
- Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, United States of America
| | - Sara Witcraft
- Department of Psychology, University of Mississippi, Oxford, Mississippi, United States of America
| | - Mark H. Pollack
- Department of Psychiatry, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Jasper A. J. Smits
- Department of Psychology, University of Texas at Austin, Austin, Texas, United States of America
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Abstract
Cognitive models suggest that social anxiety disorder (SAD) is maintained through the use of safety behaviours. Previous reports propose that these safety behaviours can be subdivided into two main categories: avoidance and impression management. Study 1 investigates whether certain safety behaviours are specific to SAD. The social behaviour questionnaire was administered to individuals with SAD (N = 106), post-traumatic stress disorder (N = 28) and non-patient controls (N = 59). A factor analysis (N = 164) replicated the previously reported avoidance and impression management subtypes. Scores for both subtypes were significantly higher in individuals with SAD than in individuals with post-traumatic stress disorder or non-patient controls. Study 2 investigated the causal role of such safety behaviours using an experimental design in a non-clinical population (N = 96). Pairs of participants each engaged in two conversations. In one of the conversations, a randomly selected participant performed either avoidance or impression management safety behaviours. In the other conversation, neither participant was instructed to use safety behaviours. Each participant rated their own anxiety and performance as well as rating the other person. Videos of the conversations were also rated. Both types of safety behaviour increased anxiety in the person performing the safety behaviour. The avoidance subtype also had broader effects on the other person that were largely absent from the impression management subtype. Taken together the studies provide support for the distinction between safety behaviour subtypes and have implications for the treatment of SAD.
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Affiliation(s)
- Emily Gray
- Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, Oxford, United Kingdom
| | - Esther T. Beierl
- Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, Oxford, United Kingdom
| | - David M. Clark
- Oxford Centre for Anxiety Disorders and Trauma, University of Oxford, Oxford, United Kingdom
- Oxford Health NHS Foundation Trust, Oxford, United Kingdom
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Ahmed-Leitao F, Rosenstein D, Marx M, Young S, Korte K, Seedat S. Posttraumatic stress disorder, social anxiety disorder and childhood trauma: Differences in hippocampal subfield volume. Psychiatry Res Neuroimaging 2019; 284:45-52. [PMID: 30684895 DOI: 10.1016/j.pscychresns.2018.12.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 12/14/2018] [Accepted: 12/29/2018] [Indexed: 12/22/2022]
Abstract
Volume-based hippocampal findings in Social Anxiety Disorder (SAD) and Posttraumatic Stress Disorder (PTSD) have been inconsistent, with very little investigation of hippocampal subfields. We assessed the effects of early childhood trauma on hippocampal subfields in participants with SAD with and without early childhood trauma and PTSD, compared to healthy controls. The sample comprised 26 participants SAD with early childhood trauma, 22 participants with SAD without early childhood trauma, 17 with PTSD secondary to early childhood trauma and 25 control participants. We used Freesurfer version 6 to determine hippocampal subfield volumes. Findings included significant reduction in right parasubiculum volume between the PTSD group secondary to early childhood trauma and the SAD group without early childhood trauma, as well as a significant reduction in left HATA (Hippocampal Amygdala Transition Area) volume between PTSD with early childhood trauma compared to controls, as well as compared to SAD with early childhood trauma. These findings did withstand correction for multiple resting using the false discovery rate. Our findings of an association of reduced volumes in the parasubiculum and HATA regions with PTSD secondary to childhood trauma are interesting. Further work should investigate whether parasubiculum and HATA regional volume reductions in PTSD are a specific effect of early childhood trauma or a specific manifestation of PTSD pathology. Further work should also be undertaken to determine if hippocampal subfield atrophy is associated with SAD in the setting of early childhood maltreatment.
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Affiliation(s)
- Fatima Ahmed-Leitao
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa.
| | - David Rosenstein
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Melanie Marx
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Susanne Young
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
| | - Kristina Korte
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, United States
| | - Soraya Seedat
- South African Research Chairs Initiative (SARChI) in Posttraumatic Stress Disorder, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, PO Box 241, Tygerberg 8000, South Africa
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Iverach L, Jones M, Lowe R, O'Brian S, Menzies RG, Packman A, Onslow M. Comparison of adults who stutter with and without social anxiety disorder. J Fluency Disord 2018; 56:55-68. [PMID: 29602052 DOI: 10.1016/j.jfludis.2018.03.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 01/09/2018] [Accepted: 01/16/2018] [Indexed: 05/14/2023]
Abstract
PURPOSE Social anxiety disorder is a debilitating anxiety disorder associated with significant life impairment. The purpose of the present study is to evaluate overall functioning for adults who stutter with and without a diagnosis of social anxiety disorder. METHOD Participants were 275 adults who stuttered (18-80 years), including 219 males (79.6%) and 56 females (20.4%), who were enrolled to commence speech treatment for stuttering. Comparisons were made between participants diagnosed with social anxiety disorder (n = 82, 29.8%) and those without that diagnosis (n = 193, 70.2%). RESULTS Although the socially anxious group was significantly younger than the non-socially anxious group, no other demographic differences were found. When compared to the non-socially anxious group, the socially anxious group did not demonstrate significantly higher self-reported stuttering severity or percentage of syllables stuttered. Yet the socially anxious group reported more speech dissatisfaction and avoidance of speaking situations, significantly more psychological problems, and a greater negative impact of stuttering. CONCLUSION Significant differences in speech and psychological variables between groups suggest that, despite not demonstrating more severe stuttering, socially anxious adults who stutter demonstrate more psychological difficulties and have a more negative view of their speech. The present findings suggest that the demographic status of adults who stutter is not worse for those with social anxiety disorder. These findings pertain to a clinical sample, and cannot be generalized to the wider population of adults who stutter from the general community. Further research is needed to understand the longer-term impact of social anxiety disorder for those who stutter.
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Affiliation(s)
- Lisa Iverach
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Mark Jones
- School of Public Health, University of Queensland, Level 2, Public Health Building, Herston Road, Herston, QLD, 4006, Australia.
| | - Robyn Lowe
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Susan O'Brian
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Ross G Menzies
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Ann Packman
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
| | - Mark Onslow
- The University of Sydney, Faculty of Health Science, Australian Stuttering Research Centre, PO Box 170, Lidcombe, Sydney, NSW 1825, Australia.
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Bas-Hoogendam JM, van Steenbergen H, Nienke Pannekoek J, Fouche JP, Lochner C, Hattingh CJ, Cremers HR, Furmark T, Månsson KN, Frick A, Engman J, Boraxbekk CJ, Carlbring P, Andersson G, Fredrikson M, Straube T, Peterburs J, Klumpp H, Phan KL, Roelofs K, Veltman DJ, van Tol MJ, Stein DJ, van der Wee NJ. Voxel-based morphometry multi-center mega-analysis of brain structure in social anxiety disorder. Neuroimage Clin 2017; 16:678-688. [PMID: 30140607 PMCID: PMC6103329 DOI: 10.1016/j.nicl.2017.08.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Accepted: 08/01/2017] [Indexed: 01/04/2023]
Abstract
Social anxiety disorder (SAD) is a prevalent and disabling mental disorder, associated with significant psychiatric co-morbidity. Previous research on structural brain alterations associated with SAD has yielded inconsistent results concerning the direction of the changes in gray matter (GM) in various brain regions, as well as on the relationship between brain structure and SAD-symptomatology. These heterogeneous findings are possibly due to limited sample sizes. Multi-site imaging offers new opportunities to investigate SAD-related alterations in brain structure in larger samples. An international multi-center mega-analysis on the largest database of SAD structural T1-weighted 3T MRI scans to date was performed to compare GM volume of SAD-patients (n = 174) and healthy control (HC)-participants (n = 213) using voxel-based morphometry. A hypothesis-driven region of interest (ROI) approach was used, focusing on the basal ganglia, the amygdala-hippocampal complex, the prefrontal cortex, and the parietal cortex. SAD-patients had larger GM volume in the dorsal striatum when compared to HC-participants. This increase correlated positively with the severity of self-reported social anxiety symptoms. No SAD-related differences in GM volume were present in the other ROIs. Thereby, the results of this mega-analysis suggest a role for the dorsal striatum in SAD, but previously reported SAD-related changes in GM in the amygdala, hippocampus, precuneus, prefrontal cortex and parietal regions were not replicated. Our findings emphasize the importance of large sample imaging studies and the need for meta-analyses like those performed by the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Consortium. Multi-center mega-analysis on gray matter (GM) in social anxiety disorder (SAD) Largest sample available for analysis to date: 174 SAD-patients vs 213 controls Larger GM volume in the right putamen in SAD-patients No SAD-related alterations in amygdala-hippocampal, prefrontal or parietal regions Results stress need for larger samples and meta-analyses - cf. ENIGMA Consortium
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Affiliation(s)
- Janna Marie Bas-Hoogendam
- Institute of Psychology, Leiden University, Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
- Corresponding author at: Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, The Netherlands.
| | - Henk van Steenbergen
- Institute of Psychology, Leiden University, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
| | - J. Nienke Pannekoek
- Neuropsychopharmacology Unit, Centre for Psychiatry, Division of Brain Sciences, Imperial College London, United Kingdom
| | - Jean-Paul Fouche
- Department of Psychiatry and Mental Health, University of Cape Town, Observatory, Cape Town, South Africa
| | - Christine Lochner
- SU/UCT MRC Unit on Anxiety & Stress Disorders, South Africa
- Department of Psychiatry, Stellenbosch University, Tygerberg, South Africa
| | - Coenraad J. Hattingh
- Department of Psychiatry and Mental Health, University of Cape Town, Observatory, Cape Town, South Africa
| | - Henk R. Cremers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Tomas Furmark
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Kristoffer N.T. Månsson
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Department of Psychology, Stockholm University, Stockholm, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Andreas Frick
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Jonas Engman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Carl-Johan Boraxbekk
- Umeå Centre for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden
- Danish Research Centre for Magnetic Resonance (DRCMR), Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark
| | - Per Carlbring
- Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Gerhard Andersson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
- Department of Behavioural Sciences and Learning, Psychology, Linköping University, Linköping, Sweden
| | - Mats Fredrikson
- Department of Psychology, Uppsala University, Uppsala, Sweden
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Jutta Peterburs
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Münster, Germany
| | - Heide Klumpp
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States
| | - K. Luan Phan
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, United States
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, United States
| | - Karin Roelofs
- Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Dick J. Veltman
- Department of Psychiatry, Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Marie-José van Tol
- Department of Neuroscience, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Observatory, Cape Town, South Africa
- SU/UCT MRC Unit on Anxiety & Stress Disorders, South Africa
| | - Nic J.A. van der Wee
- Department of Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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