Gray matter matters: The structure of the socially-anxious brain

摘要

Social anxiety disorder (SAD) is a serious, disabling and prevalentanxiety disorder, with a chronic course and a complex pathophysiology[1]. Treatment for the disorder is often only moderately effective,so insight in the neurobiological alterations underlying the conditionis pivotal in order to improve therapeutic interventions in clinicalpractice [2]. In the last decade, several neuroimaging studies haveexplored differences in brain structure between patients with SADand healthy control participants, for example by employing a megaanalyticalapproach on an international multi-center dataset of MRIdata [3]. In addition, qualitative reviews and quantitative meta-analyses,based on the results of patient-control studies with relativelysmall sample sizes, have shed light on changes in gray matter volumein SAD [4,5]. These studies point at differences in brain structure invarious subcortical (for example, putamen and thalamus) and corticalbrain regions (including prefrontal areas, regions of the parietal cortexand temporal areas), but the results are, until now, heterogeneous,probably due to methodological differences with respect tothe analyses, as well as to variations in clinical characteristics likepsychiatric comorbidity and treatment (either by pharmacologicaldrugs or cognitive behavioral therapy).