Liu Zhen, Hu Yang, Zhang Yiwen, Liu Wenjing, Zhang Lei, Wang Yunyi, Yang Hanshu, Wu Jingyi, Cheng Wenhong, Yang Zhi
Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Laboratory of Psychological Health and Imaging, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Psychol Med. 2021 Jul;51(10):1742-1751. doi: 10.1017/S0033291720000495. Epub 2020 Mar 17.
Social anxiety disorder (SAD) is a prevalent mental disorder diagnosed in childhood and adolescence. Theories regarding brain development and SAD suggest a close link between neurodevelopmental dysfunction at the adolescent juncture and SAD, but direct evidence is rare. This study aims to examine brain structural abnormalities in adolescents with SAD.
High-resolution T1-weighted images were obtained from 31 adolescents with SAD (15-17 years) and 42 matching healthy controls (HC). We evaluated symptom severity with the Social Anxiety Scale for Children (SASC) and the Screen for Child Anxiety Related Emotional Disorders (SCARED). We used voxel-based morphometry analysis to detect regional gray matter volume abnormalities and structural co-variance analysis to investigate inter-regional coordination patterns.
We found significantly higher gray matter volume in the orbitofrontal cortex (OFC) and the insula in adolescents with SAD compared to HC. We also observed significant co-variance of the gray matter volume between the OFC and amygdala, and the OFC and insula in HC, but these co-variance relationships diminished in SAD.
These findings provide the first evidence that the brain structural deficits in adolescents with SAD are not only in the core regions of the fronto-limbic system, but also represented by the diminished coordination in the development of these regions. The delayed and unsynchronized development pattern of the fronto-limbic system supports SAD as an adolescent-sensitive developmental mental disorder.
社交焦虑障碍（SAD）是一种在儿童期和青少年期被诊断出的常见精神障碍。关于大脑发育与SAD的理论表明，青少年时期的神经发育功能障碍与SAD之间存在密切联系，但直接证据很少。本研究旨在检查患有SAD的青少年的脑结构异常。
从31名患有SAD的青少年（15 - 17岁）和42名匹配的健康对照（HC）中获取高分辨率T1加权图像。我们使用儿童社交焦虑量表（SASC）和儿童焦虑相关情绪障碍筛查量表（SCARED）评估症状严重程度。我们使用基于体素的形态计量学分析来检测区域灰质体积异常，并使用结构协方差分析来研究区域间协调模式。
我们发现，与HC相比，患有SAD的青少年眶额皮质（OFC）和脑岛的灰质体积明显更高。我们还观察到，在HC中，OFC与杏仁核以及OFC与脑岛之间的灰质体积存在显著协方差，但这些协方差关系在SAD中减弱。
这些发现提供了首个证据，表明患有SAD的青少年的脑结构缺陷不仅存在于额边缘系统的核心区域，还表现为这些区域发育过程中协调性的减弱。额边缘系统延迟且不同步的发育模式支持SAD作为一种对青少年敏感的发育性精神障碍。
