Research Center for Child Mental Development, Chiba University, Chiba, Japan.
United Graduate School of Child Development, Osaka University, Suita, Japan.
Brain Connect. 2024 Oct;14(8):445-456. doi: 10.1089/brain.2024.0034. Epub 2024 Aug 28.
Generalized anxiety disorder (GAD) and social anxiety disorder (SAD) are distinguished by whether anxiety is limited to social situations. However, reports on the differences in brain functional networks between GAD and SAD are few. Our objective is to understand the pathogenesis of GAD and SAD by examining the differences in resting brain function between patients with GAD and SAD and healthy controls (HCs). This study included 21 patients with SAD, 17 patients with GAD, and 30 HCs. Participants underwent psychological assessments and resting-state functional magnetic resonance imaging. Whole-brain analyses were performed to compare resting-state functional connectivity (rsFC) among the groups. In addition, logistic regression analysis was conducted on the rsFC to identify significant differences between GAD and SAD. Patients with SAD and GAD had significantly higher rsFC between the bilateral postcentral gyri and bilateral amygdalae/thalami than HCs. Compared with patients with SAD, those with GAD had significantly higher rsFC between the right nucleus accumbens and bilateral thalami and between the left nucleus accumbens and right thalamus. rsFC between the left nucleus accumbens and right thalamus positively correlated with state anxiety in patients with SAD and GAD, respectively. In addition, logistic regression analysis revealed that the right nucleus accumbens and the right thalamus connectivity could distinguish SAD from GAD. GAD and SAD were distinguished by the right nucleus accumbens and the right thalamus connectivity. Our findings offer insights into the disease-specific neural basis of SAD and GAD. Clinical Trial Registration Number: UMIN000024087. Impact Statement This study is the first to identify a resting state functional connectivity that distinguishes social anxiety disorder (SAD) from generalized anxiety disorder (GAD) and to clarify a common connectivity in both disorders. We found that the connectivity between the right nucleus accumbens and the right thalamus differentiated SAD from GAD. Furthermore, these rsFC differences suggest an underlying basis for fear overgeneralization. Our findings shed light on the pathophysiology of these conditions and could be used as a basis for further studies to improve outcomes for such patients.
广泛性焦虑障碍（GAD）和社交焦虑障碍（SAD）的区别在于焦虑是否仅限于社交情境。然而，关于 GAD 和 SAD 之间脑功能网络差异的报告很少。我们的目的是通过检查 GAD 和 SAD 患者与健康对照者（HCs）之间静息脑功能的差异来了解 GAD 和 SAD 的发病机制。该研究纳入了 21 例 SAD 患者、17 例 GAD 患者和 30 例 HCs。参与者接受了心理评估和静息态功能磁共振成像。对三组间静息态功能连接（rsFC）进行全脑分析。此外，还对 rsFC 进行逻辑回归分析，以确定 GAD 和 SAD 之间的显著差异。SAD 和 GAD 患者双侧中央后回与双侧杏仁核/丘脑之间的 rsFC 显著高于 HCs。与 SAD 患者相比，GAD 患者右侧伏隔核与双侧丘脑之间以及左侧伏隔核与右侧丘脑之间的 rsFC 显著升高。SAD 和 GAD 患者左侧伏隔核与右侧丘脑之间的 rsFC 与状态焦虑呈正相关。此外，逻辑回归分析显示，右侧伏隔核和右侧丘脑的连接可以区分 SAD 和 GAD。GAD 和 SAD 可通过右侧伏隔核和右侧丘脑的连接来区分。我们的研究结果为 SAD 和 GAD 的疾病特异性神经基础提供了新的见解。临床试验注册号：UMIN000024087。 影响陈述 这项研究首次确定了一种能够区分社交焦虑障碍（SAD）和广泛性焦虑障碍（GAD）的静息态功能连接，并阐明了两种障碍的共同连接。我们发现，右侧伏隔核和右侧丘脑之间的连接可区分 SAD 和 GAD。此外，这些 rsFC 差异表明存在恐惧泛化的基础。我们的发现为这些疾病的病理生理学提供了新的见解，并可作为进一步研究的基础，以改善此类患者的预后。
