Altered cortical-Amygdala coupling in social anxiety disorder during the anticipation of giving a public speech

BACKGROUND: Severe stress in social situations is a core symptom of social anxiety disorder (SAD). Connectivity between the amygdala and cortical regions is thought to be important for emotion regulation, a function that is compromised in SAD. However, it has never been tested if and how this connectivity pattern changes under conditions of stress-inducing social evaluative threat. Here we investigate changes in cortical-Amygdala coupling in SAD during the anticipation of giving a public speech.

METHOD: Twenty individuals with SAD and age-, gender-and education-matched controls (n = 20) participated in this study. During the functional magnetic resonance imaging (fMRI) session, participants underwent three 'resting-state' fMRI scans: one before, one during, and one after the anticipation of giving a public speech. Functional connectivity between cortical emotion regulation regions and the amygdala was investigated.

RESULTS: Compared to controls, SAD participants showed reduced functional integration between cortical emotion regulation regions and the amygdala during the public speech anticipation. Moreover, in SAD participants cortical-Amygdala connectivity changes correlated with social anxiety symptom severity.

CONCLUSIONS: The distinctive pattern of cortical-Amygdala connectivity suggests less effective cortical-subcortical communication during social stress-provoking situations in SAD.