Journal
NEUROPSYCHOPHARMACOLOGY
Volume 39, Issue 2, Pages 425-434Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/npp.2013.211
Keywords
diagnostic classification; selective serotonin reuptake inhibitor; SSRI; support vector machine; longitudinal; neuroimaging
Categories
Funding
- NIMH predoctoral fellowship (NRSA) [F31MH088104-02]
- National Institute of Drug Abuse [K01 DA029598]
- NARSAD Young Investigator Award
- US Army TARDEC [W56HZV-04-P-L]
- Sycamore Fund
- [PO1MH60970]
- [R21 MH077976]
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Group functional magnetic resonance imaging (fMRI) studies suggest that anxiety disorders are associated with anomalous brain activation and functional connectivity (FC). However, brain-based features sensitive enough to discriminate individual subjects with a specific anxiety disorder and that track symptom severity longitudinally, desirable qualities for putative disorder-specific biomarkers, remain to be identified. Blood oxygen level-dependent (BOLD) fMRI during emotional face perceptual tasks and a new, large-scale and condition-dependent FC and machine learning approach were used to identify features (pair-wise correlations) that discriminated patients with social anxiety disorder (SAD, N = 16) from controls (N = 19). We assessed whether these features discriminated SAD from panic disorder (PD, N = 16), and SAD from controls in an independent replication sample that performed a similar task at baseline (N: SAD = 15, controls = 17) and following 8-weeks paroxetine treatment (N: SAD = 12, untreated controls = 7). High SAD vs HCs discrimination (area under the ROC curve, AUC, arithmetic mean of sensitivity and specificity) was achieved with two FC features during unattended neutral face perception (AUC = 0.88, P<0.05 corrected). These features also discriminated SAD vs PD (AUC = 0.82, P = 0.0001) and SAD vs HCs in the independent replication sample (FC during unattended angry face perception, AUC = 0.71, P = 0.01). The most informative FC was left hippocampus-left temporal pole, which was reduced in both SAD samples (replication sample P = 0.027), and this FC increased following the treatment (post>pre, t((11)) = 2.9, P = 0.007). In conclusion, SAD is associated with reduced FC between left temporal pole and left hippocampus during face perception, and results suggest promise for emerging FC-based biomarkers for SAD diagnosis and treatment effects.
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