Journal
PSYCHOLOGICAL MEDICINE
Volume 51, Issue 10, Pages 1742-1751Publisher
CAMBRIDGE UNIV PRESS
DOI: 10.1017/S0033291720000495
Keywords
Adolescents; brain development; fronto-limbic; gray matter volume; social anxiety disorder; structural co-variance
Categories
Funding
- National Key R&D Program of China [2018YFC2001600]
- National Natural Science Foundation of China [81971682, 81571756, 81270023]
- Project of Shanghai Children's Health Service Capacity Construction [GDEK201702]
- Clinical Research Project of Shanghai Mental Health Center [CRC2019ZD04]
- Shanghai Municipal Commission of Education - Gaofeng Clinical Medicine Grant Support [20171929]
- Hundred-Talent Fund from Shanghai Municipal Commission of Health [2018BR17]
- Research Funds from Shanghai Mental Health Center [13dz2260500, 2018-YJ-02, 2018-YJ-03]
- Shanghai Jiao Tong University School of Medicine Child Developing Brain Research Center Construction Funds
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The study found significantly higher gray matter volume in the orbitofrontal cortex (OFC) and the insula in adolescents with SAD compared to healthy controls. Additionally, significant co-variance of gray matter volume between the OFC and amygdala, and the OFC and insula was observed in healthy controls but weakened in adolescents with SAD.
Background 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. Methods 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. Results 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. Conclusions 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.
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