TY - JOUR
T1 - Social anxiety is associated with BNST response to unpredictability
AU - Clauss, Jacqueline A.
AU - Avery, Suzanne N.
AU - Benningfield, Margaret M.
AU - Blackford, Jennifer U.
N1 - Funding Information:
We are grateful for assistance by Ross VanDerKlok in data collection and processing. This study was supported by the National Institutes of Health (NIMH: K01‐MH083052 to JUB; F30‐MH097344 to JAC), the Vanderbilt Institute for Clinical and Translational Research (NCRR; UL1‐RR024975, TL1‐RR024978), Developmental Psychopathology Training Grant (NIMH; T32‐MH018921); and Vanderbilt Medical Scientist Training Program (NIGMS; T32‐GM07347). Dr. Blackford's effort was partially supported by a MERIT award (CX001226) and Dr. Clauss' effort was also supported by NIMH R25‐MH094612 (MGH/McLean Research Concentration Program).
Publisher Copyright:
© 2019 Wiley Periodicals, Inc.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - Background: Anxiety disorders are highly prevalent and cause substantial suffering and impairment. Whereas the amygdala has well-established contributions to anxiety, evidence from rodent and nonhuman primate models suggests that the bed nucleus of the stria terminalis (BNST) may play a critical, and possibly distinct, role in human anxiety disorders. The BNST mediates hypervigilance and anticipatory anxiety in response to an unpredictable or ambiguous threat, core symptoms of social anxiety, yet little is known about the BNST's role in social anxiety. Methods: Functional magnetic resonance imaging was used to measure neural responses during a cued anticipation task with an unpredictable, predictable threat, and predictable neutral cues followed by threat or neutral images. Social anxiety was examined using a dimensional approach (N = 44 adults). Results: For unpredictable cues, higher social anxiety was associated with lower BNST–amygdala connectivity. For unpredictable images, higher social anxiety was associated with greater connectivity between the BNST and both the ventromedial prefrontal cortex and the posterior cingulate cortex and lower connectivity between the BNST and postcentral gyrus. Social anxiety moderated the BNST–amygdala dissociation for unpredictable images; higher social anxiety was associated with BNST > amygdala response to unpredictable threat relative to unpredictable neutral images. Conclusions: Social anxiety was associated with alterations in BNST responses to unpredictability, particularly in the BNST's interactions with other brain regions, including the amygdala and prefrontal cortex. To our knowledge, these findings provide the first evidence for the BNST's role in social anxiety, which may be a potential new target for prevention and intervention.
AB - Background: Anxiety disorders are highly prevalent and cause substantial suffering and impairment. Whereas the amygdala has well-established contributions to anxiety, evidence from rodent and nonhuman primate models suggests that the bed nucleus of the stria terminalis (BNST) may play a critical, and possibly distinct, role in human anxiety disorders. The BNST mediates hypervigilance and anticipatory anxiety in response to an unpredictable or ambiguous threat, core symptoms of social anxiety, yet little is known about the BNST's role in social anxiety. Methods: Functional magnetic resonance imaging was used to measure neural responses during a cued anticipation task with an unpredictable, predictable threat, and predictable neutral cues followed by threat or neutral images. Social anxiety was examined using a dimensional approach (N = 44 adults). Results: For unpredictable cues, higher social anxiety was associated with lower BNST–amygdala connectivity. For unpredictable images, higher social anxiety was associated with greater connectivity between the BNST and both the ventromedial prefrontal cortex and the posterior cingulate cortex and lower connectivity between the BNST and postcentral gyrus. Social anxiety moderated the BNST–amygdala dissociation for unpredictable images; higher social anxiety was associated with BNST > amygdala response to unpredictable threat relative to unpredictable neutral images. Conclusions: Social anxiety was associated with alterations in BNST responses to unpredictability, particularly in the BNST's interactions with other brain regions, including the amygdala and prefrontal cortex. To our knowledge, these findings provide the first evidence for the BNST's role in social anxiety, which may be a potential new target for prevention and intervention.
KW - BST
KW - amygdala
KW - anxiety
KW - fMRI
KW - uncertainty
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U2 - 10.1002/da.22891
DO - 10.1002/da.22891
M3 - Article
C2 - 30953446
AN - SCOPUS:85063942617
SN - 1091-4269
VL - 36
SP - 666
EP - 675
JO - Anxiety
JF - Anxiety
IS - 8
ER -