BACKGROUND: The aim was to examine the neural correlates of anxiety elicited by the anticipation of public speaking in individuals with social phobia. Positron emission tomography and (15)O-water was used to measure regional cerebral blood flow in subjects with DSM-IV defined social phobia during anxiety anticipation. Heart rate and subjective anxiety were also recorded. While being scanned, subjects were speaking alone either before or after speaking in public. To evaluate anticipatory anxiety we compared individuals speaking alone before they were speaking in front of an audience with those who did the reverse. RESULTS: Heart rate and subjective anxiety measures confirmed anticipatory anxiety in social phobics who performed their private speech before their public. This was accompanied by enhanced cerebral blood flow in the right dorsolateral prefrontal cortex, left inferior temporal cortex, and in the left amygdaloid-hippocampal region. Brain blood flow was lower in the left temporal pole and bilaterally in the cerebellum in the anticipation group. CONCLUSIONS: Brain regions with altered perfusion presumably reflect changes in neural activity associated with worry about anticipated public performance. We speculate that anticipatory anxiety in social phobics originates in an affect sensitive fear network encompassing the amygdaloid-hippocampal region, prefrontal, and temporal areas.
BACKGROUND: The aim was to examine the neural correlates of anxiety elicited by the anticipation of public speaking in individuals with social phobia. Positron emission tomography and (15)O-water was used to measure regional cerebral blood flow in subjects with DSM-IV defined social phobia during anxiety anticipation. Heart rate and subjective anxiety were also recorded. While being scanned, subjects were speaking alone either before or after speaking in public. To evaluate anticipatory anxiety we compared individuals speaking alone before they were speaking in front of an audience with those who did the reverse. RESULTS: Heart rate and subjective anxiety measures confirmed anticipatory anxiety in social phobics who performed their private speech before their public. This was accompanied by enhanced cerebral blood flow in the right dorsolateral prefrontal cortex, left inferior temporal cortex, and in the left amygdaloid-hippocampal region. Brain blood flow was lower in the left temporal pole and bilaterally in the cerebellum in the anticipation group. CONCLUSIONS: Brain regions with altered perfusion presumably reflect changes in neural activity associated with worry about anticipated public performance. We speculate that anticipatory anxiety in social phobics originates in an affect sensitive fear network encompassing the amygdaloid-hippocampal region, prefrontal, and temporal areas.
Authors: Matthew S Tryon; Kimber L Stanhope; Elissa S Epel; Ashley E Mason; Rashida Brown; Valentina Medici; Peter J Havel; Kevin D Laugero Journal: J Clin Endocrinol Metab Date: 2015-04-16 Impact factor: 5.958
Authors: Brian R Cornwell; Randi Heller; Arter Biggs; Daniel S Pine; Christian Grillon Journal: J Clin Psychiatry Date: 2010-10-05 Impact factor: 4.384
Authors: Bettina Gathmann; Frank P Schulte; Stefan Maderwald; Mirko Pawlikowski; Katrin Starcke; Lena C Schäfer; Tobias Schöler; Oliver T Wolf; Matthias Brand Journal: Exp Brain Res Date: 2014-01-10 Impact factor: 1.972