Insula activation is modulated by attention shifting in social anxiety disorder

Abstract

Social anxiety disorder (SAD) is characterized by exaggerated reactivity to social threat, often documented by biased attention to threatening information, and increased activation in brain regions involved in salience/threat processing. Attention training has been developed to ameliorate the attention bias documented in individuals with SAD, with mixed results. We investigated patterns of brain activation underlying acute attention modulation in 41 participants (29 with SAD and 12 health controls). We then investigated how brain activation changed over time in both groups in response to a 4-session attention training protocol (toward threat, away from threat, no-training control). Results revealed diminished pre-training deactivation in the insula in SAD participants during attention modulation. SAD participants also demonstrated an increase in insula deactivation over time, suggestive of an improvement in attention modulation of emotion, and this was associated with a decrease in symptom severity. Attention training did not, itself, lead to clinical improvement, though there was a trend level effect of training toward threat on increased insula deactivation over time. While deficits in attentional control and emotion modulation are documented in individuals with SAD, current attention training protocols are not robustly effective in ameliorating aberrant functioning. Pursuit of training protocols that have more robust impacts on the relevant neural circuitry may have some value.

Increased attentional network activity in premature ejaculation patients with anxiety revealed by resting‐state functional magnetic resonance imaging

“…High rates of anxiety and depression symptoms have been found in PE patients (Mourikis et al, 2015). Previous neuroimaging studies demonstrated that the brain networks for attention and emotion regulation were disrupted in patients with anxiety disorders (Duval et al, 2018;Greenberg et al, 2017;Pic o-Pérez et al, 2017;Tan et al, 2018). The prefrontal cortex, especially inferior medial prefrontal cortex, have been identified as a core area for attention and emotion processing (Doll et al, 2016;Geday & Gjedde, 2009).…”

Charting brain growth and aging at high spatial precision

“…For data sets that include repeated visits (i.e., ABCD, UKBiobank), only the first visit was included. Other included data come from studies conducted at the University of Michigan (Duval et al, 2018;Rutherford et al, 2020;Tomlinson et al, 2020;Tso et al, 2021;Weigard et al, 2021;Zucker et al, 1996), University of California Davis (Nordahl et al, 2020), University of Oslo (Nesvåg et al, 2017), King's College London (Green et al, 2012;Lythe et al, 2015), and Amsterdam University Medical Center (Mocking et al, 2016). Full details regarding sample characteristics, diagnostic procedures and acquisition protocols can be found in the publications associated with each of the studies.…”

EEG Source Localization and Attention Differences Between Children Exposed to Drugs in Utero and Those with Attention-Deficit/Hyperactivity Disorder: A Pilot Study

“…The middle insula is suggested to be associated with polymodal integration and may also play an important role in motor processes and regulation. The posterior insula is proposed to be associated with interoceptive processes and awareness of the bodily state, as well as potential in attention, sensory, and social processes (Di Cesare, Pinardi, et al, 2018;Duval, Joshi, Russman Block, Abelson, & Liberzon, 2018;Schiff et al, 2018;Wang et al, 2018;Zhang et al, 2019). It is of note that most differences, even those not reaching significance, were found in the left hemisphere.…”