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Amygdala-frontal couplings characterizing SSRI and placebo response in social anxiety disorder
Department of Psychology, Uppsala University, Uppsala, Sweden.
Department of Psychology and Neuroscience, Duke University, Durham, NC, USA.ORCID iD: 0000-0002-6355-660x
PET Centre, Uppsala University Hospital and Section of Nuclear Medicine and PET, Uppsala University, Uppsala, Sweden.
P.A.I.N. Group, Department of Anesthesia, Children's Hospital, Boston, MA, USA.
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2014 (English)In: International Journal of Neuropsychopharmacology, ISSN 1461-1457, E-ISSN 1469-5111, Vol. 17, no 8, p. 1149-57Article in journal (Refereed) Published
Abstract [en]

UNLABELLED: In patients with social anxiety disorder (SAD) it has been reported that selective serotonin reuptake inhibitors (SSRIs) and placebo induce anxiolytic effects by attenuating neural activity in overlapping amygdala subregions, i.e. left basolateral and right ventrolateral amygdala. However, it is not known whether these treatments inhibit amygdala subregions via similar or distinct brain pathways. As anxiolytic treatments may alter amygdala-frontal couplings we investigated differences and similarities in amygdala-frontal functional co-activation patterns between responders and nonresponders to SSRIs and placebo in patients with SAD. Positron emission tomography (PET) with oxygen-15-labeled water was used to measure anxiety-related regional cerebral blood flow in 72 patients with SAD before and after 6-8 wk of treatment under double-blind conditions. Functional couplings were evaluated with a seed region approach using voxel values from the left basolateral and right ventrolateral amygdala. Responders and nonresponders to SSRIs and placebo showed different treatment-induced co-activations between the left amygdala and the dorsolateral prefrontal cortex (dlPFC) as well as the rostral anterior cingulate cortex (ACC). Conjunction analysis suggested shared anxiolysis-dependent inverse co-activations in SSRI and placebo responders between the left amygdala-dlPFC and left amygdala-rostral ACC, and a shared positive co-activation between left amygdala-dorsal ACC. We demonstrate that amygdala-frontal co-activation patterns differentiate effective from ineffective anxiolytic treatments and that SSRI and placebo responders share overlapping neuromodulatory paths that may underlie improved emotion regulation and reduced expression of anxiety.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00343707.

Place, publisher, year, edition, pages
Oxford University Press, 2014. Vol. 17, no 8, p. 1149-57
Keywords [en]
Amygdala, anxiety, dlPFC, placebo, rACC, SSRI
National Category
Neurosciences Psychology
Identifiers
URN: urn:nbn:se:miun:diva-38892DOI: 10.1017/S1461145714000352ISI: 000338098500004PubMedID: 24666527Scopus ID: 2-s2.0-84938072921OAI: oai:DiVA.org:miun-38892DiVA, id: diva2:1423375
Available from: 2020-04-14 Created: 2020-04-14 Last updated: 2020-05-08Bibliographically approved

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Åhs, Fredrik

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