본문 바로가기
KERD
논문KCI 등재

Neural Correlates of Self-referential Processing and Their Clinical Implications in Social Anxiety Disorder

2

조회

0

다운로드

1

인용

0

참고문헌

키워드

초록

Social anxiety disorder (SAD) is associated with aberrant self-referential processing (SRP) such as increased self-focused attention. Aberrant SRP is one of the core features of SAD and is also related to therapeutic interventions. Understanding of the underlying neural correlates of SRP in SAD is important for identifying specific brain regions as treatment targets. We reviewed functional magnetic resonance imaging (fMRI) studies to clarify the neural correlates of SRP and their clinical implications for SAD. Task-based and resting fMRI studies have reported the cortical midline structures including the default mode network, theory of mind-related regions of the temporo-parietal junction and temporal pole, and the insula as significant neural correlates of aberrant SRP in SAD patients. Also, these neural correlates are related to clinical improvement on pharmacological and cognitive-behavioral treatments. Furthermore, these could be candidates for the development of novel SAD treatments. This review supports that neural correlates of SAD may be significant biomarkers for future pathophysiology based treatment.

Abstract

Social anxiety disorder (SAD) is associated with aberrant self-referential processing (SRP) such as increased self-focused attention. Aberrant SRP is one of the core features of SAD and is also related to therapeutic interventions. Understanding of the underlying neural correlates of SRP in SAD is important for identifying specific brain regions as treatment targets. We reviewed functional magnetic resonance imaging (fMRI) studies to clarify the neural correlates of SRP and their clinical implications for SAD. Task-based and resting fMRI studies have reported the cortical midline structures including the default mode network, theory of mind-related regions of the temporo-parietal junction and temporal pole, and the insula as significant neural correlates of aberrant SRP in SAD patients. Also, these neural correlates are related to clinical improvement on pharmacological and cognitive-behavioral treatments. Furthermore, these could be candidates for the development of novel SAD treatments. This review supports that neural correlates of SAD may be significant biomarkers for future pathophysiology based treatment.

참고문헌 (117)

  1. Kessler RC, "Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication", Arch Gen Psychiatry, 62, pp.593~602 (2005)
  2. clinical psychiatry, "Kaplan & Sadock's synopsis of psychiatry : behavioral sciences", pp.Lippincott Williams & Wilkins, Sadock BJ
  3. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders", pp.947~ (2013), American Psychiatric Association
  4. Freitas-Ferrari MC, "Neuroimaging in social anxiety disorder : a systematic review of the literature", Prog Neuropsychopharmacol Biol Psychiatry, 34, pp.565~580 (2010)
  5. Etkin A, "Functional neuroimaging of anxiety : a meta-analysis of emotional processing in PTSD, social anxiety disorder, and specific phobia", Am J Psychiatry, 164, pp.1476~1488 (2007)
  6. Blair KS, "A cognitive neuroscience approach to generalized anxiety disorder and social phobia", Emot Rev, 4, pp.133~138 (2012)
  7. Northoff G, "Self-referential processing in our brain--a meta-analysis of imaging studies on the self", Neuroimage, 31, pp.440~457 (2006)
  8. Spurr JM, "Self-focused attention in social phobia and social anxiety", Clin Psychol Rev, 22, pp.947~975 (2002)
  9. Clark DM, "International handbook of social anxiety: concepts, research, and interventions relating to the self and shyness", pp.405~430 (2001), John Wiley & Sons
  10. Fenigstein A, "Public and private self-consciousness : assessment and theory", J Consult Clin Psychol, 43, pp.522~527 (1975)
  11. Bruch MA, "Differences in perceptions of parental and personal characteristics between generalized and nongeneralized social phobics", J Anxiety Disord, 8, pp.155~168 (1994)
  12. Clark DM, "Social phobia: diagnosis, assessment, and treatment", pp.69~93 (1995), Guilford Press
  13. Rapee RM, "A cognitive-behavioral model of anxiety in social phobia", Behav Res Ther, 35, pp.741~756 (1997)
  14. Hackmann A, "Seeing yourself through others’ eyes : a study of spontaneously occurring images in social phobia", Behav Cogn Psychother, 26, pp.3~12 (1998)
  15. Hofmann SG, "Changes in self-perception during treatment of social phobia", J Consult Clin Psychol, 72, pp.588~596 (2004)
  16. Blair K, "Neural response to self-and other referential praise and criticism in generalized social phobia", Arch Gen Psychiatry, 65, pp.1176~1184 (2008)
  17. Blair KS, "Atypical modulation of medial prefrontal cortex to self-referential comments in generalized social phobia", Psychiatry Res, 193, pp.38~45 (2011)
  18. Northoff G, "Cortical midline structures and the self", Trends Cogn Sci, 8, pp.102~107 (2004)
  19. Qin P, "How is our self related to midline regions and the default-mode network", Neuroimage, 57, pp.1221~1233 (2011)
  20. Frith CD, "The neural basis of mentalizing", Neuron, 50, pp.531~534 (2006)
  21. Saxe R, "People thinking about thinking people. The role of the temporo-parietal junction in “theory of mind”", Neuroimage, 19, pp.1835~1842 (2003)
  22. Gallese V, "Mirror neurons and the simulation theory of mind-reading", Trends Cogn Sci, 2, pp.493~501 (1998)
  23. Epley N, "Perspective taking as egocentric anchoring and adjustment", J Pers Soc Psychol, 87, pp.327~339 (2004)
  24. Stein MB, "Increased amygdala activation to angry and contemptuous faces in generalized social phobia", Arch Gen Psychiatry, 59, pp.1027~1034 (2002)
  25. Straube T, "Common and distinct brain activation to threat and safety signals in social phobia", Neuropsychobiology, 52, pp.163~168 (2005)
  26. Phan KL, "Association between amygdala hyperactivity to harsh faces and severity of social anxiety in generalized social phobia", Biol Psychiatry, 59, pp.424~429 (2006)
  27. Amir N, "Increased activation of the anterior cingulate cortex during processing of disgust faces in individuals with social phobia", Biol Psychiatry, 57, pp.975~981 (2005)
  28. Straube T, "Effect of task conditions on brain responses to threatening faces in social phobics : an event-related functional magnetic resonance imaging study", Biol Psychiatry, 56, pp.921~930 (2004)
  29. Klumpp H, "Neural predictors and mechanisms of cognitive behavioral therapy on threat processing in social anxiety disorder", Prog Neuropsychopharmacol Biol Psychiatry, 45, pp.83~91 (2013)
  30. Brühl AB, "General emotion processing in social anxiety disorder : neural issues of cognitive control", Psychiatry Res, 212, pp.108~115 (2013)
  31. Schneier FR, "Neural response to eye contact and paroxetine treatment in generalized social anxiety disorder", Psychiatry Res, 194, pp.271~278 (2011)
  32. Giménez M, "Functional effects of chronic paroxetine versus placebo on the fear, stress and anxiety brain circuit in social anxiety disorder : initial validation of an imaging protocol for drug discovery", Eur Neuropsychopharmacol, 24, pp.105~116 (2014)
  33. Lee MH, "Resting-state fMRI : a review of methods and clinical applications", AJNR Am J Neuroradiol, 34, pp.1866~1872 (2013)
  34. Woodward ND, "Resting-state functional connectivity in psychiatric disorders", JAMA Psychiatry, 72, pp.743~744 (2015)
  35. Fox MD, "The human brain is intrinsically organized into dynamic, anticorrelated functional networks", Proc Natl Acad Sci U S A, 102, pp.9673~9678 (2005)
  36. Etkin A, "Disrupted amygdalar subregion functional connectivity and evidence of a compensatory network in generalized anxiety disorder", Arch Gen Psychiatry, 66, pp.1361~1372 (2009)
  37. Gusnard DA, "Medial prefrontal cortex and self-referential mental activity : relation to a default mode of brain function", Proc Natl Acad Sci U S A, 98, pp.4259~4264 (2001)
  38. Liu F, "Multivariate classification of social anxiety disorder using whole brain functional connectivity", Brain Struct Funct, 220, pp.101~115 (2015)
  39. Zhang W, "Diagnostic prediction for social anxiety disorder via multivariate pattern analysis of the regional homogeneity", Biomed Res Int, 2015, pp.763965~ (2015)
  40. Stein DJ, "Social anxiety disorder and the psychobiology of self-consciousness", Front Hum Neurosci, 9, pp.489~ (2015)
  41. Mason MF, "Wandering minds : the default network and stimulus-independent thought", Science, 315, pp.393~395 (2007)
  42. Andrews‐Hanna JR, "The default network and self‐generated thought : component processes, dynamic control, and clinical relevance", Ann N Y Acad Sci, 1316, pp.29~52 (2014)
  43. Greicius MD, "Functional connectivity in the resting brain : a network analysis of the default mode hypothesis", Proc Natl Acad Sci U S A, 100, pp.253~258 (2003)
  44. Raichle ME, "A default mode of brain function : a brief history of an evolving idea", Neuroimage, 37, pp.1083~1090 (2007)
  45. Cavanna AE, "The precuneus : a review of its functional anatomy and behavioural correlates", Brain, 129, pp.564~583 (2006)
  46. Johnson SC, "Neural correlates of self‐reflection", Brain, 125, pp.1808~1814 (2002)
  47. Zysset S, "The anterior frontomedian cortex and evaluative judgment : an fMRI study", Neuroimage, 15, pp.983~991 (2002)
  48. Fossati P, "Distributed self in episodic memory : neural correlates of successful retrieval of self-encoded positive and negative personality traits", Neuroimage, 22, pp.1596~1604 (2004)
  49. Fossati P, "In search of the emotional self : an fMRI study using positive and negative emotional words", Am J Psychiatry, 160, pp.1938~1945 (2003)
  50. Soonjo Hwang, "Neurodevelopmental Changes in Social Reinforcement Processing: A Functional Magnetic Resonance Imaging Study", Clinical Psychopharmacology and Neuroscience, 15(4), pp.369~381 (2017), 대한정신약물학회[DOI]
  51. Mitchell JP, "Dissociable medial prefrontal contributions to judgments of similar and dissimilar others", Neuron, 50, pp.655~663 (2006)
  52. Mitchell JP, "The link between social cognition and self-referential thought in the medial prefrontal cortex", J Cogn Neurosci, 17, pp.1306~1315 (2005)
  53. Gallagher HL, "Reading the mind in cartoons and stories : an fMRI study of ‘theory of mind’ in verbal and nonverbal tasks", Neuropsychologia, 38, pp.11~21 (2000)
  54. van der Meer L, "Self-reflection and the brain : a theoretical review and meta-analysis of neuroimaging studies with implications for schizophrenia", Neurosci Biobehav Rev, 34, pp.935~946 (2010)
  55. Kelley WM, "Finding the self? An event-related fMRI study", J Cogn Neurosci, 14, pp.785~794 (2002)
  56. Moran JM, "Modulation of cortical midline structures by implicit and explicit self-relevance evaluation", Soc Neurosci, 4, pp.197~211 (2009)
  57. Seeley WW, "Dissociable intrinsic connectivity networks for salience processing and executive control", J Neurosci, 27, pp.2349~2356 (2007)
  58. Menon V, "Saliency, switching, attention and control : a network model of insula function", Brain Struct Funct, 214, pp.655~667 (2010)
  59. Xie K, "Mild blast events alter anxiety, memory, and neural activity patterns in the anterior cingulate cortex", PLoS One, 8, pp.e64907~ (2013)
  60. Olson IR, "The enigmatic temporal pole : a review of findings on social and emotional processing", Brain, 130, pp.1718~1731 (2007)
  61. Damasio AR, "Subcortical and cortical brain activity during the feeling of self-generated emotions", Nat Neurosci, 3, pp.1049~1056 (2000)
  62. Paulus MP, "An insular view of anxiety", Biol Psychiatry, 60, pp.383~387 (2006)
  63. Critchley HD, "Neural systems supporting interoceptive awareness", Nat Neurosci, 7, pp.189~195 (2004)
  64. Craig AD, "How do you feel--now? The anterior insula and human awareness", Nat Rev Neurosci, 10, pp.59~70 (2009)
  65. Ronchi R, "Right insular damage decreases heartbeat awareness and alters cardio-visual effects on bodily self-consciousness", Neuropsychologia, 70, pp.11~20 (2015)
  66. Blanke O, "The out-of-body experience : disturbed self-processing at the temporo-parietal junction", Neuroscientist, 11, pp.16~24 (2005)
  67. Sri Mahavir Agarwal, "Neural Correlates of a Perspective-taking Task Using in a Realistic Three-dimmensional Environment Based Task: A Pilot Functional Magnetic Resonance Imaging Study", Clinical Psychopharmacology and Neuroscience, 15(3), pp.276~281 (2017), 대한정신약물학회[DOI]
  68. Platek SM, "Neural substrates for functionally discriminating self ‐face from personally familiar faces", Hum Brain Mapp, 27, pp.91~98 (2006)
  69. Kim MK, "Neural basis of distorted self-face recognition in social anxiety disorder", Neuroimage Clin, 12, pp.956~964 (2016)
  70. Singh-Curry V, "The functional role of the inferior parietal lobe in the dorsal and ventral stream dichotomy", Neuropsychologia, 47, pp.1434~1448 (2009)
  71. Ingram RE, "Self-focused attention in clinical disorders : review and a conceptual model", Psychol Bull, 107, pp.156~176 (1990)
  72. Bögels SM, "The causal role of self-awareness in blushing-anxious, socially-anxious and social phobics individuals", Behav Res Ther, 40, pp.1367~1384 (2002)
  73. Bögels SM, "Attention processes in the maintenance and treatment of social phobia : hypervigilance, avoidance and self-focused attention", Clin Psychol Rev, 24, pp.827~856 (2004)
  74. Alden LE, "Public self-awareness and withdrawal from social interactions", Cognit Ther Res, 16, pp.249~267 (1992)
  75. McManus F, "Why social anxiety persists : an experimental investigation of the role of safety behaviours as a maintaining factor", J Behav Ther Exp Psychiatry, 39, pp.147~161 (2008)
  76. Blair KS, "Social norm processing in adult social phobia : atypically increased ventromedial frontal cortex responsiveness to unintentional(embarrassing)transgressions", Am J Psychiatry, 167, pp.1526~1532 (2010)
  77. Goldin PR, "Effects of mindfulness-based stress reduction(MBSR)on emotion regulation in social anxiety disorder", Emotion, 10, pp.83~91 (2010)
  78. Goldin P, "Mindfulness meditation training and self-referential processing in social anxiety disorder : behavioral and neural effects", J Cogn Psychother, 23, pp.242~257 (2009)
  79. Brühl AB, "Neural correlates of altered general emotion processing in social anxiety disorder", Brain Res, 1378, pp.72~83 (2011)
  80. Roth DA, "Cognitive-behavioral models of social anxiety disorder", Psychiatr Clin North Am, 24, pp.753~771 (2001)
  81. Saboonchi F, "Perfectionism and self-consciousness in social phobia and panic disorder with agoraphobia", Behav Res Ther, 37, pp.799~808 (1999)
  82. Hope DA, "Public and private self-consciousness and social phobia", J Pers Assess, 526, pp.626~639 (1988)
  83. Wells A, "How do I look with my minds eye : perspective taking in social phobic imagery", Behav Res Ther, 36, pp.631~634 (1998)
  84. Spurr JM, "The observer perspective : effects on social anxiety and performance", Behav Res Ther, 41, pp.1009~1028 (2003)
  85. Sripada CS, "Functional neuroimaging of mentalizing during the trust game in social anxiety disorder", Neuroreport, 20, pp.984~989 (2009)
  86. Yoon HJ, "Neural activity during self-referential working memory and the underlying role of the amygdala in social anxiety disorder", Neurosci Lett, 627, pp.139~147 (2016)
  87. Boehme S, "Neural correlates of self-focused attention in social anxiety", Soc Cogn Affect Neurosci, 10, pp.856~862 (2014)
  88. Gentili C, "Beyond amygdala : default mode network activity differs between patients with social phobia and healthy controls", Brain Res Bull, 79, pp.409~413 (2009)
  89. Nakao T, "fMRI of patients with social anxiety disorder during a social situation task", Neurosci Res, 69, pp.67~72 (2011)
  90. Heitmann CY, "Abnormal brain activation and connectivity to standardized disorder‐related visual scenes in social anxiety disorder", Hum Brain Mapp, 37, pp.1559~1572 (2016)
  91. Heitmann CY, "Brain activation to task-irrelevant disorder-related threat in social anxiety disorder : the impact of symptom severity", Neuroimage Clin, 14, pp.323~333 (2017)
  92. Choi SH, "Looking at the self in front of others : neural correlates of attentional bias in social anxiety", J Psychiatr Res, 75, pp.31~40 (2016)
  93. Boehme S, "Brain activation during anticipatory anxiety in social anxiety disorder", Soc Cogn Affect Neurosci, 9, pp.1413~1418 (2014)
  94. Northoff G, "Differential parametric modulation of self‐relatedness and emotions in different brain regions", Hum Brain Mapp, 30, pp.369~382 (2009)
  95. Terasawa Y, "Anterior insular cortex mediates bodily sensibility and social anxiety", Soc Cogn Affect Neurosci, 8, pp.259~266 (2013)
  96. Gaebler M, "Behavioural and neural correlates of self-focused emotion regulation in social anxiety disorder", J Psychiatry Neurosci, 39, pp.249~258 (2014)
  97. Abraham A, "Self-referential and anxiety-relevant information processing in subclinical social anxiety : an fMRI study", Brain Imaging Behav, 7, pp.35~48 (2013)
  98. Warwick JM, "Resting brain perfusion in social anxiety disorder : a voxel-wise whole brain comparison with healthy control subjects", Prog Neuropsychopharmacol Biol Psychiatry, 32, pp.1251~1256 (2008)
  99. Evans KC, "A PET study of tiagabine treatment implicates ventral medial prefrontal cortex in generalized social anxiety disorder", Neuropsychopharmacology, 34, pp.390~398 (2009)
  100. Qiu C, "Regional homogeneity changes in social anxiety disorder : a resting-state fMRI study", Psychiatry Res, 194, pp.47~53 (2011)
  101. Liu F, "Disrupted cortical hubs in functional brain networks in social anxiety disorder", Clin Neurophysiol, 126, pp.1711~1716 (2015)
  102. Liao W, "Selective aberrant functional connectivity of resting state networks in social anxiety disorder", Neuroimage, 52, pp.1549~1558 (2010)
  103. Geiger MJ, "Altered executive control network resting-state connectivity in social anxiety disorder", World J Biol Psychiatry, 17, pp.47~57 (2016)
  104. Rabany L, "Resting-state functional connectivity in generalized anxiety disorder and social anxiety disorder : evidence for a dimensional approach", Brain Connect, 7, pp.289~298 (2017)
  105. Pannekoek JN, "Resting-state functional connectivity abnormalities in limbic and salience networks in social anxiety disorder without comorbidity", Eur Neuropsychopharmacol, 23, pp.186~195 (2013)
  106. Cui Q, "Social anxiety disorder exhibit impaired networks involved in self and theory of mind processing", Soc Cogn Affect Neurosci, 12, pp.1284~1295 (2017)
  107. Schurz M, "Fractionating theory of mind : a meta-analysis of functional brain imaging studies", Neurosci Biobehav Rev, 42, pp.9~34 (2014)
  108. Furmark T, "Cerebral blood flow changes after treatment of social phobia with the neurokinin-1 antagonist GR205171, citalopram, or placebo", Biol Psychiatry, 58, pp.132~142 (2005)
  109. Warwick JM, "A comparison of the effects of citalopram and moclobemide on resting brain perfusion in social anxiety disorder", Metab Brain Dis, 21, pp.241~252 (2006)
  110. Stein MB, "Social anxiety disorder", Lancet, 371, pp.1115~1125 (2008)
  111. Nagata T, "Generalized social anxiety disorder : a still‐neglected anxiety disorder 3 decades since Liebowitz's review", Psychiatry Clin Neurosci, 69, pp.724~740 (2015)
  112. Eskildsen A, "Pre-treatment patient variables as predictors of drop-out and treatment outcome in cognitive behavioural therapy for social phobia : a systematic review", Nord J Psychiatry, 64, pp.94~105 (2010)
  113. Dobrakowski PP, "MR-guided focused ultrasound : a new generation treatment of Parkinson's disease, essential tremor and neuropathic pain", Interv Neuroradiol, 20, pp.275~282 (2014)
  114. Jung HH, "Different magnetic resonance imaging patterns after transcranial magnetic resonance-guided focused ultrasound of the ventral intermediate nucleus of the thalamus and anterior limb of the internal capsule in patients with essential tremor or obsessive-compulsive disorder", J Neurosurg, 122, pp.162~168 (2015)
  115. Kim M, "Treatment of major depressive disorder via magnetic resonance-guided focused ultrasound surgery", Biol Psychiatry, 83, pp.e17~ (2018)[DOI]
  116. Nejad AB, "Self-referential processing, rumination, and cortical midline structures in major depression", Front Hum Neurosci, 7, pp.666~ (2013)
  117. Brühl AB, "Neuroimaging in social anxiety disorder—a meta-analytic review resulting in a new neurofunctional model", Neurosci Biobehav Rev, 47, pp.260~280 (2014)

관련 논문AI추천

이 간행물의 다른 논문 (16건)