TY - JOUR
T1 - Neural activation changes following attention bias modification treatment or a selective serotonin reuptake inhibitor for social anxiety disorder
AU - Azriel, Omer
AU - Arad, Gal
AU - Tik, Niv
AU - Weiser, Mark
AU - Bloch, Miki
AU - Garber, Eddie
AU - Lazarov, Amit
AU - Pine, Daniel S.
AU - Tavor, Ido
AU - Bar-Haim, Yair
N1 - Publisher Copyright: Copyright © The Author(s), 2024.
PY - 2024
Y1 - 2024
N2 - Background Delineation of changes in neural function associated with novel and established treatments for social anxiety disorder (SAD) can advance treatment development. We examined such changes following selective serotonin reuptake inhibitor (SSRI) and attention bias modification (ABM) variant - gaze-contingent music reward therapy (GC-MRT), a first-line and an emerging treatments for SAD. Methods Eighty-one patients with SAD were allocated to 12-week treatments of either SSRI or GC-MRT, or waitlist (ns = 22, 29, and 30, respectively). Baseline and post-treatment functional magnetic resonance imaging (fMRI) data were collected during a social-threat processing task, in which attention was directed toward and away from threat/neutral faces. Results Patients who received GC-MRT or SSRI showed greater clinical improvement relative to patients in waitlist. Compared to waitlist patients, treated patients showed greater activation increase in the right inferior frontal gyrus and anterior cingulate cortex when instructed to attend toward social threats and away from neutral stimuli. An additional anterior cingulate cortex cluster differentiated between the two active groups. Activation in this region increased in ABM and decreased in SSRI. In the ABM group, symptom change was positively correlated with neural activation change in the dorsolateral prefrontal cortex. Conclusions Brain function measures show both shared and treatment-specific changes following ABM and SSRI treatments for SAD, highlighting the multiple pathways through which the two treatments might work. Treatment-specific neural responses suggest that patients with SAD who do not fully benefit from SSRI or ABM may potentially benefit from the alternative treatment, or from a combination of the two.
AB - Background Delineation of changes in neural function associated with novel and established treatments for social anxiety disorder (SAD) can advance treatment development. We examined such changes following selective serotonin reuptake inhibitor (SSRI) and attention bias modification (ABM) variant - gaze-contingent music reward therapy (GC-MRT), a first-line and an emerging treatments for SAD. Methods Eighty-one patients with SAD were allocated to 12-week treatments of either SSRI or GC-MRT, or waitlist (ns = 22, 29, and 30, respectively). Baseline and post-treatment functional magnetic resonance imaging (fMRI) data were collected during a social-threat processing task, in which attention was directed toward and away from threat/neutral faces. Results Patients who received GC-MRT or SSRI showed greater clinical improvement relative to patients in waitlist. Compared to waitlist patients, treated patients showed greater activation increase in the right inferior frontal gyrus and anterior cingulate cortex when instructed to attend toward social threats and away from neutral stimuli. An additional anterior cingulate cortex cluster differentiated between the two active groups. Activation in this region increased in ABM and decreased in SSRI. In the ABM group, symptom change was positively correlated with neural activation change in the dorsolateral prefrontal cortex. Conclusions Brain function measures show both shared and treatment-specific changes following ABM and SSRI treatments for SAD, highlighting the multiple pathways through which the two treatments might work. Treatment-specific neural responses suggest that patients with SAD who do not fully benefit from SSRI or ABM may potentially benefit from the alternative treatment, or from a combination of the two.
KW - anterior cingulate cortex
KW - attention bias modification
KW - dorsolateral prefrontal cortex
KW - inferior frontal gyrus
KW - selective serotonin reuptake inhibitor
KW - social anxiety
UR - http://www.scopus.com/inward/record.url?scp=85204467226&partnerID=8YFLogxK
U2 - https://doi.org/10.1017/S0033291724001521
DO - https://doi.org/10.1017/S0033291724001521
M3 - مقالة
C2 - 39252484
SN - 0033-2917
JO - Psychological Medicine
JF - Psychological Medicine
ER -