Individual cognitive therapy reduces frontal-thalamic resting-state functional connectivity in social anxiety disorder

Kohei Kurita; Takayuki Obata; Chihiro Sutoh; Daisuke Matsuzawa; Naoki Yoshinaga; Jeff Kershaw; Ritu Bhusal Chhatkuli; Junko Ota; Eiji Shimizu; Yoshiyuki Hirano

doi:10.3389/fpsyt.2023.1233564

Individual cognitive therapy reduces frontal-thalamic resting-state functional connectivity in social anxiety disorder

Front Psychiatry. 2023 Dec 21:14:1233564. doi: 10.3389/fpsyt.2023.1233564. eCollection 2023.

Authors

Kohei Kurita^{1

2}, Takayuki Obata^{1

3}, Chihiro Sutoh^{3

4}, Daisuke Matsuzawa^{1

2

3}, Naoki Yoshinaga^{4

5}, Jeff Kershaw³, Ritu Bhusal Chhatkuli^{1

2

3}, Junko Ota^{1

2

3}, Eiji Shimizu^{1

2

3

4}, Yoshiyuki Hirano^{1

2

3}

Affiliations

¹ Research Center for Child Mental Development, Chiba University, Chiba, Japan.
² United Graduate School of Child Development, Osaka University, Suita, Japan.
³ Institute for Quantum Medical Science, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan.
⁴ Department of Cognitive Behavioral Physiology, Graduate School of Medicine, Chiba University, Chiba, Japan.
⁵ School of Nursing, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.

Abstract

Introduction: Previous neuroimaging studies in social anxiety disorders (SAD) have reported potential neural predictors of cognitive behavioral therapy (CBT)-related brain changes. However, several meta-analyses have demonstrated that cognitive therapy (CT) was superior to traditional exposure-based CBT for SAD.

Objective: To explore resting-state functional connectivity (rsFC) to evaluate the response to individual CT for SAD patients.

Methods: Twenty SAD patients who attended 16-week individual CT were scanned pre- and post-therapy along with twenty healthy controls (HCs). The severity of social anxiety was assessed with the Liebowitz Social Anxiety Scale (LSAS). Multi-voxel pattern analysis (MVPA) was performed on the pre-CT data to extract regions associated with a change in LSAS (∆LSAS). Group comparisons of the seed-based rsFC analysis were performed between the HCs and pre-CT patients and between the pre-and post-CT patients.

Results: MVPA-based regression analysis revealed that rsFC between the left thalamus and the frontal pole/inferior frontal gyrus was significantly correlated with ∆LSAS (adjusted R² = 0.65; p = 0.00002). Compared with HCs, the pre-CT patients had higher rsFCs between the thalamus and temporal pole and between the thalamus and superior/middle temporal gyrus/planum temporale (p < 0.05). The rsFC between the thalamus and the frontal pole decreased post-CT (p < 0.05).

Conclusion: SAD patients had significant rsFC between the thalamus and temporal pole, superior/middle temporal gyrus, and planum temporale, which may be indicators of extreme anxiety in social situations. In addition, rsFC between the thalamus and the frontal pole may be a neuromarker for the effectiveness of individual CT.

Keywords: individual cognitive therapy; neuromarker; resting-state functional connectivity; social anxiety disorder; thalamus.

Grants and funding

This study was supported by AMED Brain/MINDS Beyond Program grant number JP18dm0307002 and JSPS KAKENHI grant numbers 19K03309, 21K03084, and 22H01090.