Abnormal fear circuits activities correlated to physical symptoms in somatic anxiety patients

Yue Chen; Yue Wu; Jingjing Mu; Bensheng Qiu; Kai Wang; Yanghua Tian

doi:10.1016/j.jad.2020.05.036

Abnormal fear circuits activities correlated to physical symptoms in somatic anxiety patients

J Affect Disord. 2020 Sep 1:274:54-58. doi: 10.1016/j.jad.2020.05.036. Epub 2020 May 21.

Authors

Yue Chen¹, Yue Wu¹, Jingjing Mu², Bensheng Qiu³, Kai Wang⁴, Yanghua Tian⁵

Affiliations

¹ Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
² Anhui Mental Health Center, Hefei 230000, China.
³ Center for Biomedical Engineering, University of Science and Technology of China, Hefei 230027, China.
⁴ Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China; Department of Medical Psychology, Chaohu Clinical Medical College, Anhui Medical University, Hefei 230000, China.
⁵ Department of Neurology, the First Affiliated Hospital of Anhui Medical University, Hefei 230022, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei 230022, China; Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei 230022, China. Electronic address: ayfytyh@126.com.

PMID: 32475814
DOI: 10.1016/j.jad.2020.05.036

Abstract

Background: Somatic anxiety patients complain of physical symptoms and exhibit repeated checking behavior. Overgeneralization of fear is a characteristic of anxiety disorders. However, the role of fear in the somatic anxiety patients remains unclear. We hypothesized that somatic anxiety patients have abnormal fear circuits, including the amygdala, hippocampus, thalamus, orbitofrontal cortex and anterior cingulate cortex, which can aggravate physical symptoms.

Methods: 33 anxiety patients and 25 healthy controls (HCs) were recruited. The severity of the anxiety and somatic symptoms was assessed with the Hamilton anxiety scale and the 15-item somatic symptom severity scale from the Patient Health Questionnaire (PHQ-15). The amplitude of low-frequency fluctuations (ALFF) in resting-state functional magnetic resonance imaging was used to assess abnormalities in the fear circuit. We compared the ALFF between patients and HCs with respect to the fear circuit and conducted correlation analysis to investigate the relationship between somatic symptoms and the ALFF in abnormal cerebral regions.

Results: The ALFF of the left thalamus and left hippocampus was significantly higher in the patient group than the HC group, and was positively correlated with the PHQ-15 values.

Limitations: We did not divide the patient group into drug treated or drug free in our subgroup analysis. There was a lack of the paradigm to test the generalization of fear for patients in this study. Furthermore, the small sample size may have affected the results.

Conclusion: Somatic symptoms in patients with anxiety are related to abnormal fear circuits, whose degree of abnormality is associated with symptom severity.

Keywords: Amplitude of low-frequency fluctuations; Anxiety; Fear; Somatization.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anxiety
Anxiety Disorders*
Fear
Humans
Magnetic Resonance Imaging
Phobic Disorders*