Skip to main content
×
×
Home

Anterior cingulate cortex activity as a candidate biomarker for treatment selection in social anxiety disorder

  • Andreas Frick (a1), Jonas Engman (a2), Kurt Wahlstedt (a2), Malin Gingnell (a3), Mats Fredrikson (a4) and Tomas Furmark (a2)...
Summary

We aimed to identify biomarkers to guide the decision to add selective serotonin reuptake inhibitors (SSRI) to psychological treatment for social anxiety disorder (SAD). Forty-eight patients with SAD underwent functional magnetic resonance imaging and collection of clinical and demographic variables before treatment with cognitive–behavioural therapy, combined on a double-blind basis with either escitalopram or placebo for 9 weeks. Pre-treatment neural reactivity to aversive faces in the dorsal anterior cingulate cortex (ACC), but not clinical/demographic variables, moderated clinical outcomes. Cross-validated individual-level predictions accurately identified 81% of responders/non-responders. Dorsal ACC reactivity is thus a potential biomarker for SAD treatment selection.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Anterior cingulate cortex activity as a candidate biomarker for treatment selection in social anxiety disorder
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Anterior cingulate cortex activity as a candidate biomarker for treatment selection in social anxiety disorder
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Anterior cingulate cortex activity as a candidate biomarker for treatment selection in social anxiety disorder
      Available formats
      ×
Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Correspondence Andreas Frick, Department of Psychology, Uppsala University, Box 1225, SE-751 42 Uppsala, Sweden. Email: andreas.frick@psyk.uu.se
References
Hide All
1Gelenberg, AJ, Freeman, MP, Markowitz, JC, Rosenbaum, JF, Thase, ME, Trivedi, MH, et al. Practice guideline for the treatment of patients with major depressive disorder third edition. Am J Psychiatry 2010; 167: 13, 9–11, 13–118.
2National Institute for Health and Care Excellence. Social Anxiety Disorder: Recognition, Assessment and Treatment. CG159. NICE, 2013.
3Gingnell, M, Frick, A, Engman, J, Alaie, I, Björkstrand, J, Faria, V, et al. Combining escitalopram and cognitive–behavioural therapy for social anxiety disorder: randomised controlled fMRI trial. Br J Psychiatry 2016; 209: 229–35.
4Nordahl, HM, Vogel, PA, Morken, G, Stiles, TC, Sandvik, P, Wells, A. Paroxetine, cognitive therapy or their combination in the treatment of social anxiety disorder with and without avoidant personality disorder: a randomized clinical trial. Psychother Psychosom 2016; 85: 346–56.
5Fernandes, BS, Williams, LM, Steiner, J, Leboyer, M, Carvalho, AF, Berk, M. The new field of ‘precision psychiatry’. BMC Med 2017; 15: 80.
6McGrath, CL, Kelley, ME, Holtzheimer, PE, Dunlop, BW, Craighead, WE, Franco, AR, et al. Toward a neuroimaging treatment selection biomarker for major depressive disorder. JAMA Psychiatry 2013; 70: 821–9.
7Lueken, U, Zierhut, KC, Hahn, T, Straube, B, Kircher, T, Reif, A, et al. Neurobiological markers predicting treatment response in anxiety disorders: a systematic review and implications for clinical application. Neurosci Biobehav Rev 2016; 66: 143–62.
8Månsson, KNT, Frick, A, Boraxbekk, C-J, Marquand, AF, Williams, SCR, Carlbring, P, et al. Predicting long-term outcome of internet-delivered cognitive behavior therapy for social anxiety disorder using fMRI and support vector machine learning. Transl Psychiatry 2015; 5: e530.
9Liebowitz, MR. Social phobia. Mod Probl Pharmacopsychiatry 1987; 22: 141–73.
10R Core Team. R: A Language and Environment for Statistical Computing. R Foundation for Statistical Computing, 2017 (https://www.R-project.org/).
11Lieberman, MD, Cunningham, WA. Type I and type II error concerns in fMRI research: re-balancing the scale. Soc Cogn Affect Neurosci 2009; 4: 423–8.
12Fu, CHY, Steiner, H, Costafreda, SG. Predictive neural biomarkers of clinical response in depression: a meta-analysis of functional and structural neuroimaging studies of pharmacological and psychological therapies. Neurobiol Dis 2013; 52: 7583.
13Brühl, AB, Delsignore, A, Komossa, K, Weidt, S. Neuroimaging in social anxiety disorder—A meta-analytic review resulting in a new neurofunctional model. Neurosci Biobehav Rev 2014; 47: 260–80.
14Etkin, A, Egner, T, Kalisch, R. Emotional processing in anterior cingulate and medial prefrontal cortex. Trends Cogn Sci 2011; 15: 8593.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Open
  • ISSN: -
  • EISSN: 2056-4724
  • URL: /core/journals/bjpsych-open
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 30
Total number of PDF views: 125 *
Loading metrics...

Abstract views

Total abstract views: 209 *
Loading metrics...

* Views captured on Cambridge Core between 11th May 2018 - 24th September 2018. This data will be updated every 24 hours.

Anterior cingulate cortex activity as a candidate biomarker for treatment selection in social anxiety disorder

  • Andreas Frick (a1), Jonas Engman (a2), Kurt Wahlstedt (a2), Malin Gingnell (a3), Mats Fredrikson (a4) and Tomas Furmark (a2)...
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *