Cortical and Subcortical Brain Alterations in Specific Phobia and Its Animal and Blood-Injection-Injury Subtypes: A Mega-Analysis From the ENIGMA Anxiety Working Group

  1. Kevin Hilbert 1
  2. Ole Jonas Boeken, 1
  3. Till Langhammer 1
  4. Nynke A. Groenewold, 1
  5. Janna Marie Bas-Hoogendam 1
  6. Moji Aghajani 1
  7. André Zugman 1
  8. Åhs, Fredrik 1
  9. Arolt, Volker 1
  10. Beesdo-Baum, Katja 1
  11. Björkstrand, Johannes 1
  12. Blackford, Jennifer U. 1
  13. Blanco-Hinojo, Laura 1
  14. Böhnlein, Joscha 1
  15. Bülow, Robin 1
  16. Cano, Marta 1
  17. Cardoner, Narcis 1
  18. Caseras, Xavier 1
  19. Dannlowski, Udo 1
  20. Domschke, Katharina 1
  21. Fehm, Lydia 1
  22. Feola, Brandee 1
  23. Fredrikson, Mats 1
  24. Goossens, Liesbet 1
  25. Grabe, Hans J. 1
  26. Grotegerd, Dominik 1
  27. Gur, Raquel E. 1
  28. Hamm, Alfons O. 1
  29. Harrewijn, Anita 1
  30. Heinig, Ingmar 1
  31. Herrmann, Martin J. 1
  32. Hofmann, David 1
  33. Jackowski, Andrea P. 1
  34. Jansen, Andreas 1
  35. Kaczkurkin, Antonia N. 1
  36. Kindt, Merel 1
  37. Kingsley, Ellen N. 1
  38. Kircher, Tilo 1
  39. Klahn, Anna L. 1
  40. Koelkebeck, Katja 1
  41. Krug, Axel 1
  42. Kugel, Harald 1
  43. Larsen, Bart 1
  44. Leehr, Elisabeth J. 1
  45. Leonhardt, Lieselotte 1
  46. Lotze, Martin 1
  47. Margraf, Jürgen 1
  48. Michałowski, Jarosław 1
  49. Muehlhan, Markus 1
  50. Nenadić, Igor 1
  51. Pan, Pedro M. 1
  52. Pauli, Paul 1
  53. Peñate, Wenceslao 1
  54. Pittig, Andre 1
  55. Plag, Jens 1
  56. Pujol, Jesus 1
  57. Richter, Jan 1
  58. Francisco L. Rivero 1
  59. Salum, Giovanni A. 1
  60. Satterthwaite, Theodore D. 1
  61. Schäfer, Axel 1
  62. Schäfer, Judith 1
  63. Schienle, Anne 1
  64. Schneider, Silvia 1
  65. Schrammen, Elisabeth 1
  66. Schruers, Koen 1
  67. Schulz, Stefan M. 1
  68. Seidl, Esther 1
  69. Stark, Rudolf M. 1
  70. Stein, Frederike 1
  71. Straube, Benjamin 1
  72. Straube, Thomas 1
  73. Ströhle, Andreas 1
  74. Suchan, Boris 1
  75. Thomopoulos, Sophia I. 1
  76. Ventura-Bort, Carlos 1
  77. Visser, Renee 1
  78. Völzke, Henry 1
  79. Wabnegger, Albert 1
  80. Wannemüller, André 1
  81. Wendt, Julia 1
  82. Wiemer, Julian 1
  83. Wittchen, Hans-Ulrich 1
  84. Wittfeld, Katharina 1
  85. Wright, Barry 1
  86. Yang, Yunbo 1
  87. Zilverstand, Anna 1
  88. Zwanzger, Peter 1
  89. Veltman, Dick J. 1
  90. Winkler, Anderson M. 1
  91. Pine, Daniel S. 1
  92. Jahanshad, Neda 1
  93. Thompson, Paul M. 1
  94. Stein, Dan J. 1
  95. Van der Wee, Nic J.A. 1
  96. Lueken, Ulrike 1
  97. Mostrar todos os autores +
  1. 1 Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany (Hilbert, Boeken, Langhammer, Fehm, Lueken); Department of Psychology, Health and Medical University Erfurt, Erfurt, Germany (Hilbert); German Center for Mental Health, Partner Site Berlin/Potsdam, Berlin, Germany (Lueken); Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, and South African Medical Research Council Unit on Child and Adolescent Health, Department of Paediatrics and Child...
Revista:
American Journal of Psychiatry

ISSN: 0002-953X,  1535-7228

Ano de publicación: 2024

Volume: 181

Número: 8

Páxinas: 728-740

Tipo: Artigo

DOI: 10.1176/APPI.AJP.20230032 GOOGLE SCHOLAR lock_openAcceso aberto editor

Outras publicacións en: American Journal of Psychiatry

Resumo

Objective:Specific phobia is a common anxiety disorder, but the literature on associated brain structure alterations exhibits substantial gaps. The ENIGMA Anxiety Working Group examined brain structure differences between individuals with specific phobias and healthy control subjects as well as between the animal and blood-injection-injury (BII) subtypes of specific phobia. Additionally, the authors investigated associations of brain structure with symptom severity and age (youths vs. adults).Methods:Data sets from 31 original studies were combined to create a final sample with 1,452 participants with phobia and 2,991 healthy participants (62.7% female; ages 5–90). Imaging processing and quality control were performed using established ENIGMA protocols. Subcortical volumes as well as cortical surface area and thickness were examined in a preregistered analysis.Results:Compared with the healthy control group, the phobia group showed mostly smaller subcortical volumes, mixed surface differences, and larger cortical thickness across a substantial number of regions. The phobia subgroups also showed differences, including, as hypothesized, larger medial orbitofrontal cortex thickness in BII phobia (N=182) compared with animal phobia (N=739). All findings were driven by adult participants; no significant results were observed in children and adolescents.Conclusions:Brain alterations associated with specific phobia exceeded those of other anxiety disorders in comparable analyses in extent and effect size and were not limited to reductions in brain structure. Moreover, phenomenological differences between phobia subgroups were reflected in diverging neural underpinnings, including brain areas related to fear processing and higher cognitive processes. The findings implicate brain structure alterations in specific phobia, although subcortical alterations in particular may also relate to broader internalizing psychopathology.

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