Resting state connectivity predictors of symptom change during gaze-contingent music reward therapy of social anxiety disorder.
Resting state connectivity predictors of symptom change during gaze-contingent music reward therapy of social anxiety disorder.
复制标题
社交焦虑障碍的视在音乐奖励治疗期间症状变化的静息状态连接预测因子。
DOI：
10.1017/s0033291721005171
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发表时间：
2023-05
影响因子：
6.9
通讯作者：
Schneier, Franklin
中科院分区：
文献类型：
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作者：
Zhu, Xi;Lazarov, Amit;Dolan, Sarah;Bar-Haim, Yair;Dillon, Daniel G.;Pizzagalli, Diego A.;Schneier, Franklin
关键词：
社交焦虑障碍（SAD）是常见的，一线治疗往往只是部分有效，缺乏可靠的预测治疗反应。在这里，我们评估了治疗前和治疗早期的静息状态功能连接（rsFC）作为一种潜在的预测反应的一种新的注意力偏差修正程序，凝视-视情音乐奖励疗法（GC-MRT）。对32例成人SAD患者进行GC-MRT治疗。分别于治疗前和治疗后2-3周采用功能磁共振成像多体素模式分析（MVPA）评价rsFC。为了进行比较，在同一时间段内对20名未接受治疗的健康对照（HC）参与者进行了两次rsFC评估。所有SAD参与者在治疗前、治疗早期（第2-3周）和治疗后进行临床评估。SAD和抑郁症状从治疗前到治疗后显著改善。治疗2-3周后，执行控制网络（ECN）和显着性网络（SN）之间的连接性降低，ECN内的连接性增加，可预测第8周SAD和抑郁症状的改善。ECN和默认模式网络（DMN）之间的连接性增加预测第8周SAD的改善更大，但抑郁症状没有改善。SAD组治疗2-3周后DMN内的连接性显著降低，而HC在相同时间间隔内未发现变化。我们确定了在SAD的GC-MRT过程中rsFC的早期变化，预测了症状的变化。ECN、ECN-DMN和ECN-SN内的连接性变化可能与GC-MRT临床效果的机制相关，需要在对照试验中进一步研究。
Social anxiety disorder (SAD) is common, first-line treatments are often only partially effective, and reliable predictors of treatment response are lacking. Here, we assessed resting state functional connectivity (rsFC) at pre-treatment and during early treatment as a potential predictor of response to a novel attention bias modification procedure, gaze-contingent music reward therapy (GC-MRT). 32 adults with SAD were treated with GC-MRT. rsFC was assessed with multi-voxel pattern analysis (MVPA) of fMRI at pre-treatment and after 2–3 weeks. For comparison, 20 healthy control (HC) participants without treatment were assessed twice for rsFC over the same time period. All SAD participants underwent clinical evaluation at pre-treatment, early-treatment (week 2–3), and post-treatment. SAD and depressive symptoms improved significantly from pre-treatment to post-treatment. After 2–3 weeks of treatment, decreased connectivity between the executive control network (ECN) and salience network (SN), and increased connectivity within the ECN predicted improvement in SAD and depressive symptoms at week 8. Increased connectivity between the ECN and default mode network (DMN) predicted greater improvement in SAD but not depressive symptoms at week 8. Connectivity within the DMN decreased significantly after 2–3 weeks of treatment in the SAD group, while no changes were found in HC over the same time interval. We identified early changes in rsFC during a course of GC-MRT for SAD that predicted symptom change. Connectivity changes within the ECN, ECN-DMN and ECN-SN may be related to mechanisms underlying the clinical effects of GC-MRT and warrant further study in controlled trials.