Consistent brain grey matter volume alterations in adult patients with panic disorder and social anxiety disorder revisited

Impact of Stress on Brain Morphology: Insights into Structural Biomarkers of Stress-related Disorders

“…The critical role in interoception and control of autonomic function is also implicated as well as in emotional processing, specifically, in fear and anxiety [ 210 ]. The more consistent results indicate structural alterations emerged in PD, where patients presented reduced volumes in the insula as one of the most robust findings of structural alteration in the disorder [ 233 , 234 , 242 , 272 ]. A similar result has also been found in GAD literature [ 230 , 231 ] yet less frequently replicated in comparison to structural abnormalities within frontal regions [ 246 , 264 ].…”

“…Decreased GMV of the hippocampus is frequently reported in GAD [ 12 , 229 , 230 ] but not always [ 231 ]. Some studies found this result in PD [ 232 ] and SAD but the finding lacked consistency, as shown by recent metanalytical research [ 233 , 234 ]. No structural alterations in the hippocampus were found in specific phobia research.…”

“…When reviewing published results for each disorder, results of diminished volumes in mPFC and ACC were fairly consistent in GAD [ 229 , 231 , 246 , 263 , 264 ], however, it is worth noting no frontal lobe alterations were found in the larger mega-analysis assessing thickness and surface area metrics [ 265 ]. Prior research has indicated that PD patients might also suffer from this frontal reduced volumes [ 240 , 266 , 267 ] yet more recent works have failed to replicate results [ 233 , 243 , 268 ]. While some mixed results emerged from social anxiety disorder [ 269 , 270 ], most results do not support the hypothesis of structural frontal alterations [ 233 , 234 , 271 ].…”

“…Prior research has indicated that PD patients might also suffer from this frontal reduced volumes [ 240 , 266 , 267 ] yet more recent works have failed to replicate results [ 233 , 243 , 268 ]. While some mixed results emerged from social anxiety disorder [ 269 , 270 ], most results do not support the hypothesis of structural frontal alterations [ 233 , 234 , 271 ]. Among the limited research in specific phobia, a subtype- specific effect is suggested as results indicate increased mPFC and ACC volumes in dental phobia [ 249 ] and reduced in spider phobia [ 250 ] yet more research is required to reach a conclusive answer.…”

“…Recent research has suggested that insular atrophy might be a consequence of long illness duration [ 231 ]. Volumetric reductions of the insula have been found in SAD [ 273 - 275 ], although results come mainly from research using a priori ROI analyses and are not replicated by more recent whole-brain analyses and metanalyses [ 233 , 234 , 270 ]. Two articles have found structural alterations in the insula in specific phobia [ 249 , 251 ], with reduced volume in dental phobia and increased cortical thickness in animal phobia, highlighting the insula as a region of interest for future SP research.…”