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

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Authors
Hilbert, Kevin
Boeken, Ole Jonas
Langhammer, Till
Groenewold, Nynke A.
Bas-Hoogendam, Janna Marie
Aghajani, Moji
Zugman, André
Åhs, Fredrik
Arolt, Volker
Beesdo-Baum, Katja
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Date
2024-06-11
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American Journal of Psychiatry
Issue
8
Volume
181
Pages
Pages
728–740
DOI
ISSN
0002-953X
1535-7228
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Weblink
Access date
2024-09-10
Abstract PL
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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Keywords EN
specific phobia
animal phobia
blood-Injection-Injury phobia
structural neuroimaging
megaanalysis
ENIGMA
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https://share.swps.edu.pl/handle/swps/861
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Except as otherwise noted, this item is licensed under the Attribution licence | Permitted use of copyrighted works
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