Closing in on social anxiety: Multimodal imaging of monoamine neurotransmitter systems and neural activations before and after treatment

Anxiety disorders are disabling conditions, affecting twice as many women as men.

In particular, social anxiety disorder (SAD) is highly common and should be regarded as a significant public health concern.

SAD patients often experience approach-avoidance conflicts, likely to stem from interactions between serotonin and dopamine signaling in fear- and reward related brain areas including the striatum and amygdala.

This project aims at examining how neural activations, assessed with functional magnetic resonance imaging (fMRI), change in parallel to synthesis capacity and transporter protein availability in the serotonin and dopamine neurotransmission systems as assessed with positron emission tomography (PET).

This will be examined in patients with SAD before and after treatment with cognitive-behavior therapy or antidepressant medication.

To examine epigenetic processes, data on DNA methylation will be collected and related to brain measures and therapy outcome.

We will compare SAD patients with different personality profiles, patients with healthy controls, and treatment responders with nonresponders, on neuroimaging markers and DNA methylation.

Support vector machine learning will be used to examine the ability of brain activation (fMRI) and neurotransmission (PET) parameters to predict treatment outcome at the individual level.

Multitracer PET studies, together with fMRI and novel analytic methods, can provide vital knowledge about the causes and cures of social anxiety.