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Abstract

Introduction: Social anxiety disorder (SAD) is centered on the fear of negative evaluation. It is frequent and characterized by a heightened sensitivity to social threat, both behaviorally and neuronally through altered cerebral activation patterns. Social anxiety (SA) is also associated with a generally increased sensitivity of specialized voice and face processing areas to these cues as threat carrier signals. It remains unclear, however, if also the cerebral integration of voices and faces is increased in SAD.
Methods: 18 individuals with SAD and 18 healthy individuals participated in a functional magnetic resonance imaging experiment evaluating the audiovisual integration of voices and faces. The intensity of integration effects (standard voxel-wise and psychophysiological interaction analyses) and the spatial distribution of individual integration maxima were evaluated.
Results and Conclusions: Increased hemodynamic audiovisual integration correlates in SAD were detected in the superior temporal sulcus (STS) accompanied by stronger integration-related increases in functional connectivity between STS and (peri-)striate visual cortex. Additionally, an anteriorization of individual integration maxima along the STS correlating with SA severity was observed. This demonstrates an alteration of the intensity but also the topography of the sensory integration of faces and voices as common threat carrier signals in SAD with increased functional connectivity patterns potentially representing a driving factor. Finally, the spatial distribution analysis with the anteriorized integration maximum in SAD may offer a novel perspective on the cerebral representation of social signal processing in SAD with relevance for other psychiatric disorders or personality traits as well as sensory integration research in general.