The Relationship Between the Resting-State Functional Connectivity of the Insula and the Cerebellum and Facial Emotion Recognition in Social Anxiety Disorder

Abstract

Abstract Introduction Social anxiety disorder (SAD) is thought to negatively evaluate facial emotions. There have been reports related to facial emotion recognition in imaging studies of SAD. However, no studies have investigated the relationship between resting-state functional connectivity (rsFC) and facial in patients with SAD. Objective The objective of this study is to identify, for the first time, the association between facial emotion recognition proficiency and rsFC in SAD. Methods A total of 18 patients diagnosed with SAD and 42 Healthy Controls (HCs) were enrolled in the study. All participants underwent resting-state functional MRI, comprehensive clinical assessments, and completed emotion recognition tasks (ERT). ERT parameters underwent t-test analysis to compare HCs and patients with SAD. Whole-brain analysis was conducted to calculate rsFC, which correlated with the parameters of significant differences in ERT. Furthermore, the correlation between significant differences in ERT and clinical scale scores was computed. Results Individuals with SAD demonstrated a significantly higher accuracy in identifying expressions of disgust compared to HCs (Cohen’s d = -0.613, p = 0.034). A correlation was found between the ERT disgust and the fear subscale of the Liebowitz Social Anxiety Scale (r = 0.26, p = 0.04). The rsFC correlated with ERT disgust between the right insula and right cerebellum, with Crus II exhibiting the highest correlation. Conclusion Individuals with SAD may be more adept at recognizing disgust, which creates fear in social situations. Additionally, individuals who correctly recognized disgust exhibited decreased cognitive control over emotions arising from interoception.