Pre-COVID resting-state brain activity in the fusiform gyrus prospectively predicts social anxiety alterations during the pandemic

Abstract

Abstract Persistent social anxiety (SA) has been reported to be associated with the coronavirus disease 2019 (COVID-19) pandemic, but the neurobiopsychological mechanisms underlying this relationship remain unclear. This study aimed to elucidate the neurofunctional markers for the development of SA during the pandemic and the potential roles of COVID-related posttraumatic stress symptoms (PTSS) in the brain-SA alterations link. Before the COVID-19 pandemic (T1), 100 general college students underwent baseline brain resting-state magnetic resonance imaging and behavioral tests for SA. During the period of community-level outbreaks (T2), these students were recontacted to undergo follow-up assessments of SA and COVID-related PTSS. Whole-brain correlation analyses and prediction analyses found that pre-pandemic spontaneous neural activity (measured by fractional amplitude of low-frequency fluctuations) in the right fusiform gyrus (FG) was positively linked with SA alterations (T2 – T1) during the pandemic. Moreover, mediation analyses revealed a mediating role of COVID-specific PTSS in the association of right FG activity with SA alterations. Importantly, our results persisted even after adjusting for the effects of pre-pandemic family socioeconomic status, other stressful life events, and general anxiety. Overall, our study provides fresh evidence for neurofunctional markers of COVID-induced aggravation of SA and may help individuals vulnerable to SA exacerbation benefit from targeted clinical interventions.