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.
Kevin HilbertOle Jonas BoekenTill LanghammerNynke A GroenewoldJanna Marie Bas-HoogendamMoji AghajaniAndré ZugmanFredrik ÅhsVolker AroltKatja Beesdo-BaumJohannes BjörkstrandJennifer U BlackfordLaura Blanco-HinojoJoscha BöhnleinRobin BülowMarta CanoNarcis CardonerXavier CaserasUdo DannlowskiKatharina DomschkeLydia FehmBrandee FeolaMats FredriksonLiesbet GoossensHans J GrabeDominik GrotegerdRaquel E GurAlfons O HammAnita HarrewijnIngmar HeinigMartin J HerrmannDavid HofmannAndrea P JackowskiAndreas JansenAntonia N KaczkurkinMerel KindtEllen N KingsleyTilo KircherAnna L KlahnKatja KoelkebeckAxel KrugHarald KugelBart LarsenElisabeth J LeehrLieselotte LeonhardtMartin LotzeJürgen MargrafJarosław MichałowskiMarkus MuehlhanIgor NenadićPedro M PanPaul PauliWenceslao PeñateAndre PittigJens PlagJesus PujolJan RichterFrancisco L RiveroGiovanni A SalumTheodore D SatterthwaiteAxel SchäferJudith SchäferAnne SchienleSilvia SchneiderElisabeth SchrammenKoen SchruersStefan M SchulzEsther SeidlRudolf M StarkFrederike SteinBenjamin StraubeThomas StraubeAndreas StröhleBoris SuchanSophia I ThomopoulosCarlos Ventura-BortRenee VisserHenry VölzkeAlbert WabneggerAndré WannemüllerJulia WendtJulian WiemerHans-Ulrich WittchenKatharina WittfeldBarry WrightYunbo YangAnna ZilverstandPeter ZwanzgerDick J VeltmanAnderson M WinklerDaniel S PineNeda JahanshadPaul M ThompsonDan J SteinNic J A Van der WeeUlrike LuekenPublished in: The American journal of psychiatry (2024)
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.