Distinct Cortical Activation in Adolescents With Social Anxiety Disorder: An fNIRS Study

BACKGROUND: Social anxiety disorder (SAD) is prevalent among children and adolescents, manifesting as concerns and anticipatory anxiety in social settings. However, the precise mechanism remains to be elucidated. AIMS: To examine the hemodynamic response patterns in individuals with SAD using functional near-infrared spectroscopy (fNIRS), as well as the association with severity of social anxiety. METHODS: Twenty-nine adolescents diagnosed with SAD, and 36 healthy control (HC) were included in this study. FNIRS was used to access the frontal and temporal cerebral hemodynamics, expressed as Δ β values. The screen for child anxiety-related emotional disorders (SCARED) and the social avoidance and distress scale (SAD) were used to assess severity of social anxiety. RESULTS: Participants with SAD exhibited significantly increased Δβ values within channels CH22, CH34, and CH40 compared to the healthy control group. Conversely, diminished Δβ magnitudes were recorded in channels CH4 and CH41 among the SAD cohort relative to the HC group. The Δ β value of CH4 was negatively correlated with the social avoidance subscale of SAD, while the Δ β value of CH40 was positively correlated with the separation anxiety subscale of SCARED. CONCLUSION: Adolescents diagnosed with SAD display distinct hemodynamic responses in cortical regions, suggesting that such activation patterns may represent a potential biomarker for social anxiety The different regions of the pre-frontal cortex may play distinct roles in social avoidance and separation anxiety in adolescents with SAD.