The relationship between the salience network and facial emotion recognition in social anxiety disorder

Social anxiety disorder (SAD) is thought to involve the negative evaluation of facial emotions. Although imaging studies have examined this aspect, no study has investigated the relationship between resting-state functional connectivity (rsFC) and facial emotion recognition in SAD. Hyperconnectivity in the salience network, particularly involving the anterior cingulate cortex (ACC), has been reported to be associated with facial recognition and SAD. This study aimed to identify the association between rsFC and facial emotion recognition in patients with SAD. We included 21 patients with SAD and 34 healthy controls (HCs). Participants underwent resting-state functional MRI, clinical assessment, and emotion recognition tasks (ERT). Group differences in ERT were analyzed using a two-sample t-test. rsFC focused on the ACC as the region of interest (ROI). Partial correlation analyses, adjusted for age and sex, focused on items that showed significant differences in ERT. Furthermore, we performed a partial correlation analysis between the extracted rsFC and Liebowitz Social Anxiety Scale (LSAS) total score. Patients with SAD identified significantly more disgust facial emotions (ERT-disgust) than HCs. rsFC associated with ERT disgust was identified between the ACC and the left insula in SAD. However, rsFC did not correlate with LSAS scores. Patients with SAD accurately identified disgust facial expressions compared to HCs. The rsFC associated with disgust facial expression recognition differed between patients with SAD and HCs, with the salience network playing an important role in SAD.