Magnetic resonance spectroscopy in social phobia: preliminary findings

Proton localized magnetic resonance spectroscopy was studied in 20 social phobics and 20 age- and sex-matched controls. Stimulated Echo Acquisition Mode volume element localization was used with chemical shift imaging. Choline and creatine signal-to-noise ratios (SNRs) were significantly lower in social phobia than in controls in subcortical, thalamic, and caudate areas. In the social phobic group, N-acetylaspartate (NAA) SNR was significantly lower in cortical and subcortical regions, and ratios of NAA to other metabolites were lower in social phobia. Choline, creatine, and NAA SNRs were inversely correlated to total social phobia and fear symptoms, as measured by the Brief Social Phobia Scale, in the thalamic and noncortical gray areas. In a small number of patients who received clonazepam, posttreatment SNRs generally increased relative to baseline. Our results suggest a promising place for magnetic resonance spectroscopy in social phobia and also indicate potential pharmacodynamic uses of this technique.