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Gray Matter Density of the Dorsomedial Prefrontal Cortex Mediates the Relationship Between Catastrophizing and Anxiety in Somatic Symptom Disorder

Authors Pan X, Ding W, Sun X, Ji C, Zhou Q, Yan C, Zhou Y, Luo Y

Received 14 December 2020

Accepted for publication 18 February 2021

Published 9 March 2021 Volume 2021:17 Pages 757—764

DOI https://doi.org/10.2147/NDT.S296462

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 4

Editor who approved publication: Dr Yuping Ning


Xiandi Pan,1,* Weina Ding,2,* Xia Sun,3,* Chenfeng Ji,3 Qian Zhou,3 Chao Yan,4 Yan Zhou,2 Yanli Luo3

1Pudong New Area Mental Health Center, Tongji University School of Medicine, Shanghai, People’s Republic of China; 2Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 3Department of Psychological Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People’s Republic of China; 4Key Laboratory of Brain Functional Genomics (MOE&STCSM), Shanghai Changning-ECNU Mental Health Center, School of Psychology and Cognitive Science, East China Normal University, Shanghai, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Yanli Luo
Department of Psychological Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pujian Road 160, Shanghai, 200127, People’s Republic of China
Tel +86-21-68382998
Email [email protected]
Yan Zhou
Department of Radiology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Pujian Road 160, Shanghai, 200127, People’s Republic of China
Tel +86-21-68385105
Email [email protected]

Objective: Catastrophizing is commonly co-occurrence with anxiety in somatic symptom disorder (SSD). However, the quantitative relationship between catastrophizing and anxiety in SSD and its underlying neuropsychopathology remains unclear.
Methods: To address the issue, twenty-eight SSD patients and twenty-nine healthy controls (HCs) completed the Hamilton anxiety scale and the catastrophizing subscale of the cognitive emotion regulation questionnaire. Then they underwent structural magnetic resonance imaging and voxel-based morphometry analysis was performed to obtain gray matter density (GMD) of the dorsomedial prefrontal cortex (dmPFC).
Results: Independent samples t-tests showed no significance between SSD patients and HCs in the scores on the catastrophizing subscale and GMD of the dmPFC. However, correlation analysis found that catastrophizing was significantly positively associated with anxiety in SSD. Further, mediation analyses revealed that GMD of the dmPFC (bilateral medial Brodmann area 8) mediated the relationship between catastrophizing and anxiety in SSD.
Conclusion: These findings support Kirmayer’s disease model of SSD that catastrophic interpretations of somatic symptoms resulted in increased anxiety and demonstrate that the dmPFC may be a potential neural site linking catastrophizing and anxiety in SSD.

Keywords: somatic symptom disorder, dorsomedial prefrontal cortex, catastrophizing, anxiety, mediating effect

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