Brain Emotional Reactivity With Anxiety Symptoms in Treated Leprosy Patients: An Evaluation of a Stigmatized Condition

Stigma is a socially constructed phenomenon projecting social disgust and fear from others to someone on the basis of some shared labeling characteristic that occurs with the experience of discrimination, rejection, or social status loss. Little is known about the socioemotional functioning of treated leprosy patients in brain areas possibly affected by the disgust and fear social behaviors experienced as a result of stigma. The aim of this study was to investigate differences in emotional brain reactivity to aversive stimuli and also associated psychometric symptoms in treated leprosy patients when compared to healthy control subjects. Twenty-eight subjects were evaluated in this study, 14 treated leprosy patients who completed the multidrug therapy and 14 paired healthy controls. All participants answered self-reported psychometric questionnaires and were submitted to functional magnetic resonance imaging (fMRI) during an implicit emotion processing task with aversive faces (fear and disgust). Leprosy-treated patients had greater brain reactivity in the right insular cortex to implicit social aversive stimuli including disgust and fear when compared to healthy control subjects (p < .01; Bonferroni correction). No differences were found in the bilateral amygdala. The results of the psychometric evaluation corroborate the neuroimaging findings with greater anxiety in the patient group measured by Beck Anxiety Inventory. Overall, anxiety symptoms and emotional brain responses in treated leprosy patients may be related to their social interaction behavior and the influence of stigma in mental health, both commonly associated to different stigmatized conditions.