Aberrant functional connectivity of the bed nucleus of the stria terminalis and its age dependence in children and adolescents with social anxiety disorder

Social anxiety disorder (SAD) is a prevalent and impairing mental disorder among children and adolescents. The bed nucleus of the stria terminalis (BNST) plays a critical role in anxiety disorders, including valence surveillance and hypervigilance for potential threats. However, the role of BNST and its related functional network in children and adolescents with SAD has not been fully investigated. This study examined the aberration of BNST’s functional connectivity and its age dependence in adolescents with SAD. Using a sample of 75 SAD patients and 75 healthy controls (HCs) children aged 9–18 years old, we delineated the group-by-age interaction of BNST-seeded functional connectivity (FC) during resting state and movie-watching. The relationships between BNST-seeded FC and clinical scores were also examined. During movie viewing, the FC between the right BNST and the left amygdala, bilateral posterior cingulate cortex (PCC), bilateral superior temporal cortex, and right pericalcarine cortex showed a diagnostic group-by-age interaction. Compared to HCs, SAD patients showed a significant enhancement of the above FC at younger ages. Meanwhile, they showed an age-dependent decrease in FC between the right BNST and left amygdala. Furthermore, for SAD patients, FC between the right BNST and left amygdala during movie viewing was positively correlated with separation anxiety scores. The right BNST plays an essential role in the aberrant brain functioning in children and adolescents with SAD. The atypicality of BNST’s FC has remarkable age dependence in SAD, suggesting an association of SAD with neurodevelopmental traits. •Right BNST-seeded FC during movie watching showed group-by-age interaction.•SAD patients showed hyperconnected FC at a younger age as compared to HCs.•Age-dependent increased FC was identified in HC, but not SAD.•Age-dependent decreased BNST-amygdala FC was identified in SAD, but not HC.•BNST-amygdala FC in SAD was positively correlated with separation anxiety scores.