The purpose of this study was to compare prefrontal cortex (PFC) activity among subjects with differing social anxiety (SA) severity levels to identify a possible biomarker for severe SA. Further, SA is generally under-diagnosed, so we examined if such measurements could be acquired conveniently, non-invasively, and at low cost using a portable near-infrared spectroscopy (NIRS) system. We classified 96 participants into three groups based on Liebowitz Social Anxiety Scale (LSAS) total score: Low SA (LSA, n = 40), Moderate SA (MSA, n = 39), and High SA (HSA, n = 17). We compared the prefrontal hemodynamic responses among LSAS severity groups during a verbal fluency task using a palm-sized NIRS system. The HSA group exhibited a significantly lower hemodynamic response in the left PFC compared to LSA and MSA groups, whereas there was no significant difference between LSA and MSA groups. There was also no significant difference in the right PFC hemodynamic response among groups. Differences in the severity of SA symptoms may be related to the left PFC function. Low PFC activity during specific cognitive tasks may provide a biomarker for distinguishing severe from mild/moderate SA symptoms to guide subsequent therapeutic decisions.

本研究的目的是比较具有不同社交焦虑 (SA) 严重程度的受试者的前额叶皮层 (PFC) 活动，以确定严重 SA 的可能生物标志物。此外，SA 通常诊断不足，因此我们检查了是否可以使用便携式近红外光谱 (NIRS) 系统方便、无创且低成本地获取此类测量值。我们根据 Liebowitz 社交焦虑量表 (LSAS) 总分将 96 名参与者分为三组：低 SA（LSA，n  = 40）、中度 SA（MSA，n  = 39）和高 SA（HSA，n = 17）。我们使用手掌大小的 NIRS 系统比较了语言流畅性任务期间 LSAS 严重程度组之间的前额叶血流动力学反应。与 LSA 和 MSA 组相比，HSA 组左侧 PFC 的血流动力学反应显着降低，而 LSA 和 MSA 组之间没有显着差异。各组之间正确的 PFC 血流动力学反应也没有显着差异。SA 症状严重程度的差异可能与左侧 PFC 功能有关。特定认知任务期间的低 PFC 活动可能提供用于区分严重和轻度/中度 SA 症状的生物标志物，以指导后续的治疗决策。