A multimodal neuroimaging approach evaluation of emotional response and anxiety symptoms in leprosy patients.

BACKGROUND

Leprosy is described as a curable infectious disease but is considered a stigmatizing disease due to the damage it causes to the skin and nerves. The stigma associated with leprosy promotes social isolation and reinforces maladaptive behaviours. This study aims to investigate long-term emotional brain changes in the amygdala and cortex insular of treated leprosy patients using psychometric scales and a multimodal neuroimaging approach.

METHODS

Fourteen treated leprosy patients and fourteen paired healthy controls were evaluated by magnetic resonance imaging (MRI) using two approaches, functional connectivity analyses and brain volume morphometry. During the functional MRI exam, the participants underwent an implicit emotional recognition task comprising aversive emotional stimuli.

RESULTS

The patient's group showed greater connectivity between the amygdala and supramarginal gyrus. Granger causality analysis revealed that the patient group connectivity was bidirectional while in the control group it was unidirectional with left amygdala activity being predicted by the left supramarginal gyrus. Also, there was a positive correlation between this connectivity and anxiety scores. Leprosy-treated patients also showed a smaller bilateral amygdala volume.

CONCLUSIONS

The changes in brain connectivity and brain morphometry in the present study may represent a cumulative neurobiological effect of their mental suffering in their stigmatizing leprosy-related condition.