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Kampa M, Stark R, Klucken T. The impact of past childhood adversity and recent life events on neural responses during fear conditioning. J Neuroimaging 2024; 34:217-223. [PMID: 38009652 DOI: 10.1111/jon.13174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 11/15/2023] [Accepted: 11/15/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND AND PURPOSE Many studies have shown that exposure to life events can have a negative impact on mental health. Life events like the death of a spouse or the birth of a child pose a challenge and require temporal or permanent adjustments. Meta-analyses on brain stress responses found bilateral anterior insula activation in response to acute stress. Fear conditioning is assumed a crucial mechanism for the development of anxiety disorders associated with increased activation in the bilateral amygdala. Empirical evidence is lacking regarding the relationship of exposure to recent life events and past childhood adversity with neural processing during fear conditioning. METHODS In the present study, we analyzed data from 103 young, healthy participants. Multiple linear regressions were performed on functional magnetic resonance imaging activation during fear conditioning with the Life Events Scale for Students and the Childhood Trauma questionnaire included as covariates in two separate models. RESULTS We found a positive relationship between the number of life events in the last year and left amygdala activation to the conditioned stimulus. A second finding was a positive relationship between childhood adversity and right anterior insula response to the unconditioned stimulus. CONCLUSIONS Many studies have shown increased amygdala activity after stressful life events. In addition, the anterior insula is activated during acute stress. The present study points to stressor-induced increased salience processing during fear conditioning. We suggest that this could be a potential mechanism for resilience versus mental illness.
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Affiliation(s)
- Miriam Kampa
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University, Giessen, Germany
| | - Rudolf Stark
- Bender Institute of Neuroimaging, Justus Liebig University, Giessen, Germany
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Tim Klucken
- Department of Clinical Psychology and Psychotherapy, University of Siegen, Siegen, Germany
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Fricke S, Seinsche RJ, Neudert MK, Schäfer A, Zehtner RI, Stark R, Hermann A. Neural correlates of context-dependent extinction recall in social anxiety disorder: relevance of intrusions in response to aversive social experiences. Psychol Med 2024; 54:548-557. [PMID: 37553977 DOI: 10.1017/s0033291723002179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
BACKGROUND There are phenomenological similarities between social anxiety disorder (SAD) and posttraumatic stress disorder, such as a provoking aversive event, posttraumatic stress symptoms (e.g. intrusions) in response to these events and deficient (context-dependent) fear conditioning processes. This study investigated the neural correlates of context-dependent extinction recall and fear renewal in SAD, specifically in patients with intrusions in response to an etiologically relevant aversive social event. METHODS During functional magnetic resonance imaging a two-day context-dependent fear conditioning paradigm was conducted in 54 patients with SAD and 54 healthy controls (HC). This included fear acquisition (context A) and extinction learning (context B) on one day, and extinction recall (context B) as well as fear renewal (contexts C and A) one day later. The main outcome measures were blood oxygen level-dependent responses in regions of interest and skin conductance responses. RESULTS Patients with SAD showed reduced differential conditioned amygdala activation during extinction recall in the safe extinction context and during fear renewal in the acquisition context compared to HC. Patients with clinically relevant intrusions moreover exhibited hypoactivation of the ventromedial prefrontal cortex (vmPFC) during extinction learning, extinction recall, and fear renewal in a novel context, while amygdala activation more strongly decreased during extinction learning and increased during fear renewal in the acquisition context compared with patients without intrusions. CONCLUSIONS Our study provides first evidence that intrusions in SAD are associated with similar deficits in context-dependent regulation of conditioned fear via the vmPFC as previously demonstrated in posttraumatic stress disorder.
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Affiliation(s)
- Susanne Fricke
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Rosa J Seinsche
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Marie K Neudert
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Axel Schäfer
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Raphaela I Zehtner
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
| | - Rudolf Stark
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
| | - Andrea Hermann
- Department of Psychotherapy and Systems Neuroscience, Justus Liebig University Giessen, Giessen, Germany
- Bender Institute of Neuroimaging, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain and Behavior, Phillips University Marburg and Justus Liebig University Giessen, Giessen, Germany
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Klein Z, Shner-Livne G, Danon-Kraun S, Ginat-Frolich R, Pine DS, Shechner T. Enhanced late positive potential to conditioned threat cue during delayed extinction in anxious youth. J Child Psychol Psychiatry 2024; 65:215-228. [PMID: 37157184 DOI: 10.1111/jcpp.13814] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Deficits in threat learning relate to anxiety symptoms. Since several anxiety disorders arise in adolescence, impaired adolescent threat learning could contribute to adolescent changes in risk for anxiety. This study compared threat learning among anxious and non-anxious youth using self-reports, peripheral psychophysiology measures, and event-related potentials. Because exposure therapy, the first-line treatment for anxiety disorders, is largely based on principles of extinction learning, the study also examined the link between extinction learning and treatment outcomes among anxious youth. METHODS Clinically anxious (n = 28) and non-anxious (n = 33) youth completed differential threat acquisition and immediate extinction. They returned to the lab a week later to complete a threat generalization test and a delayed extinction task. Following these two experimental visits, anxious youth received exposure therapy for 12 weeks. RESULTS Anxious as compared to non-anxious youth demonstrated elevated cognitive and physiological responses across acquisition and immediate extinction learning, as well as greater threat generalization. In addition, anxious youth showed enhanced late positive potential response to the conditioned threat cue compared to the safety cue during delayed extinction. Finally, aberrant neural response during delayed extinction was associated with poorer treatment outcomes. CONCLUSIONS The study emphasizes differences between anxious and non-anxious youth in threat learning processes and provides preliminary support for a link between neural processing during delayed extinction and exposure-based treatment outcome in pediatric anxiety.
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Affiliation(s)
- Zohar Klein
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Gil Shner-Livne
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Shani Danon-Kraun
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Rivkah Ginat-Frolich
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
| | - Daniel S Pine
- National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA
| | - Tomer Shechner
- School of Psychological Sciences and the Integrated Brain and Behavior Research Center, University of Haifa, Haifa, Israel
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4
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Peng L, Hu X, Xu C, Xu Y, Lai H, Yang Y, Liu J, Xue Y, Li M. Altered regional homogeneity and homotopic connectivity in Chinese breast cancer survivors with fear of cancer recurrence: A resting-state fMRI study. J Psychosom Res 2023; 173:111454. [PMID: 37595543 DOI: 10.1016/j.jpsychores.2023.111454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 07/05/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND Fear of cancer recurrence (FCR) is one of the most distressing concerns for breast cancer survivors, but the neural mechanism underlying FCR remains unclear. METHODS We conducted a cross-sectional study and recruited 62 breast cancer survivors varying in FCR (31 high-FCR individuals and 31 low-FCR individuals) and compared neuroimaging findings. Data from 3 low-FCR subjects were excluded because they did not complete all experiments. All the participants underwent resting-state functional magnetic resonance imaging (rs-fMRI). Regional homogeneity (ReHo) and voxel-mirrored homotopic connectivity (VMHC) were assessed. RESULTS Breast cancer survivors with high and low FCR significantly differed in the ReHo of the left caudate nucleus and precuneus as well as in the VMHC of the posterior cerebellar lobe, superior frontal gyrus, orbital frontal gyrus, inferior frontal gyrus, occipital gyrus, inferior parietal lobule and frontal middle gyrus. FCR was negatively correlated with the mean ReHo of the left caudate nucleus (r = -0.501, p < 0.001) and positively correlated with the mean ReHo of the right precuneus (r = 0.505, p < 0.001). In addition, FCR was positively correlated with the mean VMHC of the bilateral superior occipital gyrus (r = 0.438, p < 0.001). CONCLUSION These findings suggest that the left caudate nucleus, right precuneus and bilateral superior occipital gyrus are involved in FCR, which may provide preliminary evidence to improve the present understanding of the neural mechanisms of FCR.
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Affiliation(s)
- Li Peng
- Department of Military Psychology, Army Medical University, Chongqing 400038, China
| | - Xiaofei Hu
- Department of Military Psychology, Army Medical University, Chongqing 400038, China; Department of Radiology, Southwest Hospital, Army Medical University, 400038, China
| | - Chen Xu
- Department of Military Psychology, Army Medical University, Chongqing 400038, China
| | - Yuanyuan Xu
- Department of Military Psychology, Army Medical University, Chongqing 400038, China
| | - Han Lai
- Department of Military Psychology, Army Medical University, Chongqing 400038, China
| | - Ying Yang
- Breast Center of Southwest Hospital, Army Medical University, Chongqing 400038, China
| | - Ju Liu
- Department of Foreign Languages, College of Basic Medical Sciences, Army Medical University, Chongqing 400038, China
| | - Yuan Xue
- Department of Radiology, Southwest Hospital, Army Medical University, 400038, China
| | - Min Li
- Department of Military Psychology, Army Medical University, Chongqing 400038, China.
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5
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Rapee RM, Creswell C, Kendall PC, Pine DS, Waters AM. Anxiety disorders in children and adolescents: A summary and overview of the literature. Behav Res Ther 2023; 168:104376. [PMID: 37499294 DOI: 10.1016/j.brat.2023.104376] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
Considerable work has advanced understanding of the nature, causes, management, and prevention of anxiety disorders in children and adolescents over the past 30 years. Prior to this time the primary focus was on school refusal and specific phobias. It is now recognised that children and adolescents experience the full gamut of anxiety disorders in very similar ways to adults and that anxiety disorders in the paediatric years can predict a lifelong mental-health struggle. Given the vast array of specific studies in this field, the current review summarises current knowledge about these high prevalence disorders, points to overarching limitations, and suggests potentially important future directions. Following a brief historical overview, the review summarises knowledge about demographic and epidemiological characteristics, distal and proximal risk factors, current treatment directions, and prevention. There is still a great deal to learn about the causes and treatments of child and adolescent anxiety disorders. By amalgamating our current knowledge, this review provides a window to the research directions that are likely to lead to future advances.
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Affiliation(s)
- Ronald M Rapee
- Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, Australia.
| | - Cathy Creswell
- Departments of Psychiatry and Experimental Psychology, University of Oxford, Oxford, UK
| | - Philip C Kendall
- Department of Psychology, Temple University, Child and Adolescent Anxiety Disorders Clinic, USA
| | - Daniel S Pine
- National Institute of Mental Health Intramural Research Program (NIMH-IRP), USA
| | - Allison M Waters
- School of Applied Psychology, Griffith University, Brisbane, Australia
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Beckers T, Hermans D, Lange I, Luyten L, Scheveneels S, Vervliet B. Understanding clinical fear and anxiety through the lens of human fear conditioning. NATURE REVIEWS PSYCHOLOGY 2023; 2:233-245. [PMID: 36811021 PMCID: PMC9933844 DOI: 10.1038/s44159-023-00156-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Abstract
Fear is an adaptive emotion that mobilizes defensive resources upon confrontation with danger. However, fear becomes maladaptive and can give rise to the development of clinical anxiety when it exceeds the degree of threat, generalizes broadly across stimuli and contexts, persists after the danger is gone or promotes excessive avoidance behaviour. Pavlovian fear conditioning has been the prime research instrument that has led to substantial progress in understanding the multi-faceted psychological and neurobiological mechanisms of fear in past decades. In this Perspective, we suggest that fruitful use of Pavlovian fear conditioning as a laboratory model of clinical anxiety requires moving beyond the study of fear acquisition to associated fear conditioning phenomena: fear extinction, generalization of conditioned fear and fearful avoidance. Understanding individual differences in each of these phenomena, not only in isolation but also in how they interact, will further strengthen the external validity of the fear conditioning model as a tool with which to study maladaptive fear as it manifests in clinical anxiety.
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Affiliation(s)
- Tom Beckers
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Dirk Hermans
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Iris Lange
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Laura Luyten
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Sara Scheveneels
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Bram Vervliet
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Leuven Brain Institute, KU Leuven, Leuven, Belgium
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Kitt ER, Odriozola P, Gee DG. Extinction Learning Across Development: Neurodevelopmental Changes and Implications for Pediatric Anxiety Disorders. Curr Top Behav Neurosci 2023; 64:237-256. [PMID: 37532964 DOI: 10.1007/7854_2023_430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
Alterations in extinction learning relate to the development and maintenance of anxiety disorders across the lifespan. While exposure therapy, based on principles of extinction, can be highly effective for treating anxiety, many patients do not show sufficient improvement following treatment. In particular, evidence suggests that exposure therapy does not work sufficiently for up to 40% of children who receive this evidence-based treatment.Importantly, fear learning and extinction, as well as the neural circuitry supporting these processes, undergo dynamic changes across development. An improved understanding of developmental changes in extinction learning and the associated neural circuitry may help to identify targets to improve treatment response in clinically anxious children and adolescents. In this chapter, we provide a brief overview of methods used to study fear learning and extinction in developmental populations. We then review what is currently known about the developmental changes that occur in extinction learning and related neural circuitry. We end this chapter with a discussion of the implications of these neurodevelopmental changes for the characterization and treatment of pediatric anxiety disorders.
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Affiliation(s)
| | - Paola Odriozola
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, New Haven, CT, USA.
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Stenson AF, France JM, Jovanovic T. Getting Better with Age? A Review of Psychophysiological Studies of Fear Extinction Learning Across Development. Curr Top Behav Neurosci 2023; 64:213-236. [PMID: 37651043 DOI: 10.1007/7854_2023_441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
A critical developmental task is learning what constitutes reliable threat and safety signals in the environment. In humans, atypical fear learning processes are implicated in many mental health conditions, particularly fear and anxiety disorders, pointing to the potential for laboratory measures of fear learning to facilitate early identification of at-risk individuals. This chapter reviews studies of fear learning and extinction learning that incorporate peripheral measures of psychophysiological response and include a developmental sample. Broadly, these studies indicate substantial consistency in differential learning and extinction across development, as assessed with multiple paradigms, across physiological indices. Importantly, though, response coherence across measures (e.g., physiological, neural, and behavioral) was inconsistent across studies. There was also less consistency in results from studies that probed associations between anxiety and fear learning processes. These mixed findings highlight the need for additional examination of when and why there is variability, both across development and in relation to individual differences factors, including mental health, childhood adversity, and sex. In addition, there remains a need for studies that test for developmental change in extinction recall learning and whether stimulus type impacts learning across development. Longitudinal studies designed to address these questions could provide novel insight into the developmental trajectory of fear learning and extinction.
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Affiliation(s)
- Anaïs F Stenson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA.
| | - John M France
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, USA
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Dysregulation of threat neurociruitry during fear extinction: the role of anhedonia. Neuropsychopharmacology 2021; 46:1650-1657. [PMID: 33833400 PMCID: PMC8280223 DOI: 10.1038/s41386-021-01003-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/20/2021] [Accepted: 03/12/2021] [Indexed: 01/31/2023]
Abstract
Dimensional models of anxiety and depression highlight common and distinct symptom clusters that are thought to reflect disruptions in underlying functional processes. The current study investigated how functioning of threat neurocircuitry relates to symptom dimensions of anxiety and depression. Participants were aged 18-19 years (n = 229, 158 female) and were selected to ensure a range of scores on symptom measures. Symptom dimensions of "General Distress" (common to anxiety disorders and depression), "Fears" (more specific to anxiety disorders), and "Anhedonia-apprehension" (more specific to depression) were evaluated. Participants underwent functional magnetic resonance imaging during a Pavlovian fear conditioning paradigm. Multilevel modeling analyses estimated relationships between symptom dimensions and activation in threat neural circuitry. Exploratory whole brain analyses were also conducted. Threat-related neural activity was not associated with General Distress or Fears. Anhedonia-apprehension was associated with activation of bilateral amygdala, anterior insula and dACC during late extinction. We found no evidence to support an association between symptom dimensions of General Distress or Fears with threat circuitry activation in a large sample of young adults. We did, however, find that the symptom dimension of Anhedonia-apprehension was significantly associated with threat-related neural activation during fear extinction. This effect requires replication in future work but may reflect anhedonic impairments in learning when contingencies are altered, possibly linked to the rewarding relief of an unexpectedly absent threat.
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Grasser LR, Jovanovic T. Safety learning during development: Implications for development of psychopathology. Behav Brain Res 2021; 408:113297. [PMID: 33862062 PMCID: PMC8102395 DOI: 10.1016/j.bbr.2021.113297] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 03/23/2021] [Accepted: 04/11/2021] [Indexed: 12/13/2022]
Abstract
Fear and safety learning are necessary adaptive behaviors that develop over the course of maturation. While there is a large body of literature regarding the neurobiology of fear and safety learning in adults, less is known regarding safety learning during development. Given developmental changes in the brain, there are corresponding changes in safety learning that are quantifiable; these may serve to predict risk and point to treatment targets for fear and anxiety-related disorders in children and adolescents. For healthy, typically developing youth, the main developmental variation observed is reduced discrimination between threat and safety cues in children compared to adolescents and adults, while lower expression of extinction learning is exhibited in adolescents compared to adults. Such distinctions may be related to faster maturation of the amygdala relative to the prefrontal cortex, as well as incompletely developed functional circuits between the two. Fear and anxiety-related disorders, childhood maltreatment, and behavioral problems are all associated with alterations in safety learning for youth, and this dysfunction may proceed into adulthood with corresponding abnormalities in brain structure and function-including amygdala hypertrophy and hyperreactivity. As impaired inhibition of fear to safety may reflect abnormalities in the developing brain and subsequent psychopathology, impaired safety learning may be considered as both a predictor of risk and a treatment target. Longitudinal neuroimaging studies over the course of development, and studies that query change with interventions are needed in order to improve outcomes for individuals and reduce long-term impact of developmental psychopathology.
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Affiliation(s)
- Lana Ruvolo Grasser
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Dr, Tolan Park Suite 2C Room 273, Detroit, MI 48201 United States.
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3901 Chrysler Dr, Tolan Park Suite 2C, Detroit, MI 48201 United States.
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Lamoureux-Tremblay V, Chauret M, Muckle G, Maheu F, Suffren S, Jacobson SW, Jacobson JL, Ayotte P, Lepore F, Saint-Amour D. Altered functional activations of prefrontal brain areas during emotional processing of fear in Inuit adolescents exposed to environmental contaminants. Neurotoxicol Teratol 2021; 85:106973. [PMID: 33741477 PMCID: PMC8137647 DOI: 10.1016/j.ntt.2021.106973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 01/16/2021] [Accepted: 03/09/2021] [Indexed: 10/21/2022]
Abstract
Exposure to mercury, lead and polychlorinated biphenyls (PCBs) have been associated with emotional dysregulation, but their neuronal correlates have yet to be examined. Inuit from Nunavik (Northern Quebec, Canada) face internalizing problems and are among the most exposed individuals to these environmental contaminants in the world. The aim of this study was to examine the link between pre- and postnatal exposure to these contaminants and brain fear-circuitry in Inuit adolescents. Facial expression stimuli were presented to participants (mean age = 18.3 years) in a magnetic resonance imaging (MRI) scanner. Fear conditioning and extinction tasks included neutral faces as the conditioned threat and safety cues and a fearful face paired with a shrieking scream as the unconditioned stimulus. Functional MRI data were gathered at the conditioning phase (n = 71) and at the extinction phase (n = 62). Mercury, lead and PCB 153 concentrations were measured in blood samples at birth (cord blood) and at the time of the adolescent testing to estimate pre- and postnatal exposure, respectively. For each time point, exposures were categorized in tertiles (low, moderate and high exposed groups). Mixed analyses of variance were conducted for each contaminant of interest controlling for sex, age, socioeconomic status, drug/alcohol use, food insecurity and contaminant co-exposure. Results revealed greater differential activation during the conditioning phase in the right orbitofrontal cortex in participants with moderate and high concentrations of cord blood PCB 153 compared to those in the low exposure group. During the extinction phase, the high prenatal mercury exposed group showed a lower differential activation in the right and left anterior cingulate cortex compared to those in the low-exposed group; whereas there was a higher differential activation in right dorsolateral prefrontal cortex in the high postnatal lead exposed group compared to the moderate- and low-exposed groups. Our study is the first to show alterations in the prefrontal brain areas in fear conditioning and extinction tasks in relation to environmental contaminant exposures. The observed brain correlates may advance our understanding of the emotional problems associated with environmental chemical toxicity.
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Affiliation(s)
| | - Mélissa Chauret
- Département de Psychologie, Université du Québec à Montréal, Montréal, Québec, Canada
| | - Gina Muckle
- Centre de Recherche du CHUQ de Québec-Université Laval, École de Psychologie, Université Laval, Québec, Québec, Canada
| | - Françoise Maheu
- Research Centre of CHU Ste-Justine, Montréal, Québec, Canada
| | - Sabrina Suffren
- Research Centre of CHU Ste-Justine, Montréal, Québec, Canada
| | - Sandra W Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, United States
| | - Joseph L Jacobson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, United States
| | - Pierre Ayotte
- Département de Médecine Sociale et Préventive, Faculté de Médecine, Université Laval, Québec, Québec, Canada
| | - Franco Lepore
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Dave Saint-Amour
- Département de Psychologie, Université du Québec à Montréal, Montréal, Québec, Canada; Research Centre of CHU Ste-Justine, Montréal, Québec, Canada.
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Treanor M, Rosenberg BM, Craske MG. Pavlovian Learning Processes in Pediatric Anxiety Disorders: A Critical Review. Biol Psychiatry 2021; 89:690-696. [PMID: 33220917 PMCID: PMC9027721 DOI: 10.1016/j.biopsych.2020.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 08/12/2020] [Accepted: 09/06/2020] [Indexed: 12/31/2022]
Abstract
Deficits in associative and Pavlovian learning are thought to lie at the center of anxiety-related disorders. However, the majority of studies have been carried out in adult populations. The aim of this review was to critically examine the behavioral and neuroimaging literature on Pavlovian learning in pediatric anxiety disorders. We conclude that although there is evidence for deficits in Pavlovian processes (e.g., heightened reactivity to safety cues in anxious samples), the extant literature suffers from key methodological and theoretical issues. We conclude with theoretical and methodological recommendations for future research in order to further elucidate the role of Pavlovian learning in the etiology, maintenance, and treatment of pediatric anxiety disorders.
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Affiliation(s)
- Michael Treanor
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Benjamin M Rosenberg
- Department of Psychology, University of California, Los Angeles, Los Angeles, California
| | - Michelle G Craske
- Department of Psychology, University of California, Los Angeles, Los Angeles, California; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California.
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Harrewijn A, Kitt ER, Abend R, Matsumoto C, Odriozola P, Winkler AM, Leibenluft E, Pine DS, Gee DG. Comparing neural correlates of conditioned inhibition between children with and without anxiety disorders - A preliminary study. Behav Brain Res 2021; 399:112994. [PMID: 33160010 PMCID: PMC7855938 DOI: 10.1016/j.bbr.2020.112994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 12/21/2022]
Abstract
Cognitive-behavioral therapy (CBT), a first-line treatment for pediatric anxiety disorders, is based on principles of threat learning and extinction. However, CBT does not work sufficiently for up to 40% of clinically anxious youth. The neural and behavioral correlates of conditioned inhibition might provide promising targets for attempts to improve CBT response. During conditioned inhibition, threat and safety cues appear together, forming a safety compound. Here, we test whether this safety compound elicits a reduced fear response compared to pairing the threat cue with a novel cue (novel compound). The current pilot study compares behavioral, physiological, and neural correlates of conditioned inhibition between children with (n = 17, Mage = 13.09, SDage = 3.05) and without (n = 18, Mage = 14.49, SDage = 2.38) anxiety disorders. Behavioral and physiological measures did not differ between children with and without anxiety disorders during fear acquisition. During testing, children with anxiety disorders showed overall higher skin conductance response and expected to hear the aversive sound following the novel compound more often than children without anxiety disorders. Children with anxiety disorders showed more activity in the right ventromedial prefrontal cortex (vmPFC) to the safety versus novel compound. Children without anxiety disorders showed the opposite pattern - more right vmPFC activity to the novel versus safety compound (F(1,31) = 5.40, p = 0.03). No group differences manifested within the amygdala, dorsal anterior cingulate cortex, or hippocampus. These pilot findings suggest a feasible approach for examining conditioned inhibition in pediatric anxiety disorders. If replicated in larger samples, findings may implicate perturbed conditioned inhibition in pediatric anxiety disorders and provide targets for CBT.
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Affiliation(s)
- Anita Harrewijn
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA.
| | - Elizabeth R Kitt
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Rany Abend
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Chika Matsumoto
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Paola Odriozola
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, Connecticut 06511, USA
| | - Anderson M Winkler
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Ellen Leibenluft
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Daniel S Pine
- Emotion and Development Branch, National Institute of Mental Health, 9000 Rockville Pike, Bethesda, Maryland 20892, USA
| | - Dylan G Gee
- Department of Psychology, Yale University, 2 Hillhouse Avenue, New Haven, Connecticut 06511, USA
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