Modulation of auditory neural responses by a visual context in human fear conditioning

The impact of the left inferior frontal gyrus on fear extinction: A transcranial direct current stimulation study

INTRODUCTION

Fear extinction is a fundamental component of exposure-based therapies for anxiety-related disorders. The renewal of fear in a different context after extinction highlights the importance of contextual factors. In this study, we aimed to investigate the causal role of the left inferior frontal gyrus (LiFG) in the context-dependency of fear extinction learning via administration of transcranial direct current stimulation (tDCS) over this area.

METHODS

180 healthy subjects were assigned to 9 groups: 3 tDCS conditions (anodal, cathodal, and sham) × 3 context combinations (AAA, ABA, and ABB). The fear conditioning/extinction task was conducted over three consecutive days: acquisition, extinction learning, and extinction recall. tDCS (2 mA, 10min) was administered during the extinction learning phase over the LiFG via a 4-electrode montage. Skin conductance response (SCR) data and self-report assessments were collected.

RESULTS

During the extinction learning phase, groups with excitability-enhancing anodal tDCS showed a significantly higher fear response to the threat cues compared to cathodal and sham stimulation conditions, irrespective of contextual factors. This effect was stable until the extinction recall phase. Additionally, excitability-reducing cathodal tDCS caused a significant decrease of the response difference between the threat and safety cues during the extinction recall phase. The self-report assessments showed no significant differences between the conditions throughout the experiment.

CONCLUSION

Independent of the context, excitability enhancement of the LiFG did impair fear extinction, and led to preservation of fear memory. In contrast, excitability reduction of this area enhanced fear extinction retention. These findings imply that the LiFG plays a role in the fear extinction network, which seems to be however context-independent.

Measuring human context fear conditioning and retention after consolidation

Fear conditioning is a laboratory paradigm commonly used to investigate aversive learning and memory. In context fear conditioning, a configuration of elemental cues (conditioned stimulus [CTX]) predicts an aversive event (unconditioned stimulus [US]). To quantify context fear acquisition in humans, previous work has used startle eyeblink responses (SEBRs), skin conductance responses (SCRs), and verbal reports, but different quantification methods have rarely been compared. Moreover, preclinical intervention studies mandate recall tests several days after acquisition, and it is unclear how to induce and measure context fear memory retention over such a time interval. First, we used a semi-immersive virtual reality paradigm. In two experiments (N = 23 and N = 28), we found successful declarative learning and memory retention over 7 d but no evidence of other conditioned responses. Next, we used a configural fear conditioning paradigm with five static room images as CTXs in two experiments (N = 29 and N = 24). Besides successful declarative learning and memory retention after 7 d, SCR and pupil dilation in response to CTX onset differentiated CTX+/CTX- during acquisition training, and SEBR and pupil dilation differentiated CTX+/CTX- during the recall test, with medium to large effect sizes for the most sensitive indices (SEBR: Hedge's g = 0.56 and g = 0.69; pupil dilation: Hedge's g = 0.99 and g = 0.88). Our results demonstrate that with a configural learning paradigm, context fear memory retention can be demonstrated over 7 d, and we provide robust and replicable measurement methods to this end.

Biomarkers of Anxiety Acquisition and Generalization in Virtual Reality Experiments

Abstract. Anxiety disorders are characterized by exaggerated responses to a threatening situation and overgeneralization. Context conditioning has been used for the identification of risk factors. This systematic literature search identifies 16 articles published between 1990 and 2021 on differential anxiety conditioning and generalization in humans. Additionally, we provide example data for individuals suffering from panic attacks with and without depressive symptoms. Successful anxiety acquisition (discrimination between anxiety and safety context) was found on the subjective level of anxiety and US-expectancy, on the physiological level of electrodermal activity, and in the defensive behavior of startle response. Anxiety generalization (discrimination between generalization and safety context) was found on the verbal but not on the physiobehavioral level. In sum, we emphasize the impact of virtual reality on anxiety research. Verbal and physiobehavioral responses serve as reliable biomarkers for anxiety. Few studies found ratings to be the best predictor for anxiety generalization. Genetic predisposition or personality traits might foster overgeneralization.

Neural substrates of human fear generalization: A 7T-fMRI investigation

Fear generalization - the tendency to interpret ambiguous stimuli as threatening due to perceptual similarity to a learned threat - is an adaptive process. Overgeneralization, however, is maladaptive and has been implicated in a number of anxiety disorders. Neuroimaging research has indicated several regions sensitive to effects of generalization, including regions involved in fear excitation (e.g., amygdala, insula) and inhibition (e.g., ventromedial prefrontal cortex). Research has suggested several other small brain regions may play an important role in this process (e.g., hippocampal subfields, bed nucleus of the stria terminalis [BNST], habenula), but, to date, these regions have not been examined during fear generalization due to limited spatial resolution of standard human neuroimaging. To this end, we utilized the high spatial resolution of 7T fMRI to characterize the neural circuits involved in threat discrimination and generalization. Additionally, we examined potential modulating effects of trait anxiety and intolerance of uncertainty on neural activation during threat generalization. In a sample of 31 healthy undergraduate students, significant positive generalization effects (i.e., greater activation for stimuli with increasing perceptual similarity to a learned threat cue) were observed in the visual cortex, thalamus, habenula and BNST, while negative generalization effects were observed in the dentate gyrus, CA1, and CA3. Associations with individual differences were underpowered, though preliminary findings suggested greater generalization in the insula and primary somatosensory cortex may be correlated with self-reported anxiety. Overall, findings largely support previous neuroimaging work on fear generalization and provide additional insight into the contributions of several previously unexplored brain regions.

When gut feelings teach the brain to fear pain: Context-dependent activation of the central fear network in a novel interoceptive conditioning paradigm

The relevance of contextual factors in shaping neural mechanisms underlying visceral pain-related fear learning remains elusive. However, benign interoceptive sensations, which shape patients' clinical reality, may context-dependently become conditioned predictors of impending visceral pain. In a novel context-dependent interoceptive conditioning paradigm, we elucidated the putative role of the central fear network in the acquisition and extinction of pain-related fear induced by interoceptive cues and pain-predictive contexts. In this fMRI study involving rectal distensions as a clinically-relevant model of visceroception, N = 27 healthy men and women underwent differential conditioning. During acquisition training, visceral sensations of low intensity as conditioned stimuli (CS) predicted visceral pain as unconditioned stimulus (US) in one context (Con⁺), or safety from pain in another context (Con^-). During extinction training, interoceptive CS remained unpaired in both contexts, which were operationalized as images of different rooms presented in the MRI scanner. Successful contextual conditioning was supported by increased negative valence of Con⁺ compared to Con^- after acquisition training, which resolved after extinction training. Although interoceptive CS were perceived as comparatively pleasant, they induced significantly greater neural activation of the amygdala, ventromedial PFC, and hippocampus when presented in Con⁺, while contexts alone did not elicit differential responses. During extinction training, a shift from CS to context differentiation was observed, with enhanced responses in the amygdala, ventromedial, and ventrolateral PFC to Con⁺ relative to Con^-, whereas no CS-induced differential activation emerged. Context-dependent interoceptive conditioning can turn benign interoceptive cues into predictors of visceral pain that recruit key regions of the fear network. This first evidence expands knowledge about learning and memory mechanisms underlying interoceptive hypervigilance and maladaptive avoidance behavior, with implications for disorders of the gut-brain axis.

Neural substrates of appetitive and aversive prediction error

Prediction error, defined by the discrepancy between real and expected outcomes, lies at the core of associative learning. Behavioural investigations have provided evidence that prediction error up- and down-regulates associative relationships, and allocates attention to stimuli to enable learning. These behavioural advances have recently been followed by investigations into the neurobiological substrates of prediction error. In the present paper, we review neuroscience data obtained using causal and recording neural methods from a variety of key behavioural designs. We explore the neurobiology of both appetitive (reward) and aversive (fear) prediction error with a focus on the mesolimbic dopamine system, the amygdala, ventrolateral periaqueductal gray, hippocampus, cortex and locus coeruleus noradrenaline. New questions and avenues for research are considered.

Fear Extinction Recall Modulates Human Frontomedial Theta and Amygdala Activity

Human functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) studies, as well as animal studies, indicate that the amygdala and frontomedial brain regions are critically involved in conditioned fear and that frontomedial oscillations in the theta range (4-8 Hz) may support communication between these brain regions. However, few studies have used a multimodal approach to probe interactions among these key regions in humans. Here, our goal was to bridge the gap between prior human fMRI, EEG, and animal findings. Using simultaneous EEG-fMRI recordings 24 h after fear conditioning and extinction, conditioned stimuli presented (CS+E, CS-E) and not presented during extinction (CS+N, CS-N) were compared to identify effects specific to extinction versus fear recall. Differential (CS+ vs. CS-) electrodermal, frontomedial theta (EEG) and amygdala responses (fMRI) were reduced for extinguished versus nonextinguished stimuli. Importantly, effects on theta power covaried with effects on amygdala activation. Fear and extinction recall as indicated by theta explained 60% of the variance for the analogous effect in the right amygdala. Our findings show for the first time the interplay of amygdala and frontomedial theta activity during fear and extinction recall in humans and provide insight into neural circuits consistently linked with top-down amygdala modulation in rodents.

No intermodal interference effects of threatening information during concurrent audiovisual stimulation

Changes in attention can result in sensory processing trade-off effects, in which sensory cortical responses to attended stimuli are heightened and responses to competing distractors are attenuated. However, it is unclear if competition or facilitation effects will be observed at the level of sensory cortex when attending to competing stimuli in two modalities. The present study used electroencephalogram (EEG) and frequency-tagging to quantitatively assess auditory-visual interactions during sustained multimodal sensory stimulation. The emotional content of a 6.66 Hz rapid serial visual presentation (RSVP) was manipulated to elicit well-established emotional attention effects, while a constant 63 dB tone with a 40.8 Hz modulation served as a concurrent auditory stimulus in two experiments. As a directed attention manipulation, participants were instructed to detect transient sound level events in the auditory stream in Experiment 1. To manipulate attention through threat anticipation, participants were instructed to expect an aversive noise burst after a higher 40.8 Hz modulated tone in Experiment 2. Each stimulus evoked reliable steady-state sensory cortical responses in all participants (n = 30) in both experiments. The visual cortical responses were modulated by the auditory detection task, but not by threat anticipation: Visual responses were smaller during auditory streams with a transient target as compared to uninterrupted auditory streams. Conversely, visual stimulus condition had no significant effects on auditory sensory cortical responses in either experiment. These results indicate that there is neither a competition nor facilitation effect of visual content on concurrent auditory sensory cortical processing. They further indicate that competition effects of auditory stream content on sustained visuocortical responses are limited to auditory target processing.

The Future of Contextual Fear Learning for PTSD Research: A Methodological Review of Neuroimaging Studies

There has been a great deal of recent interest in human models of contextual fear learning, particularly due to the use of such paradigms for investigating neural mechanisms related to the etiology of posttraumatic stress disorder. However, the construct of "context" in fear conditioning research is broad, and the operational definitions and methods used to investigate contextual fear learning in humans are wide ranging and lack specificity, making it difficult to interpret findings about neural activity. Here we will review neuroimaging studies of contextual fear acquisition in humans. We will discuss the methodology associated with four broad categories of how contextual fear learning is manipulated in imaging studies (colored backgrounds, static picture backgrounds, virtual reality, and configural stimuli) and highlight findings for the primary neural circuitry involved in each paradigm. Additionally, we will offer methodological recommendations for human studies of contextual fear acquisition, including using stimuli that distinguish configural learning from discrete cue associations and clarifying how context is experimentally operationalized.

Context conditioning in humans using commercially available immersive Virtual Reality

Despite a wealth of knowledge on how humans and nonhuman animals learn to associate meaningful events with cues in the environment, far less is known about how humans learn to associate these events with the environment itself. Progress on understanding spatiotemporal contextual processes in humans has been slow in large measure by the methodological constraint of generating and manipulating immersive spatial environments in well-controlled laboratory settings. Fortunately, immersive Virtual Reality (iVR) technology has improved appreciably and affords a relatively straightforward methodology to investigate the role of context on learning, memory, and emotion while maintaining experimental control. Here, we review context conditioning literature in humans and describe challenges to study contextual learning in humans. We then provide details for a novel context threat (fear) conditioning paradigm in humans using a commercially available VR headset and a cross-platform game engine. This paradigm resulted in the acquisition of subjective threat, threat-conditioned defensive responses, and explicit threat memory. We make the paradigm publicly available and describe obstacles and solutions to optimize future studies of context conditioning using iVR. As computer technology advances to replicate the sensation of realistic environments, there are increasing opportunities to bridge the translational gap between rodent and human research on how context modulates cognition, which may ultimately lead to more optimal treatment strategies for anxiety- and stress-related disorders.

Feedback from the heart: Emotional learning and memory is controlled by cardiac cycle, interoceptive accuracy and personality

Feedback processing is critical to trial-and-error learning. Here, we examined whether interoceptive signals concerning the state of cardiovascular arousal influence the processing of reinforcing feedback during the learning of 'emotional' face-name pairs, with subsequent effects on retrieval. Participants (N=29) engaged in a learning task of face-name pairs (fearful, neutral, happy faces). Correct and incorrect learning decisions were reinforced by auditory feedback, which was delivered either at cardiac systole (on the heartbeat, when baroreceptors signal the contraction of the heart to the brain), or at diastole (between heartbeats during baroreceptor quiescence). We discovered a cardiac influence on feedback processing that enhanced the learning of fearful faces in people with heightened interoceptive ability. Individuals with enhanced accuracy on a heartbeat counting task learned fearful face-name pairs better when feedback was given at systole than at diastole. This effect was not present for neutral and happy faces. At retrieval, we also observed related effects of personality: First, individuals scoring higher for extraversion showed poorer retrieval accuracy. These individuals additionally manifested lower resting heart rate and lower state anxiety, suggesting that attenuated levels of cardiovascular arousal in extraverts underlies poorer performance. Second, higher extraversion scores predicted higher emotional intensity ratings of fearful faces reinforced at systole. Third, individuals scoring higher for neuroticism showed higher retrieval confidence for fearful faces reinforced at diastole. Our results show that cardiac signals shape feedback processing to influence learning of fearful faces, an effect underpinned by personality differences linked to psychophysiological arousal.

Individual Differences in Anticipatory Somatosensory Cortex Activity for Shock is Positively Related with Trait Anxiety and Multisensory Integration

Anxiety is associated with an exaggerated expectancy of harm, including overestimation of how likely a conditioned stimulus (CS+) predicts a harmful unconditioned stimulus (US). In the current study we tested whether anxiety-associated expectancy of harm increases primary sensory cortex (S1) activity on non-reinforced (i.e., no shock) CS+ trials. Twenty healthy volunteers completed a differential-tone trace conditioning task while undergoing fMRI, with shock delivered to the left hand. We found a positive correlation between trait anxiety and activity in right, but not left, S1 during CS+ versus CS− conditions. Right S1 activity also correlated with individual differences in both primary auditory cortices (A1) and amygdala activity. Lastly, a seed-based functional connectivity analysis demonstrated that trial-wise S1 activity was positively correlated with regions of dorsolateral prefrontal cortex (dlPFC), suggesting that higher-order cognitive processes contribute to the anticipatory sensory reactivity. Our findings indicate that individual differences in trait anxiety relate to anticipatory reactivity for the US during associative learning. This anticipatory reactivity is also integrated along with emotion-related sensory signals into a brain network implicated in fear-conditioned responding.

Sustained attention in context conditioning: Evidence from steady-state VEPs

In classical fear conditioning an aversive event is paired repeatedly with a predictive stimulus, which later elicits fear. Repeated presentation of an aversive event in the absence of a predictive cue however may induce anxiety, and the context may gain a threatening value. As such conditioned anxiety can be considered a sustained reaction compared to phasic fear, it would be interesting to track continuous cortical responses during context conditioning. The present study realized a differential context conditioning paradigm and assessed sustained cortical activations to the threatening and the safe context and how neutral cues are processed within both contexts. Two pictures of different office rooms presented for 20s served as contexts. One room became associated with an unpleasant noise that was presented unpredictably (CTX+) while the other office (CTX-) was never associated with this unpleasant noise. After acquisition, a social agent or an object was presented as a distractor in both contexts. Cortical activations in response to contexts and distractors were assessed separately by steady-state visually evoked potentials (ssVEPs) using frequency tagging. Results revealed enhanced ssVEP-amplitudes for CTX+ compared to CTX- in a lateral occipital cluster during acquisition. Similarly, CTX+ elicited higher ssVEP-amplitudes during the test phase, and these context conditioning effects were not reduced by the simultaneous presentation of novel distractors. These results indicate that context conditioning was successfully implemented and that the anxiety context received facilitated cortical processing across the whole viewing time. We conclude that threatening contexts capture attention over a longer period of time, and are immune to distraction by new objects.

On the Road to Translation for PTSD Treatment: Theoretical and Practical Considerations of the Use of Human Models of Conditioned Fear for Drug Development

The use of quantitative, laboratory-based measures of threat in humans for proof-of-concept studies and target development for novel drug discovery has grown tremendously in the last 2 decades. In particular, in the field of posttraumatic stress disorder (PTSD), human models of fear conditioning have been critical in shaping our theoretical understanding of fear processes and importantly, validating findings from animal models of the neural substrates and signaling pathways required for these complex processes. Here, we will review the use of laboratory-based measures of fear processes in humans including cued and contextual conditioning, generalization, extinction, reconsolidation, and reinstatement to develop novel drug treatments for PTSD. We will primarily focus on recent advances in using behavioral and physiological measures of fear, discussing their sensitivity as biobehavioral markers of PTSD symptoms, their response to known and novel PTSD treatments, and in the case of d-cycloserine, how well these findings have translated to outcomes in clinical trials. We will highlight some gaps in the literature and needs for future research, discuss benefits and limitations of these outcome measures in designing proof-of-concept trials, and offer practical guidelines on design and interpretation when using these fear models for drug discovery.

Emotional valence and spatial congruency differentially modulate crossmodal processing: an fMRI study

Salient exogenous stimuli modulate attentional processes and lead to attention shifts-even across modalities and at a pre-attentive level. Stimulus properties such as hemispheric laterality and emotional valence influence processing, but their specific interaction in audio-visual attention paradigms remains ambiguous. We conducted an fMRI experiment to investigate the interaction of supramodal spatial congruency, emotional salience, and stimulus presentation side on neural processes of attention modulation. Emotionally neutral auditory deviants were presented in a dichotic listening oddball design. Simultaneously, visual target stimuli (schematic faces) were presented, which displayed either a negative or a positive emotion. These targets were presented in the left or in the right visual field and were either spatially congruent (valid) or incongruent (invalid) with the concurrent deviant auditory stimuli. According to our expectation we observed that deviant stimuli serve as attention-directing cues for visual target stimuli. Region-of-interest (ROI) analyses suggested differential effects of stimulus valence and spatial presentation on the hemodynamic response in bilateral auditory cortices. These results underline the importance of valence and presentation side for attention guidance by deviant sound events and may hint at a hemispheric specialization for valence and attention processing.

The effect of glucose on hippocampal-dependent contextual fear conditioning

BACKGROUND

The metabolic challenge of trauma disrupts hippocampal functioning, which is necessary for processing the complex co-occurring elements comprising the traumatic context. Poor contextual memory of trauma may subsequently contribute to intrusive memories and overgeneralization of fear. Glucose consumption following trauma may be a means to protect hippocampal functioning and contextual fear learning. This study experimentally examined the effect of glucose on hippocampal-dependent contextual learning versus cued fear learning in humans.

METHODS

Forty-two male participants underwent cued conditioning with an unconditional stimulus (US) (shock) paired with a discrete conditional stimulus (geometric shape) and context conditioning (requiring hippocampal processing) with a US unpredictably paired with a background context (picture of room). Participants were then blindly randomized to consume either a 25 g glucose or sweet-tasting placebo drink and returned for a test phase 24 hours later. Measures included acoustic startle response, US expectancy, blood glucose levels, and arousal ratings.

RESULTS

The glucose group showed superior retention of hippocampal-dependent contextual learning at test relative to the placebo group, as demonstrated by acoustic startle response and US expectancy ratings. Glucose and placebo groups did not differ on any measure of cued fear learning at test.

CONCLUSIONS

This study provides experimental evidence that in mildly stressed humans postconditioning glucose consumption improves retention of hippocampal-dependent contextual learning but not cued learning. Ultimately, glucose consumption following trauma may be a means of improving learning about the traumatic context, thereby preventing subsequent development of symptoms of posttraumatic stress.

Extinction in multiple virtual reality contexts diminishes fear reinstatement in humans

Although conditioned fear can be effectively extinguished by unreinforced exposure to a threat cue, fear responses tend to return when the cue is encountered some time after extinction (spontaneous recovery), in a novel environment (renewal), or following presentation of an aversive stimulus (reinstatement). As extinction represents a context-dependent form of new learning, one possible strategy to circumvent the return of fear is to conduct extinction across several environments. Here, we tested the effectiveness of multiple context extinction in a two-day fear conditioning experiment using 3-D virtual reality technology to create immersive, ecologically-valid context changes. Fear-potentiated startle served as the dependent measure. All three experimental groups initially acquired fear in a single context. A multiple extinction group then underwent extinction in three contexts, while a second group underwent extinction in the acquisition context and a third group underwent extinction in a single different context. All groups returned 24h later to test for return of fear in the extinction context (spontaneous recovery) and a novel context (renewal and reinstatement/test). Extinction in multiple contexts attenuated reinstatement of fear but did not reduce spontaneous recovery. Results from fear renewal were tendential. Our findings suggest that multi-context extinction can reduce fear relapse following an aversive event--an event that often induces return of fear in real-world settings--and provides empirical support for conducting exposure-based clinical treatments across a variety of environments.

The contextual brain: implications for fear conditioning, extinction and psychopathology

Contexts surround and imbue meaning to events; they are essential for recollecting the past, interpreting the present and anticipating the future. Indeed, the brain's capacity to contextualize information permits enormous cognitive and behavioural flexibility. Studies of Pavlovian fear conditioning and extinction in rodents and humans suggest that a neural circuit including the hippocampus, amygdala and medial prefrontal cortex is involved in the learning and memory processes that enable context-dependent behaviour. Dysfunction in this network may be involved in several forms of psychopathology, including post-traumatic stress disorder, schizophrenia and substance abuse disorders.

Fear extinction as a model for translational neuroscience: ten years of progress

The psychology of extinction has been studied for decades. Approximately 10 years ago, however, there began a concerted effort to understand the neural circuits of extinction of fear conditioning, in both animals and humans. Progress during this period has been facilitated by a high degree of coordination between rodent and human researchers examining fear extinction. Here we review the major advances and highlight new approaches to understanding and exploiting fear extinction. Research in fear extinction could serve as a model for translational research in other areas of behavioral neuroscience.

Arousal enhanced memory retention is eliminated following temporal lobe resection

The amygdala, situated in the anterior medial temporal lobe (MTL), is involved in the emotional enhancement of memory. The present study evaluated whether anterior MTL-resections attenuated arousal induced memory enhancement for pictures. Also, the effect of MTL-resections on response latencies at retrieval was assessed. Thirty-one patients with unilateral MTL-resections (17 left, 14 right) together with 16 controls participated in a forced choice memory task with pictorial stimuli varying in arousal. Response latencies increased with stimulus arousal in controls but not in patients. This was paralleled by attenuated recognition memory for moderately and highly arousing pictures in MTL-resectioned patients as compared to healthy controls. However, patients and controls did not differ in memory performance for non-arousing pictures. These results suggest that the MTL is necessary for arousal induced memory enhancement.

Emotion and the auditory brainstem response to speech

Effects of emotion have been reported as early as 20 ms after an auditory stimulus onset for negative valence, and bivalent effects between 30 and 130 ms. To understand how emotional state influences the listener's brainstem evoked responses to speech, subjects looked at emotion-evoking pictures while listening to an unchanging auditory stimulus (danny). The pictures (positive, negative, or neutral valence) were selected from the IAPS database and controlled for dominance and arousal. Utilizing an array of measurements to assess subcortical modulation, we have found that emotion does not substantially alter brainstem alter although there is a subtle effect of background noise suppression in both emotional conditions.

Emotion modulates early auditory response to speech

In order to understand how emotional state influences the listener's physiological response to speech, subjects looked at emotion-evoking pictures while 32-channel EEG evoked responses (ERPs) to an unchanging auditory stimulus ("danny") were collected. The pictures were selected from the International Affective Picture System database. They were rated by participants and differed in valence (positive, negative, neutral), but not in dominance and arousal. Effects of viewing negative emotion pictures were seen as early as 20 msec (p = .006). An analysis of the global field power highlighted a time period of interest (30.4-129.0 msec) where the effects of emotion are likely to be the most robust. At the cortical level, the responses differed significantly depending on the valence ratings the subjects provided for the visual stimuli, which divided them into the high valence intensity group and the low valence intensity group. The high valence intensity group exhibited a clear divergent bivalent effect of emotion (ERPs at Cz during viewing neutral pictures subtracted from ERPs during viewing positive or negative pictures) in the time period of interest (r(Phi) = .534, p < .01). Moreover, group differences emerged in the pattern of global activation during this time period. Although both groups demonstrated a significant effect of emotion (ANOVA, p = .004 and .006, low valence intensity and high valence intensity, respectively), the high valence intensity group exhibited a much larger effect. Whereas the low valence intensity group exhibited its smaller effect predominantly in frontal areas, the larger effect in the high valence intensity group was found globally, especially in the left temporal areas, with the largest divergent bivalent effects (ANOVA, p < .00001) in high valence intensity subjects around the midline. Thus, divergent bivalent effects were observed between 30 and 130 msec, and were dependent on the subject's subjective state, whereas the effects at 20 msec were evident only for negative emotion, independent of the subject's behavioral responses. Taken together, it appears that emotion can affect auditory function early in the sensory processing stream.

Influence of trait anxiety on brain activity during the acquisition and extinction of aversive conditioning

BACKGROUND

We examined how individual differences in trait anxiety (TA) influence the neural responses associated with the acquisition and extinction of anticipatory anxiety elicited through a context conditioning paradigm, with particular focus on the amygdala and the subgenual anterior cingulate cortex (sgACC).

METHOD

During two sessions of echo-planar functional magnetic resonance imaging (fMRI), 18 healthy volunteers completed a decision-making task with two randomly alternating 28-s to 32-s background screen colour blocks. One of the colours was associated with the presentation of an aversive noise (CTX+) and the other colour was 'safe' (CTX-). In the first session (Acquisition), 33% of CTX+ colour blocks were paired with noise and in the second session (Extinction) no noise was presented.

RESULTS

The amygdala displayed an increased response to CTX+ compared to CTX- colour blocks during the Acquisition and Extinction sessions and the ACC displayed an increased response to CTX+ compared to CTX- colour blocks during Extinction only. In addition, a greater conditioned response (CTX+ minus CTX-) was observed in the ACC when comparing the Extinction and Acquisition sessions. Correlation analyses further showed that higher levels of TA were associated with a higher conditioned response in the amygdala during Extinction as well as a greater differential conditioned response (i.e. Extinction>Acquisition) in the ACC.

CONCLUSIONS

Our results support the idea that individuals with high levels of anxiety-relevant traits and vulnerable to developing an anxiety disorder display a more resilient anxiety response during extinction that is characterized by hyper-responsivity in the amygdala.

Models and mechanisms of anxiety: evidence from startle studies

RATIONALE

Preclinical data indicates that threat stimuli elicit two classes of defensive behaviors, those that are associated with imminent danger and are characterized by flight or fight (fear), and those that are associated with temporally uncertain danger and are characterized by sustained apprehension and hypervigilance (anxiety).

OBJECTIVE

The objectives of the study are to (1) review evidence for a distinction between fear and anxiety in animal and human experimental models using the startle reflex as an operational measure of aversive states, (2) describe experimental models of anxiety, as opposed to fear, in humans, (3) examine the relevance of these models to clinical anxiety.

RESULTS

The distinction between phasic fear to imminent threat and sustained anxiety to temporally uncertain danger is suggested by psychopharmacological and behavioral evidence from ethological studies and can be traced back to distinct neuroanatomical systems, the amygdala and the bed nucleus of the stria terminalis. Experimental models of anxiety, not fear, are relevant to non-phobic anxiety disorders.

CONCLUSIONS

Progress in our understanding of normal and abnormal anxiety is critically dependent on our ability to model sustained aversive states to temporally uncertain threat.

Context conditioning and extinction in humans: differential contribution of the hippocampus, amygdala and prefrontal cortex

Functional magnetic resonance imaging was used to investigate the role of the hippocampus, amygdala and medial prefrontal cortex (mPFC) in a contextual conditioning and extinction paradigm provoking anxiety. Twenty-one healthy persons participated in a differential context conditioning procedure with two different background colours as contexts. During acquisition increased activity to the conditioned stimulus (CS+) relative to the CS- was found in the left hippocampus and anterior cingulate cortex (ACC). The amygdala, insula and inferior frontal cortex were differentially active during late acquisition. Extinction was accompanied by enhanced activation to CS+ vs. CS- in the dorsal anterior cingulate cortex (dACC). The results are in accordance with animal studies and provide evidence for the important role of the hippocampus in contextual learning in humans. Connectivity analyses revealed correlated activity between the left posterior hippocampus and dACC (BA32) during early acquisition and the dACC, left posterior hippocampus and right amygdala during extinction. These data are consistent with theoretical models that propose an inhibitory effect of the mPFC on the amygdala. The interaction of the mPFC with the hippocampus may reflect the context-specificity of extinction learning.

Effect of emotional context in auditory-cortex processing

We examined how emotional context influences processing of emotionally neutral acoustic stimuli in the human auditory cortex. Nine subjects performed a simple discrimination task. In the positive-emotional trials correct performance was awarded with money, whereas in the negative-emotional trials, correct performance resulted in avoidance of the loss of money. Auditory stimuli were identical in both trial types. An event-related brain potential (ERP) N100 deflection, generated in the auditory cortex, was significantly larger in the negative as compared to the positive-emotional trials. This result demonstrates that emotional context influences early sensory-specific cortical processing. In addition, we found some evidence in favor of assumption that processing of positive visual feedback was faster in negative-emotional trials. This was reflected in the tendency for the latency of visual ERPs to be shorter in the latter case. We suggest that our results indicate that the systemic organization at all stages of deployment of behavior depends on emotional context. Dynamics of learning the discrimination task was also dependent on emotional context.

Feeling the Real World: Limbic Response to Music Depends on Related Content

Emotions are often object related--they are about someone or something in the world. It is yet an open question whether emotions and the associated perceptual contents that they refer to are processed by different parts of the brain or whether the brain regions that mediate emotions are also involved in the processing of the associated content they refer to. Using functional magnetic resonance imaging, we showed that simply combining music (rich in emotion but poor in information about the concrete world) with neutral films (poor in emotionality but rich in real-world details) yields increased activity in the amygdala, hippocampus, and lateral prefrontal regions. In contrast, emotional music on its own did not elicit a differential response in these regions. The finding that the amygdala, the heart of the emotional brain, responds increasingly to an emotional stimulus when it is associated with realistic scenes supports a fundamental role for concrete real-world content in emotional processing.

Amygdala responses to nonlinguistic emotional vocalizations

Whereas there is ample evidence for a role of the amygdala in the processing of visual emotional stimuli, particularly those with negative value, discrepant results have been reported regarding amygdala responses to emotional auditory stimuli. The present study used event-related functional magnetic resonance imaging to investigate cerebral activity underlying processing of emotional nonlinguistic vocalizations, with a particular focus on neural changes in the amygdala. Fourteen healthy volunteers were scanned while performing a gender identification task. Stimuli, previously validated on emotional valence, consisted of positive (happiness and sexual pleasure) and negative (sadness and fear) vocalizations, as well as emotionally neutral sounds (e.g., coughs). Results revealed bilateral amygdala activation in response to all emotional vocalizations when compared to neutral stimuli. These findings suggest that the generally accepted involvement of the amygdala in the perception of emotional visual stimuli, such as facial expressions, also applies to stimuli within the auditory modality. Importantly, this amygdala response was observed for both positive and negative emotional vocalizations.

The influence of trait anxiety on autonomic response and cognitive performance during an anticipatory anxiety task

The interaction between emotion and cognition is thought to be intimately involved in the development and maintenance of anxiety disorders. In a set of studies, we investigated whether trait anxiety modulates cognitive performance and autonomic activity during an anticipatory anxiety task. Participants completed a letter-size decision-making task with two alternating 28-32 s background screen color-blocks. One of the colors was associated with the presentation of an aversive noise [unconditioned stimulus (UCS)]. Participants were aware of the background color that would (CTX+) and would not (CTX-) be paired with the UCS but did not know when or how often the UCS would be presented. Two experiments were conducted. In Experiment 1, the UCS was presented during the decision-making task in the CTX+ color-blocks using a partial reinforcement schedule. Different noises were presented each time to increase unpredictability and prevent habituation. In Experiment 2, the UCS was never presented during the decision-making task. Results suggested that only the paradigm used in Experiment 1 was successful in eliciting anticipatory anxiety. In Experiment 1, continuously measured skin conductance response (SCR) data suggested that anxiety was significantly greater during CTX+ compared to CTX- trials; no SCR differences were found between high and low trait-anxious participants. Results further indicated that high trait-anxious participants responded significantly faster on the decision-making task during CTX+ compared to CTX- trials, whereas low trait-anxious participants displayed the opposite pattern. Our results reveal an interesting dissociation between the effects of individual differences in trait anxiety on autonomic activity and cognitive performance during an anticipatory anxiety task.

Fear extinction in rats: Implications for human brain imaging and anxiety disorders

Fear extinction is the decrease in conditioned fear responses that normally occurs when a conditioned stimulus (CS) is repeatedly presented in the absence of the aversive unconditioned stimulus (US). Extinction does not erase the initial CS-US association, but is thought to form a new memory. After extinction training, extinction memory competes with conditioning memory for control of fear expression. Deficits in fear extinction are thought to contribute to post-traumatic stress disorder (PTSD). Herein, we review studies performed in rats showing that the medial prefrontal cortex plays a critical role in the retention and expression of extinction memory. We also review human studies indicating that prefrontal areas homologous to those critical for extinction in rats are structurally and functionally deficient in patients with PTSD. We then discuss how findings from rat studies may allow us to: (1) develop new fear extinction paradigms in humans, (2) make specific predictions as to the location of extinction-related areas in humans, and (3) improve current extinction-based behavioral therapies for anxiety disorders.

Fear but not awareness predicts enhanced sensory processing in fear conditioning

It is not clear whether enhanced cortical processing of reinforced stimuli as reported by neuroimaging studies is due to expectancy of an aversive event alone or to activation of the fear system. The present study investigated cortical and autonomic responses of aware participants using an instructed fear conditioning design. Steady-state visual evoked fields (ssVEF) and heart rate change were recorded to assess sensory processing and activation of the fear system by reinforced (CS+) and nonreinforced stimuli (CS-). Participants who showed heart rate acceleration demonstrated increased ssVEFs in visual and parietal cortex during CS+ in acquisition trials. Heart rate decelerators did not show enhanced cortical activation with respect to the CS+. Participants in both groups reported awareness of CS-US contingencies. Awareness of stimulus contingency in fear conditioning seems not to be sufficient to elicit enhanced visual cortical processing.

Cortical activation during Pavlovian fear conditioning depends on heart rate response patterns: An MEG study

In the present study, we examined stimulus-driven neuromagnetic activity in a delayed Pavlovian aversive conditioning paradigm using steady state visual evoked fields (SSVEF). Subjects showing an accelerative heart rate (HR) component to the CS+ during learning trials exhibited an increased activation in sensory and parietal cortex due to CS+ depiction in the extinction block. This was accompanied by a selective orientation response (OR) to the CS+ during extinction as indexed by HR deceleration. However, they did not show any differential cortical activation patterns during acquisition. In contrast, subjects not showing an accelerative HR component but rather unspecific HR changes during learning were characterized by greater activity in left orbito-frontal brain regions in the acquisition block but did not show differential SSVEF patterns during extinction. The results suggest that participants expressing different HR responses also differ in their stimulus-driven neuromagnetic response pattern to an aversively conditioned stimulus.

Is voice processing species-specific in human auditory cortex? An fMRI study

Recent studies suggested a sensitivity of regions of the human superior temporal sulcus (STS) to the sound of the human voice. However, the question of the species specificity of this response is still open. Healthy adult volunteers were scanned in an event-related fMRI design to compare responses in the STS to human and animal vocalizations, as well as to control nonvocal sounds (e.g., musical instruments). Bilateral activation of anterior STS was observed for human vocalizations, when contrasted with both nonvocal sounds and animal vocalizations. Animal vocalizations, compared to nonvocal sounds, elicited a more restricted left STS activation, although this region responded even more strongly to human vocalizations. This study provides the first evidence suggesting a species specificity in STS responses to vocalizations in humans.

Neural correlates of behavioral preference for culturally familiar drinks

Coca-Cola (Coke) and Pepsi are nearly identical in chemical composition, yet humans routinely display strong subjective preferences for one or the other. This simple observation raises the important question of how cultural messages combine with content to shape our perceptions; even to the point of modifying behavioral preferences for a primary reward like a sugared drink. We delivered Coke and Pepsi to human subjects in behavioral taste tests and also in passive experiments carried out during functional magnetic resonance imaging (fMRI). Two conditions were examined: (1) anonymous delivery of Coke and Pepsi and (2) brand-cued delivery of Coke and Pepsi. For the anonymous task, we report a consistent neural response in the ventromedial prefrontal cortex that correlated with subjects' behavioral preferences for these beverages. In the brand-cued experiment, brand knowledge for one of the drinks had a dramatic influence on expressed behavioral preferences and on the measured brain responses.

Amygdala automaticity in emotional processing

The question addressed in this paper is whether the human amygdala processes threat-related stimuli independent of selective attention. This is considered from a functional neuroimaging perspective, describing studies in normal volunteers and patients with brain lesions. The conclusion is that the evidence for such automaticity is strong, indicating that important distinctions exist between emotion and other forms of cognition.

Sound-induced illusory flash perception: role of gamma band responses

In the recently discovered sound-induced illusory flash phenomenon, a single flash accompanied with two auditory beeps is perceived as two flashes in a majority of trials. Here we asked what the neural substrates distinguishing illusion and no-illusion (i.e. perception of single flash) percepts are under identical stimulus configuration. Wavelet based method was used to analyze gamma band (> 30 Hz) responses in the event-related potential (ERP) signals recorded over visual cortical regions. We found: (i) significantly higher oscillatory and induced gamma band responses in illusion than in no-illusion trials, and (ii) significant supra-additive audio-visual interactions only in illusion trials. These results provide a clear neurophysiological correlate to the perception of illusion. Furthermore, the results suggest that auditory stimuli modulate cortical processing of visual stimuli, and the flash illusion (qualitative alteration of visual percept) only takes place when this modulation exceeds some critical threshold for the registration of conscious awareness.