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Bas‐Hoogendam JM, Groenewold NA, Aghajani M, Freitag GF, Harrewijn A, Hilbert K, Jahanshad N, Thomopoulos SI, Thompson PM, Veltman DJ, Winkler AM, Lueken U, Pine DS, van der Wee NJA, Stein DJ. ENIGMA-anxiety working group: Rationale for and organization of large-scale neuroimaging studies of anxiety disorders. Hum Brain Mapp 2022; 43:83-112. [PMID: 32618421 PMCID: PMC8805695 DOI: 10.1002/hbm.25100] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/09/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022] Open
Abstract
Anxiety disorders are highly prevalent and disabling but seem particularly tractable to investigation with translational neuroscience methodologies. Neuroimaging has informed our understanding of the neurobiology of anxiety disorders, but research has been limited by small sample sizes and low statistical power, as well as heterogenous imaging methodology. The ENIGMA-Anxiety Working Group has brought together researchers from around the world, in a harmonized and coordinated effort to address these challenges and generate more robust and reproducible findings. This paper elaborates on the concepts and methods informing the work of the working group to date, and describes the initial approach of the four subgroups studying generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobia. At present, the ENIGMA-Anxiety database contains information about more than 100 unique samples, from 16 countries and 59 institutes. Future directions include examining additional imaging modalities, integrating imaging and genetic data, and collaborating with other ENIGMA working groups. The ENIGMA consortium creates synergy at the intersection of global mental health and clinical neuroscience, and the ENIGMA-Anxiety Working Group extends the promise of this approach to neuroimaging research on anxiety disorders.
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Affiliation(s)
- Janna Marie Bas‐Hoogendam
- Department of Developmental and Educational PsychologyLeiden University, Institute of PsychologyLeidenThe Netherlands
- Department of PsychiatryLeiden University Medical CenterLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeidenThe Netherlands
| | - Nynke A. Groenewold
- Department of Psychiatry & Mental HealthUniversity of Cape TownCape TownSouth Africa
| | - Moji Aghajani
- Department of PsychiatryAmsterdam UMC / VUMCAmsterdamThe Netherlands
- Department of Research & InnovationGGZ inGeestAmsterdamThe Netherlands
| | - Gabrielle F. Freitag
- National Institute of Mental Health, Emotion and Development BranchBethesdaMarylandUSA
| | - Anita Harrewijn
- National Institute of Mental Health, Emotion and Development BranchBethesdaMarylandUSA
| | - Kevin Hilbert
- Department of PsychologyHumboldt‐Universität zu BerlinBerlinGermany
| | - Neda Jahanshad
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics InstituteLos AngelesCaliforniaUSA
| | - Sophia I. Thomopoulos
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics InstituteLos AngelesCaliforniaUSA
| | - Paul M. Thompson
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics InstituteLos AngelesCaliforniaUSA
| | - Dick J. Veltman
- Department of PsychiatryAmsterdam UMC / VUMCAmsterdamThe Netherlands
| | - Anderson M. Winkler
- National Institute of Mental Health, Emotion and Development BranchBethesdaMarylandUSA
| | - Ulrike Lueken
- Department of PsychologyHumboldt‐Universität zu BerlinBerlinGermany
| | - Daniel S. Pine
- National Institute of Mental Health, Emotion and Development BranchBethesdaMarylandUSA
| | - Nic J. A. van der Wee
- Department of PsychiatryLeiden University Medical CenterLeidenThe Netherlands
- Leiden Institute for Brain and CognitionLeidenThe Netherlands
| | - Dan J. Stein
- Department of Psychiatry & Mental HealthUniversity of Cape TownCape TownSouth Africa
- University of Cape TownSouth African MRC Unit on Risk & Resilience in Mental DisordersCape TownSouth Africa
- University of Cape TownNeuroscience InstituteCape TownSouth Africa
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Kark SM, Slotnick SD, Kensinger EA. Repetition Enhancement of Amygdala and Visual Cortex Functional Connectivity Reflects Nonconscious Memory for Negative Visual Stimuli. J Cogn Neurosci 2016; 28:1933-1946. [PMID: 27676616 DOI: 10.1162/jocn_a_01049] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Most studies using a recognition memory paradigm examine the neural processes that support the ability to consciously recognize past events. However, there can also be nonconscious influences from the prior study episode that reflect repetition suppression effects-a reduction in the magnitude of activity for repeated presentations of stimuli-that are revealed by comparing neural activity associated with forgotten items to correctly rejected novel items. The present fMRI study examined the effect of emotional valence (positive vs. negative) on repetition suppression effects. Using a standard recognition memory task, 24 participants viewed line drawings of previously studied negative, positive, and neutral photos intermixed with novel line drawings. For each item, participants made an old-new recognition judgment and a sure-unsure confidence rating. Collapsed across valence, repetition suppression effects were found in ventral occipital-temporal cortex and frontal regions. Activity levels in the majority of these regions were not modulated by valence. However, repetition enhancement of the amygdala and ventral occipital-temporal cortex functional connectivity reflected nonconscious memory for negative items. In this study, valence had little effect on activation patterns but had a larger effect on functional connectivity patterns that were markers of nonconscious memory. Beyond memory and emotion, these findings are relevant to other cognitive and social neuroscientists that utilize fMRI repetition effects to investigate perception, attention, social cognition, and other forms of learning and memory.
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van den Bulk BG, Somerville LH, van Hoof MJ, van Lang NDJ, van der Wee NJA, Crone EA, Vermeiren RRJM. Amygdala habituation to emotional faces in adolescents with internalizing disorders, adolescents with childhood sexual abuse related PTSD and healthy adolescents. Dev Cogn Neurosci 2016; 21:15-25. [PMID: 27591712 PMCID: PMC6987649 DOI: 10.1016/j.dcn.2016.08.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Revised: 08/23/2016] [Accepted: 08/23/2016] [Indexed: 11/24/2022] Open
Abstract
A study investigating habituation patterns in the amygdala. Compares adolescents with internalizing disorders and adolescents with CSA-related PTSD. Initial heightened response and fast habituation in amygdala for the PTSD group. No habituation of amygdala response in the internalizing group. Possible difference in underlying neurobiological mechanisms for emotional face processing.
Adolescents with internalizing disorders and adolescents with childhood sexual abuse related post-traumatic stress disorder (CSA-related PTSD) show a large overlap in symptomatology. In addition, brain research indicated hyper-responsiveness and sustained activation instead of habituation of amygdala activation to emotional faces in both groups. Little is known, however, about whether the same patterns of amygdala habituation are present in these two groups. The current study examined habituation patterns of amygdala activity to emotional faces (fearful, happy and neutral) in adolescents with a DSM-IV depressive and/or anxiety disorder (N = 25), adolescents with CSA-related PTSD (N = 19) and healthy controls (N = 26). Behaviourally, the adolescents from the internalizing and CSA-related PTSD group reported more anxiety to fearful and neutral faces than adolescents from the control group and adolescents from the CSA-related PTSD group reacted slower compared to the internalizing group. At the whole brain level, there was a significant interaction between time and group within the left amygdala. Follow-up ROI analysis showed elevated initial activity in the amygdala and rapid habituation in the CSA-related PTSD group compared to the internalizing group. These findings suggest that habituation patterns of amygdala activation provide additional information on problems with emotional face processing. Furthermore, the results suggest there are differences in the underlying neurobiological mechanisms related to emotional face processing for adolescents with internalizing disorders and adolescents with CSA-related PTSD. Possibly CSA-related PTSD is characterized by a stronger primary emotional response driven by the amygdala.
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Affiliation(s)
- Bianca G van den Bulk
- Curium-LUMC, Department of Child Psychiatry, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands; Leiden Consortium on Individual Development, Department of Child and Family Studies, Leiden University, P.O. box 9555, 2300 RB Leiden, the Netherlands; Institute of Psychology, Brain and Development Lab, Leiden University, P.O. box 9555, 2300 RB Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands.
| | - Leah H Somerville
- Department of Psychology, Affective Neuroscience and Development Lab, Harvard University, 52 Oxford Street, Cambridge, MA 02138, USA
| | - Marie-José van Hoof
- Curium-LUMC, Department of Child Psychiatry, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands; GGZ Rivierduinen, Psychotraumacenter and Department of Child and Adolescent Psychiatry, P.O. box 2211, 2301 CE Leiden, the Netherlands
| | - Natasja D J van Lang
- Curium-LUMC, Department of Child Psychiatry, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands
| | - Nic J A van der Wee
- Leiden Institute for Brain and Cognition, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands; Department of Psychiatry, Leiden University Medical Centre. P.O. box 9600, 2300 RC Leiden, the Netherlands
| | - Eveline A Crone
- Institute of Psychology, Brain and Development Lab, Leiden University, P.O. box 9555, 2300 RB Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands
| | - Robert R J M Vermeiren
- Curium-LUMC, Department of Child Psychiatry, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands; Leiden Institute for Brain and Cognition, Leiden University Medical Centre, P.O. box 9600, 2300 RC Leiden, the Netherlands; Department of Child Psychiatry, VU University Medical Centre, P.O. box 303, 1115 ZG Duivendrecht, the Netherlands
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Petrowski K, Wintermann GB, Kirschbaum C, Strahler J. Salivary alpha-amylase response following repeated psychosocial stress in patients with panic disorder. J Anxiety Disord 2016; 37:54-63. [PMID: 26625098 DOI: 10.1016/j.janxdis.2015.10.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Revised: 09/30/2015] [Accepted: 10/01/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND This study examined autonomic responses (salivary alpha-amylase, sAA; heart rate, HR) to repeated psychosocial stress as a candidate mechanism linking autonomic hyper-arousal and sensitization to the occurrence of panic disorder (PD). METHODS Thirty-three patients with PD and 34 healthy controls were exposed to the Trier Social Stress Test (TSST) twice on consecutive days. RESULTS sAA changes were comparable between PD and controls on both testing days with overall decreasing sAA responses (delta) on day two. In contrast, HR delta increased on day two in both groups. This sensitization was driven by female controls while male PD showed most pronounced HR changes to the first TSST. CONCLUSIONS Overall, a general autonomic hyper-arousal in PD could not be confirmed. In contrast, sAA responses slightly habituated to repeated stress. Whether sAA findings mirror assumed habituation effects of repeated stress exposure on normalizing autonomic reactivity remains to be investigated in longitudinal studies.
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Affiliation(s)
- Katja Petrowski
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Germany.
| | - Gloria-Beatrice Wintermann
- Department of Psychotherapy and Psychosomatic Medicine, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Germany
| | - Clemens Kirschbaum
- Biological Psychology, Department of Psychology, Technische Universität Dresden, Germany
| | - Jana Strahler
- Clinical Biopsychology, Department of Psychology, Philipps-Universität Marburg, Germany
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Herrmann MJ, Boehme S, Becker MPI, Tupak SV, Guhn A, Schmidt B, Brinkmann L, Straube T. Phasic and sustained brain responses in the amygdala and the bed nucleus of the stria terminalis during threat anticipation. Hum Brain Mapp 2015; 37:1091-102. [PMID: 26678871 DOI: 10.1002/hbm.23088] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 11/12/2015] [Accepted: 12/03/2015] [Indexed: 12/19/2022] Open
Abstract
Several lines of evidence suggest that the amygdala and the bed nucleus of the stria terminalis (BNST) are differentially involved in phasic and sustained fear. Even though, results from neuroimaging studies support this distinction, a specific effect of a temporal dissociation with phasic responses to onset versus sustained responses during prolonged states of threat anticipation has not been shown yet. To explore this issue, we investigated brain activation during anticipation of threat in 38 healthy participants by means of functional magnetic resonance imaging. Participants were presented different visual cues indicated the temporally unpredictable occurrence of a subsequent aversive or neutral stimulus. During the onset of aversive versus neutral anticipatory cues, results showed a differential phasic activation of amygdala, anterior cingulate cortex (ACC), and ventrolateral prefrontal cortex (PFC). In contrast, activation in the BNST and other brain regions, including insula, dorsolateral PFC, ACC, cuneus, posterior cingulate cortex, and periaqueductal grey was characterized by a sustained response during the threat versus neutral anticipation period. Analyses of functional connectivity showed phasic amygdala response as positively associated with activation, mainly in sensory cortex areas whereas sustained BNST activation was negatively associated with activation in visual cortex and positively correlated with activation in the insula and thalamus. These findings suggest that the amygdala is responsive to the onset of cues signaling the unpredictable occurrence of a potential threat while the BNST in concert with other areas is involved in sustained anxiety. Furthermore, the amygdala and BNST are characterized by distinctive connectivity patterns during threat anticipation.
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Affiliation(s)
- Martin J Herrmann
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Fuechsleinstraße 15, Würzburg, D-97080, Germany
| | - Stephanie Boehme
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Fuechsleinstraße 15, Würzburg, D-97080, Germany
| | - Michael P I Becker
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, Muenster, D-48149, Germany
| | - Sara V Tupak
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, Muenster, D-48149, Germany
| | - Anne Guhn
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Fuechsleinstraße 15, Würzburg, D-97080, Germany
| | - Brigitte Schmidt
- Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Fuechsleinstraße 15, Würzburg, D-97080, Germany
| | - Leonie Brinkmann
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, Muenster, D-48149, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, Muenster, D-48149, Germany
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Lindner K, Neubert J, Pfannmöller J, Lotze M, Hamm AO, Wendt J. Fear-potentiated startle processing in humans: Parallel fMRI and orbicularis EMG assessment during cue conditioning and extinction. Int J Psychophysiol 2015; 98:535-45. [DOI: 10.1016/j.ijpsycho.2015.02.025] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 01/29/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022]
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Li Z, Coles CD, Lynch ME, Luo Y, Hu X. Longitudinal changes of amygdala and default mode activation in adolescents prenatally exposed to cocaine. Neurotoxicol Teratol 2015; 53:24-32. [PMID: 26577285 DOI: 10.1016/j.ntt.2015.11.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 10/29/2015] [Accepted: 11/09/2015] [Indexed: 12/30/2022]
Abstract
Prenatal cocaine exposure (PCE) is associated with long-term and negative effect on arousal regulation. Recent neuroimaging studies have examined brain mechanisms related to arousal dysregulation with cross-sectional experimental designs; but longitudinal changes in the brain, reflecting group differences in neurodevelopment, have never been directly examined. To directly assess the interaction of PCE and neurodevelopment, the present study used a longitudinal design to analyze functional magnetic resonance imaging (fMRI) data collected from 33 adolescents (21 with PCE and 12 non-exposed controls) while they performed the same working memory task with emotional distracters at two points in time. The mean age of participants was 14.3 years at time_1 and 16.7 years at time_2. With confounding factors statistically controlled, the fMRI data revealed significant exposure-by-time interaction in the activations of the amygdala and default mode network (DMN). For the control adolescents, brain activations associated with emotional arousal (amygdala) and cognitive effort (DMN) were both reduced at time_2 as compared to that at time_1. However, these activation reductions were not observed in the PCE group, indicating persistently high levels of emotional arousal and cognitive effort. In addition, correlations between longitudinal changes in the brain and in behavior have shown that adolescents with persistently high emotional arousal were more likely in need of high cognitive effort; and their cognitive performance was more likely to be affected by distractive challenges. The present results complement and extend previous findings from cross-sectional studies with further evidence supporting the view of PCE associated long-term teratogenic effects on arousal regulation.
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Affiliation(s)
- Zhihao Li
- Institute of Affective and Social Neuroscience, Shenzhen University, Shenzhen 518060, Guangdong, PR China; Biomedical Imaging Technology Center, Department of Biomedical Engineering, Emory University & Georgia Institute of Technology, Atlanta 30322, GA, USA.
| | - Claire D Coles
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta 30322, GA, USA
| | - Mary Ellen Lynch
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta 30322, GA, USA
| | - Yuejia Luo
- Institute of Affective and Social Neuroscience, Shenzhen University, Shenzhen 518060, Guangdong, PR China
| | - Xiaoping Hu
- Biomedical Imaging Technology Center, Department of Biomedical Engineering, Emory University & Georgia Institute of Technology, Atlanta 30322, GA, USA.
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Czekóová K, Shaw DJ, Janoušová E, Urbánek T. It's all in the past: temporal-context effects modulate subjective evaluations of emotional visual stimuli, regardless of presentation sequence. Front Psychol 2015; 6:367. [PMID: 25904877 PMCID: PMC4387863 DOI: 10.3389/fpsyg.2015.00367] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 03/16/2015] [Indexed: 12/01/2022] Open
Abstract
The aim of this study was to investigate if and how temporal context influences subjective affective responses to emotional images. To do so, we examined whether the subjective evaluation of a target image is influenced by the valence of its preceding image, and/or its overall position in a sequence of images. Furthermore, we assessed if these potentially confounding contextual effects can be moderated by a common procedural control: randomized stimulus presentation. Four groups of participants evaluated the same set of 120 pictures from the International Affective System (IAPS) presented in four different sequences. Our data reveal strong effects of both aspects of temporal context in all presentation sequences, modified only slightly in their nature and magnitude. Furthermore, this was true for both valence and arousal ratings. Subjective ratings of negative target images were influenced by temporal context most strongly across all sequences. We also observed important gender differences: females expressed greater sensitivity to temporal-context effects and design manipulations relative to males, especially for negative images. Our results have important implications for future emotion research that employs normative picture stimuli, and contributes to our understanding of context effects in general.
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Affiliation(s)
- Kristína Czekóová
- Behavioral and Social Neuroscience Research Group, Central European Institute of Technology, Masaryk University Brno, Czech Republic
| | - Daniel J Shaw
- Behavioral and Social Neuroscience Research Group, Central European Institute of Technology, Masaryk University Brno, Czech Republic
| | - Eva Janoušová
- Faculty of Medicine, Institute of Biostatistics and Analyses, Masaryk University Brno, Czech Republic
| | - Tomáš Urbánek
- Institute of Psychology, Academy of Sciences of the Czech Republic Brno, Czech Republic
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Abstract
OBJECTIVE This article reviews neuroimaging studies that inform psychotherapy research. An introduction to neuroimaging methods is provided as background for the increasingly sophisticated breadth of methods and findings appearing in psychotherapy research. METHOD We compiled and assessed a comprehensive list of neuroimaging studies of psychotherapy outcome, along with selected examples of other types of studies that also are relevant to psychotherapy research. We emphasized magnetic resonance imaging (MRI) since it is the dominant neuroimaging modality in psychological research. RESULTS We summarize findings from neuroimaging studies of psychotherapy outcome, including treatment for depression, obsessive compulsive disorder (OCD), and schizophrenia. CONCLUSIONS The increasing use of neuroimaging methods in the study of psychotherapy continues to refine our understanding of both outcome and process. We suggest possible directions for future neuroimaging studies in psychotherapy research.
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Affiliation(s)
- Carol P Weingarten
- a Department of Psychiatry and Behavioral Sciences , Duke University , Durham , NC , USA
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Labudda K, Mertens M, Steinkroeger C, Bien CG, Woermann FG. Lesion side matters - an fMRI study on the association between neural correlates of watching dynamic fearful faces and their evaluation in patients with temporal lobe epilepsy. Epilepsy Behav 2014; 31:321-8. [PMID: 24210457 DOI: 10.1016/j.yebeh.2013.10.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 10/08/2013] [Accepted: 10/10/2013] [Indexed: 11/27/2022]
Abstract
Most studies assessing facial affect recognition in patients with TLE reported emotional disturbances in patients with TLE. Results from the few fMRI studies assessing neural correlates of affective face processing in patients with TLE are divergent. Some, but not all, found asymmetrical mesiotemporal activations, i.e., stronger activations within the hemisphere contralateral to seizure onset. Little is known about the association between neural correlates of affect processing and subjective evaluation of the stimuli presented. Therefore, we investigated the neural correlates of processing dynamic fearful faces in 37 patients with mesial temporal lobe epilepsy (TLE; 18 with left-sided TLE (lTLE), 19 with right-sided TLE (rTLE)) and 20 healthy subjects. We additionally assessed individual ratings of the fear intensity and arousal perception of the fMRI stimuli and correlated these data with the activations induced by the fearful face paradigm and activation lateralization within the mesiotemporal structures (in terms of individual lateralization indices, LIs). In healthy subjects, whole-brain analysis showed bilateral activations within a widespread network of mesial and lateral temporal, occipital, and frontal areas. The patient groups activated different parts of this network. In patients with lTLE, we found predominantly right-sided activations within the mesial and lateral temporal cortices and the superior frontal gyrus. In patients with rTLE, we observed bilateral activations in the posterior regions of the lateral temporal lobe and within the occipital cortex. Mesiotemporal region-of-interest analysis showed bilateral symmetric activations associated with watching fearful faces in healthy subjects. According to the region of interest and LI analyses, in the patients with lTLE, mesiotemporal activations were lateralized to the right hemisphere. In the patients with rTLE, we found left-sided mesiotemporal activations. In patients with lTLE, fear ratings were comparable to those of healthy subjects and were correlated with relatively stronger activations in the right compared to the left amygdala. Patients with rTLE showed significantly reduced fear ratings compared to healthy subjects, and we did not find associations with amygdala lateralization. Although we found stronger activations within the contralateral mesial temporal lobe in the majority of all patients, our results suggest that only in the event of left-sided mesiotemporal damage is the right mesial temporal lobe able to preserve intact facial fear recognition. In the event of right-sided mesiotemporal damage, fear recognition is disturbed. This underlines the hypothesis that the right amygdala is biologically predisposed to processing fear, and its function cannot be fully compensated in the event of right-sided mesiotemporal damage.
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Affiliation(s)
- Kirsten Labudda
- Mara Hospital, Bethel Epilepsy Center, Maraweg 21, 33617 Bielefeld, Germany
| | - Markus Mertens
- Mara Hospital, Bethel Epilepsy Center, Maraweg 21, 33617 Bielefeld, Germany
| | | | - Christian G Bien
- Mara Hospital, Bethel Epilepsy Center, Maraweg 21, 33617 Bielefeld, Germany
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Boehme S, Mohr A, Becker MPI, Miltner WHR, Straube T. Area-dependent time courses of brain activation during video-induced symptom provocation in social anxiety disorder. BIOLOGY OF MOOD & ANXIETY DISORDERS 2014; 4:6. [PMID: 24921039 PMCID: PMC4052290 DOI: 10.1186/2045-5380-4-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 04/11/2014] [Indexed: 05/16/2023]
Abstract
BACKGROUND Previous functional imaging studies using symptom provocation in patients with social anxiety disorder (SAD) reported inconsistent findings, which might be at least partially related to different time-dependent activation profiles in different brain areas. In the present functional magnetic resonance imaging study, we used a novel video-based symptom provocation design in order to investigate the magnitude and time course of activation in different brain areas in 20 SAD patients and 20 healthy controls. RESULTS The disorder-related videos induced increased anxiety in patients with SAD as compared to healthy controls. Analyses of brain activation to disorder-related versus neutral video clips revealed amygdala activation during the first but not during the second half of the clips in patients as compared to controls. In contrast, the activation in the insula showed a reversed pattern with increased activation during the second but not during the first half of the video clips. Furthermore, a cluster in the anterior dorsal anterior cingulate cortex showed a sustained response for the entire duration of the videos. CONCLUSIONS The present findings suggest that different regions of the fear network show differential temporal response patterns during video-induced symptom provocation in SAD. While the amygdala is involved during initial threat processing, the insula seems to be more involved during subsequent anxiety responses. In accordance with cognitive models of SAD, a medial prefrontal region engaged in emotional-cognitive interactions is generally hyperactivated.
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Affiliation(s)
- Stephanie Boehme
- Department of Biological and Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3 // 1, Jena D-07743, Germany
| | - Alexander Mohr
- Department of Biological and Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3 // 1, Jena D-07743, Germany
| | - Michael PI Becker
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, Muenster D-48149, Germany
| | - Wolfgang HR Miltner
- Department of Biological and Clinical Psychology, Friedrich Schiller University Jena, Am Steiger 3 // 1, Jena D-07743, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, Muenster D-48149, Germany
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12
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Abstract
Es gehört zu den zentralen menschlichen Fertigkeiten, Emotionen, welche durch externale oder internale Ereignisse ausgelöst werden gemäß der kurz- und langfristigen Handlungsziele zu regulieren. Diese Fertigkeiten werden über neuronale Netzwerke im präfrontalen Kortex vermittelt. Der dorsolaterale und ventromediale präfrontale Kortex ist entscheidend beteiligt, wenn Menschen über Neubewertung der Situation versuchen ihre Emotionen kognitiv zu modulieren. Die neuronalen Netzwerke dieser präfrontalen Kortexareale hemmen dabei die Aktivität der Amygdala und reduzieren somit die Signifikanz des emotionsauslösenden Ereignisses. Emotionsregulation wird daher als Zusammenspiel von emotionsgenerierenden Regionen (z. B. Amygdala, Insel etc.) und regulierenden Kontrollregionen (z. B. dorsolateraler und ventromedialer präfrontaler Kortex) betrachtet.
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