1
|
Binder FP, Pöhlchen D, Zwanzger P, Spoormaker VI. Facing Your Fear in Immersive Virtual Reality: Avoidance Behavior in Specific Phobia. Front Behav Neurosci 2022; 16:827673. [PMID: 35571283 PMCID: PMC9094686 DOI: 10.3389/fnbeh.2022.827673] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/25/2022] [Indexed: 11/30/2022] Open
Abstract
Specific phobias are the most common anxiety disorder and are characterized by avoidance behavior. Avoidance behavior impacts daily function and is proposed to impair extinction learning. However, despite its prevalence, its objective assessment remains a challenge. To this end, we developed a fully automated experimental procedure using immersive virtual reality. The procedure contained a behavioral search, forced-choice, and an approach task with varying degrees of freedom and task relevance of the stimuli. In this study, we examined the sensitivity and feasibility of these tasks to assess avoidance behavior in patients with specific phobia. We adapted the tasks by replacing the originally conditioned stimuli with a spider and a neutral animal and investigated 31 female participants composed of 15 spider-phobic and 16 non-phobic participants. As the non-phobics were quite heterogeneous in terms of their Fear of Spiders Questionnaire (FSQ) scores, we subdivided them into six “fearfuls” that had elevated FSQ scores, and 10 “non-fearfuls” that had no fear of spiders. The phobics successfully managed to complete the procedure and showed consistent avoidance behavior across all behavioral tasks. Compared to the non-fearfuls, which did not show any avoidance behavior at all, the phobics looked at the spider much more often and clearly directed their body toward it in the search task. In the approach task, they hesitated most when they were close to the spider, and their difficulty to touch the spider was reflected in a strong increase in right hand acceleration changes. The fearfuls showed avoidance behavior depending on the tasks: strongest in the search task and weakest in the approach task. Additionally, we identified subjective valence ratings of the spider as the main influence on both objective avoidance behavior and subjective well-being after exposure, mediating the effect of the FSQ. In summary, the behavioral tasks are well suited to assess avoidance behavior in phobic participants and provide detailed insights into the process of avoidance.
Collapse
Affiliation(s)
- Florian P. Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Max Planck Institute of Psychiatry, Munich, Germany
- *Correspondence: Florian P. Binder,
| | - Dorothee Pöhlchen
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Max Planck Institute of Psychiatry, Munich, Germany
| | - Peter Zwanzger
- kbo-Inn-Salzach-Hospital, Clinical Center for Psychiatry, Psychotherapy, Psychosomatic Medicine and Geriatrics, Wasserburg am Inn, Germany
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Victor I. Spoormaker
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| |
Collapse
|
2
|
Ruat J, Heinz DE, Binder FP, Stark T, Neuner R, Hartmann A, Kaplick PM, Chen A, Czisch M, Wotjak CT. Structural correlates of trauma-induced hyperarousal in mice. Prog Neuropsychopharmacol Biol Psychiatry 2021; 111:110404. [PMID: 34303744 DOI: 10.1016/j.pnpbp.2021.110404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/23/2021] [Accepted: 07/17/2021] [Indexed: 11/18/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a chronic disease caused by traumatic incidents. Numerous studies have revealed grey matter volume differences in affected individuals. The nature of the disease renders it difficult to distinguish between a priori versus a posteriori changes. To overcome this difficulty, we studied the consequences of a traumatic event on brain morphology in mice before and 4 weeks after exposure to brief foot shocks (or sham treatment), and correlated morphology with symptoms of hyperarousal. In the latter context, we assessed hyperarousal upon confrontation with acoustic, visual, or composite (acoustic/visual/tactile) threats and integrated the individual readouts into a single Hyperarousal Score using logistic regression analysis. MRI scans with subsequent whole-brain deformation-based morphometry (DBM) analysis revealed a volume decrease of the dorsal hippocampus and an increase of the reticular nucleus in shocked mice when compared to non-shocked controls. Using the Hyperarousal Score as regressor for the post-exposure MRI measurement, we observed negative correlations with several brain structures including the dorsal hippocampus. If the development of changes with respect to the basal MRI was considered, reduction in globus pallidus volume reflected hyperarousal severity. Our findings demonstrate that a brief traumatic incident can cause volume changes in defined brain structures and suggest the globus pallidus as an important hub for the control of fear responses to threatening stimuli of different sensory modalities.
Collapse
Affiliation(s)
- Julia Ruat
- Department Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, 80804 Munich, Germany; International Max Planck Research School for Translational Psychiatry (IMPRS-TP), 80804 Munich, Germany
| | - Daniel E Heinz
- Research Group Neuronal Plasticity, Max Planck Institute of Psychiatry, 80804 Munich, Germany; Max Planck School of Cognition, 04103 Leipzig, Germany
| | - Florian P Binder
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), 80804 Munich, Germany; Department Translational Research in Psychiatry, Max Planck Institute of Psychiatry, 80804 Munich, Germany
| | - Tibor Stark
- Scientific Core Unit Neuroimaging, Max Planck Institute of Psychiatry, 80804 Munich, Germany; Department of Pharmacology, Faculty of Medicine, Masaryk University, 62500 Brno, Czechia
| | - Robert Neuner
- Research Group Neuronal Plasticity, Max Planck Institute of Psychiatry, 80804 Munich, Germany
| | - Alice Hartmann
- Research Group Neuronal Plasticity, Max Planck Institute of Psychiatry, 80804 Munich, Germany
| | - Paul M Kaplick
- Research Group Neuronal Plasticity, Max Planck Institute of Psychiatry, 80804 Munich, Germany
| | - Alon Chen
- Department Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, 80804 Munich, Germany; Department of Neurobiology, Weizmann Institute of Science, 76100 Rehovot, Israel
| | - Michael Czisch
- Scientific Core Unit Neuroimaging, Max Planck Institute of Psychiatry, 80804 Munich, Germany
| | - Carsten T Wotjak
- Research Group Neuronal Plasticity, Max Planck Institute of Psychiatry, 80804 Munich, Germany; Max Planck School of Cognition, 04103 Leipzig, Germany; Central Nervous System Diseases Research (CNSDR), Boehringer Ingelheim Pharma GmbH & Co KG, 88397, Biberach an der Riss, Germany.
| |
Collapse
|
3
|
Fietz J, Pöhlchen D, Binder FP, Czisch M, Sämann PG, Spoormaker VI. Pupillometry tracks cognitive load and salience network activity in a working memory functional magnetic resonance imaging task. Hum Brain Mapp 2021; 43:665-680. [PMID: 34622518 PMCID: PMC8720183 DOI: 10.1002/hbm.25678] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 08/16/2021] [Accepted: 09/16/2021] [Indexed: 01/29/2023] Open
Abstract
The diameter of the human pupil tracks working memory processing and is associated with activity in the frontoparietal network. At the same time, recent neuroimaging research has linked human pupil fluctuations to activity in the salience network. In this combined functional magnetic resonance imaging (fMRI)/pupillometry study, we recorded the pupil size of healthy human participants while they performed a blockwise organized working memory task (N‐back) inside an MRI scanner in order to monitor the pupil fluctuations associated neural activity during working memory processing. We first confirmed that mean pupil size closely followed working memory load. Combining this with fMRI data, we focused on blood oxygen level dependent (BOLD) correlates of mean pupil size modeled onto the task blocks as a parametric modulation. Interrogating this modulated task regressor, we were able to retrieve the frontoparietal network. Next, to fully exploit the within‐block dynamics, we divided the blocks into 1 s time bins and filled these with corresponding pupil change values (first‐order derivative of pupil size). We found that pupil change within N‐back blocks was positively correlated with BOLD amplitudes in the areas of the salience network (namely bilateral insula, and anterior cingulate cortex). Taken together, fMRI with simultaneous measurement of pupil parameters constitutes a valuable tool to dissect working memory subprocesses related to both working memory load and salience of the presented stimuli.
Collapse
Affiliation(s)
- Julia Fietz
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Max Planck Institute of Psychiatry, Munich, Germany
| | - Dorothee Pöhlchen
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Max Planck Institute of Psychiatry, Munich, Germany
| | - Florian P Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Max Planck Institute of Psychiatry, Munich, Germany
| | -
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,Max Planck Institute of Psychiatry, Munich, Germany
| | | | | | - Victor I Spoormaker
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| |
Collapse
|
4
|
Pöhlchen D, Priouret M, Kraft MS, Binder FP, Gürsel DA, Berberich G, Koch K, Spoormaker VI. Examining Differences in Fear Learning in Patients With Obsessive-Compulsive Disorder With Pupillometry, Startle Electromyography and Skin Conductance Responses. Front Psychiatry 2021; 12:730742. [PMID: 34658966 PMCID: PMC8517251 DOI: 10.3389/fpsyt.2021.730742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 09/02/2021] [Indexed: 11/13/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is characterized by recurrent, persistent thoughts and repetitive behaviors causing stress and anxiety. In the associative learning model of OCD, mechanisms of fear extinction are supposed to partly underlie symptom development, maintenance and treatment of OCD, proposing that OCD patients suffer from rigid memory associations and inhibitory learning deficits. To test these assumptions, previous studies have used skin conductance and subjective ratings as readouts in fear conditioning paradigms, finding impaired fear extinction learning, impaired fear extinction recall or no differences between individuals with OCD and healthy controls. Against this heterogeneous background, we tested fear acquisition and extinction in 37 OCD patients and 56 healthy controls, employing skin conductance as well as pupillometry and startle electromyography. Extinction recall was also included in a subsample. We did not observe differences between groups in any of the task phases, except a trend toward higher startle amplitudes during extinction for OCD. Overall, sensitive readouts such as pupillometry and startle responses did not provide evidence for moderate-to-large inhibitory learning deficits using classical fear conditioning, challenging the assumption of generically impaired extinction learning and memory in OCD.
Collapse
Affiliation(s)
- Dorothee Pöhlchen
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Marthe Priouret
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Miriam S Kraft
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Florian P Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Deniz A Gürsel
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Munich, Germany
| | - Götz Berberich
- Windach Institute and Hospital of Neurobehavioural Research and Therapy, Windach, Germany
| | | | - Kathrin Koch
- Department of Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center (TUM-NIC), Technical University of Munich, Munich, Germany
| | - Victor I Spoormaker
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| |
Collapse
|
5
|
Abstract
Avoidance behavior is a key symptom of most anxiety disorders and a central readout in animal research. However, the quantification of real-life avoidance behavior in humans is typically restricted to clinical populations, who show actual avoidance of phobic objects. In experimental approaches for healthy participants, many avoidance tasks utilize button responses or a joystick navigation on the screen as indicators of avoidance behavior. To allow the ecologically valid assessment of avoidance behavior in healthy participants, we developed a new automated immersive Virtual Reality paradigm, where participants could freely navigate in virtual 3-dimensional, 360-degrees scenes by real naturalistic body movements. A differential fear conditioning procedure was followed by three newly developed behavioral tasks to assess participants’ avoidance behavior of the conditioned stimuli: an approach, a forced-choice, and a search task. They varied in instructions, degrees of freedom, and high or low task-related relevance of the stimuli. We initially examined the tasks in a quasi-experiment (N = 55), with four consecutive runs and various experimental adaptations. Here, although we observed avoidance behavior in all three tasks after additional reinforcement, we only detected fear-conditioned avoidance behavior in the behavioral forced-choice and search tasks. These findings were largely replicated in a confirmatory experiment (N = 72) with randomized group allocation, except that fear-conditioned avoidance behavior was only manifest in the behavioral search task. This supports the notion that the behavioral search task is sensitive to detect avoidance behavior after fear conditioning only, whereas the behavioral approach and forced-choice tasks are still able to detect “strong” avoidance behavior after fear conditioning and additional reinforcement.
Collapse
Affiliation(s)
- Florian P Binder
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany.,International Max Planck Research School - Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Victor I Spoormaker
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| |
Collapse
|
6
|
Pöhlchen D, Leuchs L, Binder FP, Blaskovich B, Nantawisarakul T, Topalidis P, Brückl TM, Norrholm SD, Jovanovic T, Spoormaker VI, Binder EB, Czisch M, Erhardt A, Grandi NC, Ilic-Cocic S, Lucae S, Sämann P, Tontsch A. No robust differences in fear conditioning between patients with fear-related disorders and healthy controls. Behav Res Ther 2020; 129:103610. [DOI: 10.1016/j.brat.2020.103610] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 03/09/2020] [Accepted: 03/23/2020] [Indexed: 11/29/2022]
|