Association between resting-state connectivity patterns in the defensive system network and treatment response in spider phobia-a replication approach

Although highly effective on average, exposure-based treatments do not work equally well for all patients with anxiety disorders. The identification of pre-treatment response-predicting patient characteristics may enable patient stratification. Preliminary research highlights the relevance of inhibitory fronto-limbic networks as such. We aimed to identify pre-treatment neural signatures differing between exposure treatment responders and non-responders in spider phobia and to validate results through rigorous replication. Data of a bi-centric intervention study comprised clinical phenotyping and pre-treatment resting-state functional connectivity (rsFC) data of n = 79 patients with spider phobia (discovery sample) and n = 69 patients (replication sample). RsFC data analyses were accomplished using the Matlab-based CONN-toolbox with harmonized analyses protocols at both sites. Treatment response was defined by a reduction of >30% symptom severity from pre- to post-treatment (Spider Phobia Questionnaire Score, primary outcome). Secondary outcome was defined by a reduction of >50% in a Behavioral Avoidance Test (BAT). Mean within-session fear reduction functioned as a process measure for exposure. Compared to non-responders and pre-treatment, results in the discovery sample seemed to indicate that responders exhibited stronger negative connectivity between frontal and limbic structures and were characterized by heightened connectivity between the amygdala and ventral visual pathway regions. Patients exhibiting high within-session fear reduction showed stronger excitatory connectivity within the prefrontal cortex than patients with low within-session fear reduction. Whereas these results could be replicated by another team using the same data (cross-team replication), cross-site replication of the discovery sample findings in the independent replication sample was unsuccessful. Results seem to support negative fronto-limbic connectivity as promising ingredient to enhance response rates in specific phobia but lack sufficient replication. Further research is needed to obtain a valid basis for clinical decision-making and the development of individually tailored treatment options. Notably, future studies should regularly include replication approaches in their protocols.

Higher-order comparative reward processing is affected by noninvasive stimulation of the ventromedial prefrontal cortex

A crucial skill, especially in rapidly changing environments, is to be able to learn efficiently from prior rewards or losses and apply this acquired knowledge in upcoming situations. Often, we must weigh the risks of different options and decide whether an option is worth the risk or whether we should choose a safer option. The ventromedial prefrontal cortex (vmPFC) is suggested as a major hub for basic but also higher-order reward processing. Dysfunction in this region has been linked to cognitive risk factors for depression and behavioral addictions, including reduced optimism and feedback learning. Here, we test whether modulations of vmPFC excitability via noninvasive transcranial direct current stimulation (tDCS) can alter reward anticipation and reward processing. In a financial gambling task, participants chose between a higher and a lower monetary risk option and eventually received feedback whether they won or lost. Simultaneously feedback on the unchosen option was presented as well. Behavioral and magnetoencephalographic correlates of reward processing were evaluated in direct succession of either excitatory or inhibitory tDCS of the vmPFC. We were able to show modulated reward approach behavior (expectancy of greater reward magnitudes) as well as altered reevaluation of received feedback by vmPFC tDCS as indicated by modified choice behavior following the feedback. Thereby, tDCS not only influenced early, rather basic reward processing, but it also modulated higher-order comparative feedback evaluation of gains and losses relative to alternative outcomes. The neural results underline this idea, as stimulation-driven modulations of the basic reward-related effect occurred at rather early time intervals and were followed by stimulation effects related to comparative reward processing. Importantly, behavioral ratings were correlated with neural activity in left frontal areas. Our results imply a dual function of the vmPFC consisting of approaching reward (as indicated by more risky choices) and elaborately evaluating outcomes. In addition, our data suggest that vmPFC activity is associated with adaptive decision-making in the future via modulated behavioral adaptation or reinforcement learning.

Tinnitus-on the interplay between emotion and cognition

Subjective tinnitus (hereafter tinnitus) is often considered and studied as a perceptual phenomenon. Accordingly, various abnormalities in the area of cognitive processing have been reported in patients with tinnitus. At the same time, the disorder is characterized by considerable emotional distress, which is associated with a high comorbidity of affective disorders. Here, we aim to outline the close link between cognition and emotion, and how current research from the field of cognitive neuroscience examines the processing and acquisition of emotional stimuli. The emotional valence of stimuli can be acquired after brief exposure to learning, leading from neutral to appetitive or aversive evaluation. In contrast to neutral stimuli, emotional stimuli attract attention very early (about 100 ms) during processing, leading to deeper processing and corresponding memory effects. The involved subcortical and cortical network encompasses limbic and sensory areas. In particular, prefrontal regions are involved in the acquisition and evaluation of emotional stimuli as also shown in studies of patients with affect disorders. The interplay of cognitive and emotional processes seems to be central to the development, maintenance, and treatment of tinnitus.

Mechanisms of action underlying virtual reality exposure treatment in spider phobia: Pivotal role of within-session fear reduction

Although virtual-reality exposure treatment (VRET) for anxiety disorders is an efficient treatment option for specific phobia, mechanisms of action for immediate and sustained treatment response need to be elucidated. Towards this aim, core therapy process variables were assessed as predictors for short- and long-term VR treatment outcomes. In a bi-centric study, n = 186 patients with spider phobia completed a baseline-assessment, a one-session VRET, a post-therapy assessment, and a 6-month-follow-up assessment (ClinicalTrials.gov, ID: NCT03208400). Short- and long-term outcomes regarding self-reported symptoms in the spider phobia questionnaire (SPQ) and final patient-spider distance in the behavioral avoidance test (BAT) were predicted via logistic regression models with the corresponding baseline score, age, initial fear activation, within-session fear reduction and fear expectancy violation as predictors. To predict long-term remission status at 6-month-follow-up, dimensional short-term changes in the SPQ and BAT were additionally included. Higher within-session fear reductions predicted better treatment outcomes (long-term SPQ; short- and long-term BAT). Lower initial fear activation tended to be associated with better long-term outcomes (SPQ), while fear expectancy violation was not associated with any outcome measure. Short-term change in the SPQ predicted remission status. Findings highlight that in VRET for spider phobia, the experience of fear reduction is central for short- and long-term treatment success and should be focused by therapists.

Excitatory stimulation of the ventromedial prefrontal cortex reduces cognitive gambling biases via improved feedback learning

Humans are subject to a variety of cognitive biases, such as the framing-effect or the gambler's fallacy, that lead to decisions unfitting of a purely rational agent. Previous studies have shown that the ventromedial prefrontal cortex (vmPFC) plays a key role in making rational decisions and that stronger vmPFC activity is associated with attenuated cognitive biases. Accordingly, dysfunctions of the vmPFC are associated with impulsive decisions and pathological gambling. By applying a gambling paradigm in a between-subjects design with 33 healthy adults, we demonstrate that vmPFC excitation via transcranial direct current stimulation (tDCS) reduces the framing-effect and the gambler's fallacy compared to sham stimulation. Corresponding magnetoencephalographic data suggest improved inhibition of maladaptive options after excitatory vmPFC-tDCS. Our analyses suggest that the underlying mechanism might be improved reinforcement learning, as effects only emerge over time. These findings encourage further investigations of whether excitatory vmPFC-tDCS has clinical utility in treating pathological gambling or other behavioral addictions.

[Tinnitus-on the interplay between emotion and cognition. German version]

Subjective tinnitus (hereafter tinnitus) is often considered and studied as a perceptual phenomenon. Accordingly, various abnormalities in the area of cognitive processing have been reported in patients with tinnitus. At the same time, the disorder is characterized by considerable emotional distress, which is associated with a high comorbidity of affective disorders. Here, we aim to outline the close link between cognition and emotion, and how current research from the field of cognitive neuroscience examines the processing and acquisition of emotional stimuli. The emotional valence of stimuli can be acquired after brief exposure to learning, leading from neutral to appetitive or aversive evaluation. In contrast to neutral stimuli, emotional stimuli attract attention very early (about 100 ms) during processing, leading to deeper processing and corresponding memory effects. The involved subcortical and cortical network encompasses limbic and sensory areas. In particular, prefrontal regions are involved in the acquisition and evaluation of emotional stimuli as also shown in studies of patients with affect disorders. The interplay of cognitive and emotional processes seems to be central to the development, maintenance, and treatment of tinnitus.

Non-invasive stimulation reveals ventromedial prefrontal cortex function in reward prediction and reward processing

Introduction

Studies suggest an involvement of the ventromedial prefrontal cortex (vmPFC) in reward prediction and processing, with reward-based learning relying on neural activity in response to unpredicted rewards or non-rewards (reward prediction error, RPE). Here, we investigated the causal role of the vmPFC in reward prediction, processing, and RPE signaling by transiently modulating vmPFC excitability using transcranial Direct Current Stimulation (tDCS).

Methods

Participants received excitatory or inhibitory tDCS of the vmPFC before completing a gambling task, in which cues signaled varying reward probabilities and symbols provided feedback on monetary gain or loss. We collected self-reported and evaluative data on reward prediction and processing. In addition, cue-locked and feedback-locked neural activity via magnetoencephalography (MEG) and pupil diameter using eye-tracking were recorded.

Results

Regarding reward prediction (cue-locked analysis), vmPFC excitation (versus inhibition) resulted in increased prefrontal activation preceding loss predictions, increased pupil dilations, and tentatively more optimistic reward predictions. Regarding reward processing (feedback-locked analysis), vmPFC excitation (versus inhibition) resulted in increased pleasantness, increased vmPFC activation, especially for unpredicted gains (i.e., gain RPEs), decreased perseveration in choice behavior after negative feedback, and increased pupil dilations.

Discussion

Our results support the pivotal role of the vmPFC in reward prediction and processing. Furthermore, they suggest that transient vmPFC excitation via tDCS induces a positive bias into the reward system that leads to enhanced anticipation and appraisal of positive outcomes and improves reward-based learning, as indicated by greater behavioral flexibility after losses and unpredicted outcomes, which can be seen as an improved reaction to the received feedback.

Tinnitus and Multimodal Cortical Interaction

The term of subjective tinnitus is used to describe a perceived noise without an external sound source. Therefore, it seems to be obvious that tinnitus can be understood as purely auditory, sensory problem. From a clinical point of view, however, this is a very inadequate description, as there are significant comorbidities associated with chronic tinnitus. Neurophysiological investigations with different imaging techniques give a very similar picture, because not only the auditory system is affected in chronic tinnitus patients, but also a widely ramified subcortical and cortical network. In addition to auditory processing systems, networks consisting of frontal and parietal regions are particularly disturbed. For this reason, some authors conceptualize tinnitus as a network disorder rather than a disorder of a circumscribed system. These findings and this concept suggest that tinnitus must be diagnosed and treated in a multidisciplinary and multimodal manner.

Bioelectromagnetism in Human Brain Research: New Applications, New Questions

Bioelectromagnetism has contributed some of the most commonly used techniques to human neuroscience such as magnetoencephalography (MEG), electroencephalography (EEG), transcranial magnetic stimulation (TMS), and transcranial electric stimulation (TES). The considerable differences in their technical design and practical use give rise to the impression that these are quite different techniques altogether. Here, we review, discuss and illustrate the fundamental principle of Helmholtz reciprocity that provides a common ground for all four techniques. We show that, more than 150 years after its discovery by Helmholtz in 1853, reciprocity is important to appreciate the strengths and limitations of these four classical tools in neuroscience. We build this case by explaining the concept of Helmholtz reciprocity, presenting a methodological account of this principle for all four methods and, finally, by illustrating its application in practical clinical studies.

Developmental aspects of fear generalization - A MEG study on neurocognitive correlates in adolescents versus adults

BACKGROUND

Fear generalization is pivotal for the survival-promoting avoidance of potential danger, but, if too pronounced, it promotes pathological anxiety. Similar to adult patients with anxiety disorders, healthy children tend to show overgeneralized fear responses.

OBJECTIVE

This study aims to investigate neuro-developmental aspects of fear generalization in adolescence - a critical age for the development of anxiety disorders.

METHODS

We compared healthy adolescents (14-17 years) with healthy adults (19-34 years) regarding their fear responses towards tilted Gabor gratings (conditioned stimuli, CS; and slightly differently titled generalization stimuli, GS). In the conditioning phase, CS were paired (CS+) or remained unpaired (CS-) with an aversive stimulus (unconditioned stimuli, US). In the test phase, behavioral, peripheral and neural responses to CS and GS were captured by fear- and UCS expectancy ratings, a perceptual discrimination task, pupil dilation and source estimations of event-related magnetic fields.

RESULTS

Closely resembling adults, adolescents showed robust generalization gradients of fear ratings, pupil dilation, and estimated neural source activity. However, in the UCS expectancy ratings, adolescents revealed shallower generalization gradients indicating overgeneralization. Moreover, adolescents showed stronger visual cortical activity after as compared to before conditioning to all stimuli.

CONCLUSION

Various aspects of fear learning and generalization appear to be mature in healthy adolescents. Yet, cognitive aspects might show a slower course of development.

Neural correlates of fear conditioning are associated with treatment-outcomes to behavioral exposure in spider phobia - Evidence from magnetoencephalography

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Magnetoencephalographic effects of fear conditioning predict exposure outcomes.

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No associations between fear ratings of conditioned stimuli and exposure outcomes.

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Prefrontal correlates of safety processing and/or fear inhibition are treatment-relevant.

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Individual neural differences might be a promising predictor of exposure success.

Background

Models of anxiety disorders and the rationale of exposure therapy (ET) are grounded on classical fear conditioning. Yet, it is unclear whether lower fear ratings of conditioned safety versus threat cues and corresponding neural markers of safety-learning and/or fear inhibition assessed before treatment would predict better outcomes of behavioral exposure.

Methods

Sixty-six patients with spider phobia completed pre-treatment clinical and experimental fear conditioning assessments, one session of virtual reality ET, a post-treatment clinical assessment, and a 6-month follow-up assessment. Tilted Gabor gratings served as conditioned stimuli (CS) that were either paired (CS+) or remained unpaired (CS-) with an aversive phobia-related and phobia-unrelated unconditioned stimulus (UCS). CS+/CS- differences in fear ratings and magnetoencephalographic event-related fields (ERFs) were related to percentual symptom reductions from pre- to post-treatment, as assessed via spider phobia questionnaire (SPQ), behavioral avoidance test (BAT), and remission status at 6-month follow-up.

Results

We observed no associations between pre-treatment CS+/CS- differences in fear ratings and any treatment outcome. CS+/CS- differences in source estimations of ERFs revealed that higher CS- activity in bilateral dorsolateral prefrontal cortex (dlPFC) was related with SPQ- and BAT-reductions. Associations between CS+/CS- differences and treatment outcomes were also observed in left ventromedial prefrontal cortex (vmPFC) regions, which additionally revealed associations with the follow-up remission status.

Conclusions

Results provide initial evidence that neural pre-treatment CS+/CS- differences may hold predictive information regarding outcomes of behavioral exposure. Our findings highlight a key role of neural responses to safety cues with potentially inhibitory effects on affect-generating structures during fear conditioning.

Centromedial amygdala is more relevant for phobic confrontation relative to the bed nucleus of stria terminalis in patients with spider phobia

Recent studies indicate differential involvement of the centromedial amygdala (CM) and the bed nucleus of the stria terminalis (BNST) during processing (anticipation and confrontation) of threat stimuli. Here, temporal predictability was shown to be a relevant factor. In this study, we want to investigate the relevance of these effects, which were found in healthy subjects, for anxiety disorders. Therefore, we investigated the differential involvement of CM and BNST in the anticipation and confrontation of phobic stimuli under variation of temporal predictability in spider phobia. 21 patients with spider phobia and 21 healthy controls underwent a temporally predictable/unpredictable phobic and neutral anticipation and confrontation paradigm using functional magnetic resonance imaging (fMRI) and ROI analyses. During the anticipation phase, healthy controls showed higher CM and BNST activity during the predictable compared with the unpredictable condition compared with the anxiety patients. During a confrontation phase that followed the anticipation phase, CM was more activated than BNST during the phobic compared with the neutral confrontation. While this effect was independent of threat predictability in patients, healthy controls showed higher activation in the CM compared with the BNST only during the predictable spider confrontation compared with the predictable bird confrontation. The results contribute to a better understanding of the separate roles of the CM and BNST during phobic processes. The CM was found to be more relevant to phobic confrontation in patients with spider phobia compared with the BNST.

Transcranial Direct Current Stimulation of the Ventromedial Prefrontal Cortex Modulates Perceptual and Neural Patterns of Fear Generalization

BACKGROUND

Overgeneralization of fear is a pathogenic marker of anxiety and stress-related disorders and has been linked with perceptual discrimination deficits, reduced fear inhibition, and prefrontal hyporeactivity to safety-signaling stimuli. We aimed to examine whether behavioral and neural patterns of fear generalization are influenced by the fear-inhibiting ventromedial prefrontal cortex (vmPFC).

METHODS

Three groups of healthy participants received excitatory (n = 27), inhibitory (n = 26), or sham (n = 26) transcranial direct current stimulation of the vmPFC after a fear conditioning phase and before a fear generalization phase. We obtained, as dependent variables, fear ratings and unconditioned stimulus-expectancy ratings, perceptual aspects of fear generalization (perceptual discrimination), pupil dilations, and source estimations of event-related fields elicited by conditioned and generalization stimuli.

RESULTS

After inhibitory (compared with excitatory and sham) vmPFC stimulation, we observed reduced performance in perceptual discrimination and less negative inhibitory gradients in frontal structures at midlatency and late time intervals. Fear and unconditioned stimulus-expectancy ratings as well as pupil dilation remained unaffected by stimulation.

CONCLUSIONS

These findings reveal a causal contribution of vmPFC reactivity to generalization patterns and suggest that vmPFC hyporeactivity consequent on inhibitory vmPFC stimulation may serve as a model for pathological processes of fear generalization (reduced discrimination, impaired fear inhibition via frontal brain structures). This encourages further basic and clinical research on the potential of targeted brain stimulation to modulate fear generalization and overgeneralization.

Neural processing of emotional facial stimuli in specific phobia: An fMRI study

BACKGROUND

Patients with specific phobia (SP) show altered brain activation when confronted with phobia-specific stimuli. It is unclear whether this pathogenic activation pattern generalizes to other emotional stimuli. This study addresses this question by employing a well-powered sample while implementing an established paradigm using nonspecific aversive facial stimuli.

METHODS

N = 111 patients with SP, spider subtype, and N = 111 healthy controls (HCs) performed a supraliminal emotional face-matching paradigm contrasting aversive faces versus shapes in a 3-T magnetic resonance imaging scanner. We performed region of interest (ROI) analyses for the amygdala, the insula, and the anterior cingulate cortex using univariate as well as machine-learning-based multivariate statistics based on this data. Additionally, we investigated functional connectivity by means of psychophysiological interaction (PPI).

RESULTS

Although the presentation of emotional faces showed significant activation in all three ROIs across both groups, no group differences emerged in all ROIs. Across both groups and in the HC > SP contrast, PPI analyses showed significant task-related connectivity of brain areas typically linked to higher-order emotion processing with the amygdala. The machine learning approach based on whole-brain activity patterns could significantly differentiate the groups with 73% balanced accuracy.

CONCLUSIONS

Patients suffering from SP are characterized by differences in the connectivity of the amygdala and areas typically linked to emotional processing in response to aversive facial stimuli (inferior parietal cortex, fusiform gyrus, middle cingulate, postcentral cortex, and insula). This might implicate a subtle difference in the processing of nonspecific emotional stimuli and warrants more research furthering our understanding of neurofunctional alteration in patients with SP.

Behavioral and Magnetoencephalographic Correlates of Fear Generalization are Associated with Responses to Later Virtual Reality Exposure Therapy in Spider Phobia

BACKGROUND

As overgeneralization of fear is a pathogenic marker of anxiety disorders, we investigated whether pre-treatment levels of fear generalization in spider-phobic patients are related to their response to exposure-based treatment, in order to identify pre-treatment moderators of treatment success.

METHODS

Ninety patients with spider phobia completed pre-treatment clinical and magnetoencephalography (MEG) assessments, one session of virtual reality exposure therapy, and a post-treatment clinical assessment. Based on the primary outcome (30% symptom reduction in self-reported symptoms) they were categorized as responders or non-responders. In a pre-treatment MEG fear generalization paradigm involving fear conditioning with two unconditioned stimuli (UCS), we obtained fear ratings, UCS-expectancy ratings, and event-related fields to conditioned stimuli (CS-, CS+) and 7 different generalization stimuli (GS) on a perceptual continuum from CS- to CS+.

RESULTS

Prior to treatment, non-responders showed behavioral overgeneralization indicated by more linear generalization gradients in fear ratings. Analyses of MEG source estimations revealed that non-responders showed a decline of their (inhibitory) frontal activations to safety-signaling CS- and GS compared to CS+ over time, while responders maintained these activations at early (<300ms) and late processing stages.

CONCLUSIONS

Results provide initial evidence that pre-treatment differences of behavioral and neural markers of fear generalization may act as moderators of later responses to behavioral exposure. Stimulating further research on fear generalization as a potential predictive marker, our findings are an important first step in the attempt to identify patients who may not profit from ET, and to personalize and optimize treatment strategies for this vulnerable patient group.

Ratings of Emotional Expressions in Static and Dynamic Facial Recordings Before and After Upper Face Botulinum Injections-An Observational Prospective Study

BACKGROUND

Botulinum toxin A (BTX), a neurotoxin widely used for facial aesthetics, causes dose-dependent muscle paralysis. It was hypothesized that treatment of mimic muscles with BTX might have a positive impact on emotional expression in static images (photographs), but a negative impact in dynamic recordings (videos).

OBJECTIVES

The aim of this study was to compare of emotional expression recorded in photographs and videos before and after treatment with BTX.

METHODS

Twenty healthy women (mean age, 45 years) received a dose of 19 mouse units of XEOMIN (Merz, Frankfurt am Main, Germany) into the procerus, occipitofrontalis, and orbicularis oculi muscles. Photographs and videos of the participants' faces with neutral and happy expressions were recorded before treatment and 2 weeks later. Recordings were rated by naive raters blind to the conditions and in balanced order.

RESULTS

Videos were generally rated as more pleasant, arousing, attractive, and genuine than photographs (all Ps > 0.001). This was especially the case for videos with neutral expression (P = 0.003). Independent of presentation mode and facial expression, women were rated as more attractive after BTX treatment (P = 0.03).

CONCLUSIONS

In contrast to the hypothesis, the reduced mobility had no detectable negative impact on dynamic emotional expression, but videos received more positive ratings, particularly for neutral expressions. It is thus recommended to assess emotional expression with dynamic recordings to evaluate the effects of treatment with BTX. BTX seems to improve perceived attractiveness, although the cause of this effect remains unclear.

Testing the effect of tACS over parietal cortex in modulating endogenous alpha rhythm and temporal integration windows in visual perception

Neural oscillations in the alpha band (8-12 Hz) have been proposed as a key mechanism for the temporal resolution of visual perception. Higher alpha frequencies have been related to improved segregation of visual events over time, whereas lower alpha frequencies have been related to improved temporal integration. Similarly, also the phase of ongoing alpha has been shown to correlate with temporal integration/segregation. To test a causal relationship between alpha oscillations and perception, we here employed multi-channel transcranial alternating current stimulation (mc-tACS) over the right parietal cortex, whereas participants performed a visual temporal integration/segregation task that used identical stimuli with different instructions. Before and after mc-tACS we recorded the resting-state electroencephalogram (EEG) to extract the individual alpha frequency (IAF) and delivered electrical stimulation at slightly slower and faster frequencies (IAF±2 Hz). We hypothesized that this would not only drive endogenous alpha rhythms, but also affect temporal integration and segregation in an opposite way. However, the mc-tACS protocol used here did not consistently increase or decrease the IAF after the stimulation and did not affect temporal integration/segregation accuracy as expected. Although we found some preliminary evidence for an influence of tACS phase on temporal integration accuracy, the ongoing phase of mc-tACS oscillations did not reliably modulate temporal integration/segregation accuracy in a sinusoidal way as would have been predicted by an effective entrainment of brain oscillations. These findings may guide future studies using different stimulation montages for investigating the role of cortical alpha oscillations for human vision.

Theranostic markers for personalized therapy of spider phobia: Methods of a bicentric external cross-validation machine learning approach

OBJECTIVES

Embedded in the Collaborative Research Center "Fear, Anxiety, Anxiety Disorders" (CRC-TRR58), this bicentric clinical study aims at identifying biobehavioral markers of treatment (non-)response by applying machine learning methodology with an external cross-validation protocol. We hypothesize that a priori prediction of treatment (non-)response is possible in a second, independent sample based on multimodal markers.

METHODS

One-session virtual reality exposure treatment (VRET) with patients with spider phobia was conducted on two sites. Clinical, neuroimaging, and genetic data were assessed at baseline, post-treatment and after 6 months. The primary and secondary outcomes defining treatment response are as follows: 30% reduction regarding the individual score in the Spider Phobia Questionnaire and 50% reduction regarding the individual distance in the behavioral avoidance test.

RESULTS

N = 204 patients have been included (n = 100 in Würzburg, n = 104 in Münster). Sample characteristics for both sites are comparable.

DISCUSSION

This study will offer cross-validated theranostic markers for predicting the individual success of exposure-based therapy. Findings will support clinical decision-making on personalized therapy, bridge the gap between basic and clinical research, and bring stratified therapy into reach. The study is registered at ClinicalTrials.gov (ID: NCT03208400).

Contextual information resolves uncertainty about ambiguous facial emotions: Behavioral and magnetoencephalographic correlates

Environmental conditions bias our perception of other peoples' facial emotions. This becomes quite relevant in potentially threatening situations, when a fellow's facial expression might indicate potential danger. The present study tested the prediction that a threatening environment biases the recognition of facial emotions. To this end, low- and medium-expressive happy and fearful faces (morphed to 10%, 20%, 30%, or 40% emotional) were presented within a context of instructed threat-of-shock or safety. Self-reported data revealed that instructed threat led to a biased recognition of fearful, but not happy facial expressions. Magnetoencephalographic correlates revealed spatio-temporal clusters of neural network activity associated with emotion recognition and contextual threat/safety in early to mid-latency time intervals in the left parietal cortex, bilateral prefrontal cortex, and the left temporal pole regions. Early parietal activity revealed a double dissociation of face-context information as a function of the expressive level of facial emotions: When facial expressions were difficult to recognize (low-expressive), contextual threat enhanced fear processing and contextual safety enhanced processing of subtle happy faces. However, for rather easily recognizable faces (medium-expressive) the left hemisphere (parietal cortex, PFC, and temporal pole) showed enhanced activity to happy faces during contextual threat and fearful faces during safety. Thus, contextual settings reduce the salience threshold and boost early face processing of low-expressive congruent facial emotions, whereas face-context incongruity or mismatch effects drive neural activity of easier recognizable facial emotions. These results elucidate how environmental settings help recognize facial emotions, and the brain mechanisms underlying the recognition of subtle nuances of fear.

Biased emotional attention in patients with dental phobia

Biased motivated attention towards phobia-relevant pictures is a typical finding in specific phobia. In the visual system, the allocation of motivated attention is indexed by two event-related potential components - the Early Posterior Negativity and the Late Positive Potential. Enhanced Early Posterior Negativity and Late Positive Potential amplitudes are reliably observed in specific phobia such as, for instance, snake, spider, or blood-injection-injury phobia and to some extent also in dental phobia. However, regarding dental phobia results are sparse and its theoretical concept is not undisputed. To further elucidate the electrophysiological characteristics of dental phobia, we investigated visual emotional processing in dental phobia patients and controls. Subjects viewed neutral, phobia-irrelevant and phobia-relevant pictures while magnetoencephalographic and behavioural measures were recorded. All patients reported a history of traumatic experiences and depressive and anxiety symptoms, as well as dissociative and posttraumatic symptoms. In the magnetoencephalography, patients showed generally less evoked neural activation at parietal and temporal regions and a reduced differentiation between picture categories compared to controls. At the behavioural level, patients rated phobia-relevant pictures as clearly more negative as did controls. In contrast to previous reports, our results suggest that dental phobia cannot be associated with the typical effects of biased motivated attention seen in other specific phobias. Instead, results indicate that dental phobia shares typical characteristics with mild forms of posttraumatic stress disorder.

Targeting Heterogeneous Findings in Neuronal Oscillations in Tinnitus: Analyzing MEG Novices and Mental Health Comorbidities

Tinnitus is a prevalent phenomenon and bothersome for people affected by it. Its occurrence and maintenance have a clear neuroscientific tie and one aspect are differences in the neuronal oscillatory pattern, especially in auditory cortical areas. As studies in this field come to different results, the aim of this study was to analyze a large number of participants to achieve more stable results. Furthermore, we expanded our analysis to two variables of potential influence, namely being a novice to neuroscientific measurements and the exclusion of psychological comorbidities. Oscillatory brain activity of 88 subjects (46 with a chronic tinnitus percept, 42 without) measured in resting state by MEG was investigated. In the analysis based on the whole group, in sensor space increased activity in the delta frequency band was found in tinnitus patients. Analyzing the subgroup of novices, a significant difference in the theta band emerged additionally to the delta band difference (sensor space). Localizing the origin of the activity, we found a difference in theta and gamma band for the auditory regions for the whole group and the same significant difference in the subgroup of novices. However, no differences in oscillatory activity were observed between tinnitus and control groups once subjects with mental health comorbidity were excluded. Against the background of previous studies, the study at hand underlines the fragility of the results in the field of neuronal cortical oscillations in tinnitus. It supports the body of research arguing for low frequency oscillations and gamma band activity as markers associated with tinnitus.

An evil face? Verbal evaluative multi-CS conditioning enhances face-evoked mid-latency magnetoencephalographic responses

Humans have a remarkable capacity for rapid affective learning. For instance, using first-order US such as odors or electric shocks, magnetoencephalography (MEG) studies of multi-CS conditioning demonstrate enhanced early (<150 ms) and mid-latency (150–300 ms) visual evoked responses to affectively conditioned faces, together with changes in stimulus evaluation. However, particularly in social contexts, human affective learning is often mediated by language, a class of complex higher-order US. To elucidate mechanisms of this type of learning, we investigate how face processing changes following verbal evaluative multi-CS conditioning. Sixty neutral expression male faces were paired with phrases about aversive crimes (30) or neutral occupations (30). Post conditioning, aversively associated faces evoked stronger magnetic fields in a mid-latency interval between 220 and 320 ms, localized primarily in left visual cortex. Aversively paired faces were also rated as more arousing and more unpleasant, evaluative changes occurring both with and without contingency awareness. However, no early MEG effects were found, implying that verbal evaluative conditioning may require conceptual processing and does not engage rapid, possibly sub-cortical, pathways. Results demonstrate the efficacy of verbal evaluative multi-CS conditioning and indicate both common and distinct neural mechanisms of first- and higher-order multi-CS conditioning, thereby informing theories of associative learning.

Modulating Emotion Perception: Opposing Effects of Inhibitory and Excitatory Prefrontal Cortex Stimulation

BACKGROUND

Excitatory repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (dlPFC) is approved by the U.S. Food and Drug Administration for the treatment of adult patients with treatment-resistant major depressive disorder (MDD). This stimulation is supposed to restore excitability of prefrontal cortex regions that exhibit diminished regulation of emotion-generative systems in MDD. Based on the valence lateralization hypothesis, inhibitory rTMS of the right dlPFC has also been applied in MDD. This approach has proved to be effective, although meta-analyses of emotional perception and affective regulation in healthy control subjects and patients with depression do not support functional asymmetries within dlPFC regions.

METHODS

To shed more light on this discrepancy, the effects of excitatory and inhibitory rTMS of the right dlPFC on visual emotional perception were compared in two groups of 41 healthy participants overall. Before and after rTMS stimulation, participants viewed fearful and neutral faces while whole-head magnetoencephalography was recorded and supplemented by behavioral tests.

RESULTS

Visual sensory processing of fearful facial expressions, relative to neutral facial expressions, was reduced after excitatory stimulation and was increased after inhibitory stimulation within right occipital and right temporal regions. Correspondingly, after excitatory rTMS compared with inhibitory rTMS, participants displayed relatively reduced reaction times in an emotion discrimination task and showed reduced emotional arousal.

CONCLUSIONS

These results support the hypothesis that excitatory rTMS compared with inhibitory rTMS of the right dlPFC strengthens top-down control of aversive stimuli in healthy control subjects, which should encourage more research on mechanisms of excitatory/inhibitory dlPFC-rTMS protocols in general and on neuromodulatory treatment of MDD.

Hypervigilance-avoidance in children with anxiety disorders: magnetoencephalographic evidence

BACKGROUND

An altered pattern of threat processing is deemed critical for the development of anxiety disorders (AD). According to the hypervigilance-avoidance hypothesis, AD patients show hypervigilance to threat cues at early stages of processing but avoid threat cues at later stages of processing. Consistently, adults with AD show enhanced neurophysiological responses to threat in early time windows and reduced responses to threat in late time windows. The presence of such a hypervigilance-avoidance effect and its underlying neural sources remain to be determined in clinically anxious children.

METHODS

Twenty-three children diagnosed with an AD and 23 healthy control children aged 8-14 years saw faces with angry and neutral expressions while whole-head magnetoencephalography (MEG) was recorded. Neural sources were estimated based on L2-Minimum Norm inverse source modeling and analyzed in early, midlatency, and late time windows.

RESULTS

In visual cortical regions, early threat processing was relatively enhanced in patients compared to controls, whereas this relation was inverted in a late interval. Consistent with the idea of affective regulation, the right dorsolateral prefrontal cortex revealed relatively reduced inhibition of early threat processing but revealed enhanced inhibition at a late interval in patients. Both visual-sensory and prefrontal effects were correlated with individual trait anxiety.

CONCLUSIONS

These results support the hypothesis of early sensory hypervigilance followed by later avoidance of threat in anxiety disordered children, presumably modulated by early reduced and later enhanced prefrontal inhibition. This neuronal hypervigilance-avoidance pattern unfolds gradually with increasing trait anxiety, reflecting a progressively biased allocation of attention to threat.

Impact of electroconvulsive therapy on magnetoencephalographic correlates of dysfunctional emotional processing in major depression

In major depressive disorder (MDD), electrophysiological and imaging studies provide evidence for a reduced neural activity in parietal and dorsolateral prefrontal regions. In the present study, neural correlates and temporal dynamics of visual affective perception have been investigated in patients with unipolar depression in a pre/post treatment design using magnetoencephalography (MEG). Nineteen in-patients and 19 balanced healthy controls passed MEG measurement while passively viewing pleasant, unpleasant and neutral pictures. After a 4-week treatment with electroconvulsive therapy or 4-week waiting period without intervention respectively, 16 of these patients and their 16 corresponding controls participated in a second MEG measurement. Before treatment neural source estimations of magnetic fields evoked by the emotional scenes revealed a general bilateral parietal hypoactivation in depressed patients compared to controls predominately at early and mid-latency time intervals. Successful ECT treatment, as reflected by a decline in clinical scores (Hamilton Depression Scale; HAMD) led to a normalization of this distinct parietal hypoactivation. Effective treatment was also accompanied by relatively increased neural activation at right temporo-parietal regions. The present study indicates dysfunctional parietal information processing and attention processes towards emotional stimuli in MDD patients which can be returned to normal by ECT treatment. Since convergent neural hypoactivations and treatment effects have recently been shown in MDD patients before and after pharmacological therapy, this electrophysiological correlate might serve as a biomarker for objective treatment evaluation and thereby potentially advance treatment options and support the prediction of individual treatment responses.

Modulatory Effects of Attention on Lateral Inhibition in the Human Auditory Cortex

Reduced neural processing of a tone is observed when it is presented after a sound whose spectral range closely frames the frequency of the tone. This observation might be explained by the mechanism of lateral inhibition (LI) due to inhibitory interneurons in the auditory system. So far, several characteristics of bottom up influences on LI have been identified, while the influence of top-down processes such as directed attention on LI has not been investigated. Hence, the study at hand aims at investigating the modulatory effects of focused attention on LI in the human auditory cortex. In the magnetoencephalograph, we present two types of masking sounds (white noise vs. withe noise passing through a notch filter centered at a specific frequency), followed by a test tone with a frequency corresponding to the center-frequency of the notch filter. Simultaneously, subjects were presented with visual input on a screen. To modulate the focus of attention, subjects were instructed to concentrate either on the auditory input or the visual stimuli. More specific, on one half of the trials, subjects were instructed to detect small deviations in loudness in the masking sounds while on the other half of the trials subjects were asked to detect target stimuli on the screen. The results revealed a reduction in neural activation due to LI, which was larger during auditory compared to visual focused attention. Attentional modulations of LI were observed in two post-N1m time intervals. These findings underline the robustness of reduced neural activation due to LI in the auditory cortex and point towards the important role of attention on the modulation of this mechanism in more evaluative processing stages.

Rapid prefrontal cortex activation towards aversively paired faces and enhanced contingency detection are observed in highly trait-anxious women under challenging conditions

Relative to healthy controls, anxiety-disorder patients show anomalies in classical conditioning that may either result from, or provide a risk factor for, clinically relevant anxiety. Here, we investigated whether healthy participants with enhanced anxiety vulnerability show abnormalities in a challenging affective-conditioning paradigm, in which many stimulus-reinforcer associations had to be acquired with only few learning trials. Forty-seven high and low trait-anxious females underwent MultiCS conditioning, in which 52 different neutral faces (CS+) were paired with an aversive noise (US), while further 52 faces (CS-) remained unpaired. Emotional learning was assessed by evaluative (rating), behavioral (dot-probe, contingency report), and neurophysiological (magnetoencephalography) measures before, during, and after learning. High and low trait-anxious groups did not differ in evaluative ratings or response priming before or after conditioning. High trait-anxious women, however, were better than low trait-anxious women at reporting CS+/US contingencies after conditioning, and showed an enhanced prefrontal cortex (PFC) activation towards CS+ in the M1 (i.e., 80-117 ms) and M170 time intervals (i.e., 140-160 ms) during acquisition. These effects in MultiCS conditioning observed in individuals with elevated trait anxiety are consistent with theories of enhanced conditionability in anxiety vulnerability. Furthermore, they point towards increased threat monitoring and detection in highly trait-anxious females, possibly mediated by alterations in visual working memory.

Facing Challenges in Differential Classical Conditioning Research: Benefits of a Hybrid Design for Simultaneous Electrodermal and Electroencephalographic Recording

Several challenges make it difficult to simultaneously investigate central and autonomous nervous system correlates of conditioned stimulus (CS) processing in classical conditioning paradigms. Such challenges include, for example, the discrepant requirements of electroencephalography (EEG) and electrodermal activity (EDA) recordings with regard to multiple repetitions of conditions and sufficient trial duration. Here, we propose a MultiCS conditioning set-up, in which we increased the number of CSs, decreased the number of learning trials, and used trials of short and long durations for meeting requirements of simultaneous EEG–EDA recording in a differential aversive conditioning task. Forty-eight participants underwent MultiCS conditioning, in which four neutral faces (CS+) were paired four times each with aversive electric stimulation (unconditioned stimulus) during acquisition, while four different neutral faces (CS−) remained unpaired. When comparing after relative to before learning measurements, EEG revealed an enhanced centro-posterior positivity to CS+ vs. CS− during 368–600 ms, and subjective ratings indicated CS+ to be less pleasant and more arousing than CS−. Furthermore, changes in CS valence and arousal were strong enough to bias subjective ratings when faces of CS+/CS− identity were displayed with different emotional expression (happy, angry) in a post-experimental behavioral task. In contrast to a persistent neural and evaluative CS+/CS− differentiation that sustained multiple unreinforced CS presentations, electrodermal differentiation was rapidly extinguished. Current results suggest that MultiCS conditioning provides a promising paradigm for investigating pre–post-learning changes under minimal influences of extinction and overlearning of simple stimulus features. Our data also revealed methodological pitfalls, such as the possibility of occurring artifacts when combining different acquisition systems for central and peripheral psychophysiological measures.

Cognitive emotion regulation in children: Reappraisal of emotional faces modulates neural source activity in a frontoparietal network

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Reappraisal of emotional faces in children was examined with magnetoencephalography.

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Neural activity in the LPP time-interval was modulated in frontoparietal networks.

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Occipital activity was reduced with increasing age, indexing neural maturation.

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A similar reduction was linked to better emotion regulation and less anxiety.

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This may indicate an age-independent advance in neural maturation.

Emotion regulation has an important role in child development and psychopathology. Reappraisal as cognitive regulation technique can be used effectively by children. Moreover, an ERP component known to reflect emotional processing called late positive potential (LPP) can be modulated by children using reappraisal and this modulation is also related to children's emotional adjustment. The present study seeks to elucidate the neural generators of such LPP effects. To this end, children aged 8–14 years reappraised emotional faces, while neural activity in an LPP time window was estimated using magnetoencephalography-based source localization. Additionally, neural activity was correlated with two indexes of emotional adjustment and age. Reappraisal reduced activity in the left dorsolateral prefrontal cortex during down-regulation and enhanced activity in the right parietal cortex during up-regulation. Activity in the visual cortex decreased with increasing age, more adaptive emotion regulation and less anxiety. Results demonstrate that reappraisal changed activity within a frontoparietal network in children. Decreasing activity in the visual cortex with increasing age is suggested to reflect neural maturation. A similar decrease with adaptive emotion regulation and less anxiety implies that better emotional adjustment may be associated with an advance in neural maturation.

Abnormal, affect-specific modulatory effects on early auditory processing in schizophrenia: magnetoencephalographic evidence

Abnormalities in the perception and identification of emotions have frequently been reported in schizophrenia. Hemodynamic neuroimaging studies found functional abnormalities in cortical and subcortical brain circuits that are involved in normal affective processing, but the temporal dynamics of abnormal emotion processing in schizophrenia remain largely elusive. To investigate this issue, we recorded early auditory evoked field components by means of whole-head magnetoencephalography that were in response to emotion-associated tones in seventeen patients with schizophrenia and in seventeen healthy, matched controls. Forty-two click-like tones (conditioned stimuli; CS) acquired differential emotional meaning through an affective associative learning procedure by pairing each CS three times with either pleasant, unpleasant or neutral auditory scenes. As expected, differential affect-specific modulation in patients vs. controls was evident, starting at the auditory N1m onset latency of approximately 70ms, extending to 230ms. While controls showed the expected enhanced processing of emotion associated CS, patients revealed an inverted pattern with reduced processing of arousal, when compared to neutral stimuli, in the right prefrontal cortex. The present finding suggests impairments in the prioritization of emotionally salient vs. non-salient stimuli in patients with schizophrenia. Dysfunction in higher cognitive processes and behavior in schizophrenia may therefore reflect dysfunction in fundamental, early emotion processing stages.

All in its proper time: monitoring the emergence of a memory bias for novel, arousing-negative words in individuals with high and low trait anxiety

The well-established memory bias for arousing-negative stimuli seems to be enhanced in high trait-anxious persons and persons suffering from anxiety disorders. We monitored the emergence and development of such a bias during and after learning, in high and low trait anxious participants. A word-learning paradigm was applied, consisting of spoken pseudowords paired either with arousing-negative or neutral pictures. Learning performance during training evidenced a short-lived advantage for arousing-negative associated words, which was not present at the end of training. Cued recall and valence ratings revealed a memory bias for pseudowords that had been paired with arousing-negative pictures, immediately after learning and two weeks later. This held even for items that were not explicitly remembered. High anxious individuals evidenced a stronger memory bias in the cued-recall test, and their ratings were also more negative overall compared to low anxious persons. Both effects were evident, even when explicit recall was controlled for. Regarding the memory bias in anxiety prone persons, explicit memory seems to play a more crucial role than implicit memory. The study stresses the need for several time points of bias measurement during the course of learning and retrieval, as well as the employment of different measures for learning success.

Committee report: publication guidelines and recommendations for studies using electroencephalography and magnetoencephalography

Electromagnetic data collected using electroencephalography (EEG) and magnetoencephalography (MEG) are of central importance for psychophysiological research. The scope of concepts, methods, and instruments used by EEG/MEG researchers has dramatically increased and is expected to further increase in the future. Building on existing guideline publications, the goal of the present paper is to contribute to the effective documentation and communication of such advances by providing updated guidelines for conducting and reporting EEG/MEG studies. The guidelines also include a checklist of key information recommended for inclusion in research reports on EEG/MEG measures.

Early prefrontal brain responses to the Hedonic quality of emotional words--a simultaneous EEG and MEG study

The hedonic meaning of words affects word recognition, as shown by behavioral, functional imaging, and event-related potential (ERP) studies. However, the spatiotemporal dynamics and cognitive functions behind are elusive, partly due to methodological limitations of previous studies. Here, we account for these difficulties by computing combined electro-magnetoencephalographic (EEG/MEG) source localization techniques. Participants covertly read emotionally high-arousing positive and negative nouns, while EEG and MEG were recorded simultaneously. Combined EEG/MEG current-density reconstructions for the P1 (80–120 ms), P2 (150–190 ms) and EPN component (200–300 ms) were computed using realistic individual head models, with a cortical constraint. Relative to negative words, the P1 to positive words predominantly involved language-related structures (left middle temporal and inferior frontal regions), and posterior structures related to directed attention (occipital and parietal regions). Effects shifted to the right hemisphere in the P2 component. By contrast, negative words received more activation in the P1 time-range only, recruiting prefrontal regions, including the anterior cingulate cortex (ACC). Effects in the EPN were not statistically significant. These findings show that different neuronal networks are active when positive versus negative words are processed. We account for these effects in terms of an “emotional tagging” of word forms during language acquisition. These tags then give rise to different processing strategies, including enhanced lexical processing of positive words and a very fast language-independent alert response to negative words. The valence-specific recruitment of different networks might underlie fast adaptive responses to both approach- and withdrawal-related stimuli, be they acquired or biological.

Preferential responses to extinguished face stimuli are preserved in frontal and occipito-temporal cortex at initial but not later stages of processing

Magnetoencephalographic correlates of rapid emotional responses (50-80 ms) in frontal and occipito-temporal regions have recently been reported using a novel MultiCS Conditioning paradigm with odor-conditioned faces. As those short-latency responses were supposed to partially reflect initial access to nonextinguished emotional memories, it could be predicted that they outlast the extinction phase. To test this hypothesis, appetitively and aversively odor-conditioned faces were frequently presented during extinction while event-related magnetic fields were recorded. Affect-specific responses in frontal and occipito-temporal areas were found in the early (50-80 ms) but not in the later (130-190 ms) time interval following extinction learning. These results suggest that previously acquired emotional memories can be accessed at initial processing stages but become ineffective in modulating processing at later stages as extinction proceeds.

How 'love' and 'hate' differ from 'sleep': using combined electro/magnetoencephalographic data to reveal the sources of early cortical responses to emotional words

Emotional words--as symbols for biologically relevant concepts--are preferentially processed in brain regions including the visual cortex, frontal and parietal regions, and a corticolimbic circuit including the amygdala. Some of the brain structures found in functional magnetic resonance imaging are not readily apparent in electro- and magnetoencephalographic (EEG; MEG) measures. By means of a combined EEG/MEG source localization procedure to fully exploit the available information, we sought to reduce these discrepancies and gain a better understanding of spatiotemporal brain dynamics underlying emotional-word processing. Eighteen participants read high-arousing positive and negative, and low-arousing neutral nouns, while EEG and MEG were recorded simultaneously. Combined current-density reconstructions (L2-minimum norm least squares) for two early emotion-sensitive time intervals, the P1 (80-120 ms) and the early posterior negativity (EPN, 200-300 ms), were computed using realistic individual head models with a cortical constraint. The P1 time window uncovered an emotion effect peaking in the left middle temporal gyrus. In the EPN time window, processing of emotional words was associated with enhanced activity encompassing parietal and occipital areas, and posterior limbic structures. We suggest that lexical access, being underway within 100 ms, is speeded and/or favored for emotional words, possibly on the basis of an "emotional tagging" of the word form during acquisition. This gives rise to their differential processing in the EPN time window. The EPN, as an index of natural selective attention, appears to reflect an elaborate interplay of distributed structures, related to cognitive functions, such as memory, attention, and evaluation of emotional stimuli.

Affect-specific modulation of the N1m to shock-conditioned tones: magnetoencephalographic correlates

Despite its fundamental relevance for representing the emotional world surrounding us, human affective neuroscience research has widely neglected the auditory system, at least in comparison to the visual domain. Here, we have investigated the spatiotemporal dynamics of human affective auditory processing using time-sensitive whole-head magnetoencephalography. A novel and highly challenging affective associative learning procedure, 'MultiCS conditioning', involving multiple conditioned stimuli (CS) per affective category, was adopted to test whether previous findings from intramodal conditioning of multiple click-tones with an equal number of auditory emotional scenes (Bröckelmann et al., 2011 J. Neurosci., 31, 7801) would generalise to crossmodal conditioning of multiple click-tones with an electric shock as single aversive somatosensory unconditioned stimulus (UCS). Event-related magnetic fields were recorded in response to 40 click-tones before and after four contingent pairings of 20 CS with a shock and the other half remaining unpaired. In line with previous findings from intramodal MultiCS conditioning we found an affect-specific modulation of the auditory N1m component 100-150 ms post-stimulus within a distributed frontal-temporal-parietal neural network. Increased activation for shock-associated tones was lateralised to right-hemispheric regions, whereas unpaired safety-signalling tones were preferentially processed in the left hemisphere. Participants did not show explicit awareness of the contingent CS-UCS relationship, yet behavioural conditioning effects were indicated on an indirect measure of stimulus valence. Our findings imply converging evidence for a rapid and highly differentiating affect-specific modulation of the auditory N1m after intramodal as well crossmodal MultiCS conditioning and a correspondence of the modulating impact of emotional attention on early affective processing in vision and audition.

Rapid and Highly Resolving: Affective Evaluation of Olfactorily Conditioned Faces

Evidence from hemodynamic and electrophysiological measures suggests that the processing of emotionally relevant information occurs in a spatially and temporally distributed affective network. ERP studies of emotional stimulus processing frequently report differential responses to emotional stimuli starting around 120 msec. However, the involvement of structures that seem to become activated at earlier latencies (i.e., amygdala and OFC) would allow for more rapid modulations, even in distant cortical areas. Consistent with this notion, recent ERP studies investigating associative learning have provided evidence for rapid modulations in sensory areas earlier than 120 msec, but these studies either used simple and/or very few stimuli. The present study used high-density whole-head magneto-encephalography to measure brain responses to a multitude of neutral facial stimuli, which were associated with an aversive or neutral odor. Significant emotional modulations were observed at intervals of 50–80 and 130–190 msec in frontal and occipito-temporal regions, respectively. In the absence of contingency awareness and with only two learning instances, a remarkable capacity for emotional learning is observed.

The role of gamma-band activity in the representation of faces: reduced activity in the fusiform face area in congenital prosopagnosia

BACKGROUND

Congenital prosopagnosia (CP) describes an impairment in face processing that is presumably present from birth. The neuronal correlates of this dysfunction are still under debate. In the current paper, we investigate high-frequent oscillatory activity in response to faces in persons with CP. Such neuronal activity is thought to reflect higher-level representations for faces.

METHODOLOGY

Source localization of induced Gamma-Band Responses (iGBR) measured by magnetoencephalography (MEG) was used to establish the origin of oscillatory activity in response to famous and unknown faces which were presented in upright and inverted orientation. Persons suffering from congenital prosopagnosia (CP) were compared to matched controls.

PRINCIPAL FINDINGS

Corroborating earlier research, both groups revealed amplified iGBR in response to upright compared to inverted faces predominately in a time interval between 170 and 330 ms and in a frequency range from 50-100 Hz. Oscillatory activity upon known faces was smaller in comparison to unknown faces, suggesting a "sharpening" effect reflecting more efficient processing for familiar stimuli. These effects were seen in a wide cortical network encompassing temporal and parietal areas involved in the disambiguation of homogenous stimuli such as faces, and in the retrieval of semantic information. Importantly, participants suffering from CP displayed a strongly reduced iGBR in the left fusiform area compared to control participants.

CONCLUSIONS

In sum, these data stress the crucial role of oscillatory activity for face representation and demonstrate the involvement of a distributed occipito-temporo-parietal network in generating iGBR. This study also provides the first evidence that persons suffering from an agnosia actually display reduced gamma band activity. Finally, the results argue strongly against the view that oscillatory activity is a mere epiphenomenon brought fourth by rapid eye-movements (micro saccades).

The Tortured Brain

Traumatic stressors such as water boarding, electric shock, or false execution all activate similar bodily, affective, and cognitive responses even when they are quite different from one another. As a result, the memory traces merge into a “trauma network” that includes sensory memories but becomes detached from the particular episodic memory; that is, the trauma network has no time or place. As, with increasing traumatic experiences, more and more cues become integrated in the network, the threshold for excitation is continually lowered and the individual is likely to show frequent alarm and other defense responses to reminders of the trauma. Neuroplastic mechanisms determine subsequent reorganization of brain circuitry in order to adapt to a presumed permanent need for defense.

We hypothesized that aversive pictorial material is differentially processed in visual as well as frontal and limbic areas of the traumatized brain. We used Rapid Serial Visual Presentation (three pictures per second) to present aversive, neutral, and appetitive pictorial stimuli. Event-related magnetic fields were recorded in 41 survivors of torture and organized violence who suffered from posttraumatic stress disorder (PTSD) as well as 43 controls with a comparable ethnic background. Traumatized individuals showed an early shift in the processing of aversive pictures from sensory visual areas to fronto-temporal areas and the amygdala compared to controls without trauma-related symptoms. For survivors, as opposed to controls, these stimuli automatically activate aspects of the defense cascade and thus lead to an excitation of action-related neural activity. We conclude that an enlarged fear network in survivors of organized violence has a low excitation threshold, thus leading to prominent PTSD symptoms. A disintegration of the fear network by reconnecting its elements to the respective episodic memory or by some form of inhibition of the network may bring relief.

A fast neural signature of motivated attention to consumer goods separates the sexes

Emotional stimuli guide selective visual attention and receive enhanced processing. Previous event-related potential studies have identified an early (>120 ms) negative potential shift over occipito-temporal regions (early posterior negativity, EPN) presumed to indicate the facilitated processing of survival-relevant stimuli. The present study investigated whether this neural signature of motivated attention is also responsive to the intrinsic significance of man-made objects and consumer goods. To address this issue, we capitalized on gender differences towards specific man-made objects, shoes and motorcycles, for which the Statistical Yearbook 2005 of Germany's Federal Statistical Office (Statistisches Bundesamt, 2005) revealed pronounced differences in consumer behavior. In a passive viewing paradigm, male and female participants viewed pictures of motorcycles and shoes, while their magnetoencephalographic brain responses were measured. Source localization of the magnetic counterpart of the EPN (EPNm) revealed pronounced gender differences in picture processing. Specifically, between 130 and 180 ms, all female participants generated stronger activity in occipito-temporal regions when viewing shoes compared to motorcycles, while all men except one showed stronger activation for motorcycles than shoes. Thus, the EPNm allowed a sex-dimorphic classification of the processing of consumer goods. Self-report data confirmed gender differences in consumer behavior, which, however, were less distinct compared to the brain based measure. Considering the latency of the EPNm, the reflected automatic emotional network activity is most likely not yet affected by higher cognitive functions such as response strategies or social expectancy. Non-invasive functional neuroimaging measures of early brain activity may thus serve as objective measure for individual preferences towards consumer goods.

New Names for Known Things: On the Association of Novel Word Forms with Existing Semantic Information

The plasticity of the adult memory network for integrating novel word forms (lexemes) was investigated with whole-head magnetoencephalography (MEG). We showed that spoken word forms of an (artificial) foreign language are integrated rapidly and successfully into existing lexical and conceptual memory networks. The new lexemes were learned in an untutored way, by pairing them frequently with one particular object (and thus meaning), and infrequently with 10 other objects (learned set). Other novel word forms were encountered just as often, but paired with many different objects (nonlearned set). Their impact on semantic memory was assessed with cross-modal priming, with novel word forms as primes and object pictures as targets. The MEG counterpart of the N400 (N400m) served as an indicator of a semantic (mis)match between words and pictures. Prior to learning, all novel words induced a pronounced N400m mismatch effect to the pictures. This component was strongly reduced after training for the learned novel lexemes only, and now closely resembled the brain's response to semantically related native-language words. This result cannot be explained by mere stimulus repetition or stimulus–stimulus association. Thus, learned novel words rapidly gained access to existing conceptual representations, as effectively as related native-language words. This association of novel lexemes and conceptual information happened fast and almost without effort. Neural networks mediating these integration processes were found within left temporal lobe, an area typically described as one of the main generators of the N400 response.

[Magnetoencephalography in psychiatry]

Neuropsychiatric disorders usually come with only sublime structural changes. Functional imaging can point at specific disturbances in information processing in neural networks. Besides imaging of receptor and metabolic functions with PET and fMRI, electromagnetic methods such as electroencephalography (EEG) and magnetoencephalography (MEG) offer the possibility for imaging of dynamic dysfunctions. As compared to EEG, MEG has a shorter history and is less common despite offering considerable advantages in temporospatial resolution and sensitivity to detect impaired signal processing and network functioning which renders it particularly interesting for psychiatric applications. Disturbed processing in the auditory and visual domain emerging in schizophrenic, affective and anxiety disorders can be detected with high sensitivity. Moreover, the neuromagnetic baseline activity allows conclusions to be drawn regarding neural network functions. Due to its high sensitivity to single deficits in information processing and to pharmacological effects, MEG will achieve clinical significance in specific areas.