1
|
Fox AS, Shackman AJ. An Honest Reckoning With the Amygdala and Mental Illness. Am J Psychiatry 2024; 181:1059-1075. [PMID: 39616453 PMCID: PMC11611071 DOI: 10.1176/appi.ajp.20240941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2024]
Abstract
Anxiety disorders are a leading source of human misery, morbidity, and premature mortality. Existing treatments are far from curative for many, underscoring the need to clarify the underlying neural mechanisms. Although many brain regions contribute, the amygdala has received the most intense scientific attention. Over the past several decades, this scrutiny has yielded a detailed understanding of amygdala function, but it has failed to produce new clinical assays, biomarkers, or cures. Rising to this urgent public health challenge demands an honest reckoning with the functional-neuroanatomical complexity of the amygdala and a shift from theories anchored on "the amygdala" to models centered on specific amygdala nuclei and cell types. This review begins by examining evidence from studies of rodents, monkeys, and humans for the "canonical model," the idea that the amygdala plays a central role in fear- and anxiety-related states, traits, and disorders. Next, the authors selectively highlight work indicating that the canonical model, while true, is overly simplistic and fails to adequately capture the actual state of the evidentiary record, the breadth of amygdala-associated functions and illnesses, or the complexity of the amygdala's functional architecture. The authors describe the implications of these facts for basic and clinical neuroimaging research. The review concludes with some general recommendations for grappling with the complexity of the amygdala and accelerating efforts to understand and more effectively treat amygdala-related psychopathology.
Collapse
Affiliation(s)
- Andrew S. Fox
- Department of Psychology, University of California, Davis, CA 95616 USA
- California National Primate Research Center, University of California, Davis, CA 95616 USA
| | - Alexander J. Shackman
- Department of Psychology, University of Maryland, College Park, MD 20742 USA
- Department of Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD 20742 USA
- Department of Maryland Neuroimaging Center, University of Maryland, College Park, MD 20742 USA
| |
Collapse
|
2
|
Kalisch R, Russo SJ, Müller MB. Neurobiology and systems biology of stress resilience. Physiol Rev 2024; 104:1205-1263. [PMID: 38483288 PMCID: PMC11381009 DOI: 10.1152/physrev.00042.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 03/06/2024] [Accepted: 03/12/2024] [Indexed: 05/16/2024] Open
Abstract
Stress resilience is the phenomenon that some people maintain their mental health despite exposure to adversity or show only temporary impairments followed by quick recovery. Resilience research attempts to unravel the factors and mechanisms that make resilience possible and to harness its insights for the development of preventative interventions in individuals at risk for acquiring stress-related dysfunctions. Biological resilience research has been lagging behind the psychological and social sciences but has seen a massive surge in recent years. At the same time, progress in this field has been hampered by methodological challenges related to finding suitable operationalizations and study designs, replicating findings, and modeling resilience in animals. We embed a review of behavioral, neuroimaging, neurobiological, and systems biological findings in adults in a critical methods discussion. We find preliminary evidence that hippocampus-based pattern separation and prefrontal-based cognitive control functions protect against the development of pathological fears in the aftermath of singular, event-type stressors [as found in fear-related disorders, including simpler forms of posttraumatic stress disorder (PTSD)] by facilitating the perception of safety. Reward system-based pursuit and savoring of positive reinforcers appear to protect against the development of more generalized dysfunctions of the anxious-depressive spectrum resulting from more severe or longer-lasting stressors (as in depression, generalized or comorbid anxiety, or severe PTSD). Links between preserved functioning of these neural systems under stress and neuroplasticity, immunoregulation, gut microbiome composition, and integrity of the gut barrier and the blood-brain barrier are beginning to emerge. On this basis, avenues for biological interventions are pointed out.
Collapse
Affiliation(s)
- Raffael Kalisch
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany
| | - Scott J Russo
- Nash Family Department of Neuroscience, Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Brain and Body Research Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States
| | - Marianne B Müller
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
- Translational Psychiatry, Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany
| |
Collapse
|
3
|
Wilson KA, MacNamara A. Transdiagnostic Fear and Anxiety: Prospective Prediction Using the No-Threat, Predictable Threat, and Unpredictable Threat Task. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:930-938. [PMID: 37881540 PMCID: PMC10593901 DOI: 10.1016/j.bpsgos.2022.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/05/2022] [Accepted: 10/11/2022] [Indexed: 11/06/2022] Open
Abstract
Background Fear and anxiety are distinct dimensions of psychopathology that may be characterized by differences in dimensional threat reactivity. Heightened response to predictable threat is hypothesized to underlie fear symptomatology, whereas increased response to unpredictable threat may underlie anxiety. Despite widespread acceptance of this model, these purported associations have rarely been tested, and the prognostic value of predictable and unpredictable threat responding is unclear. Here we examined multilevel indicators of predictable and unpredictable threat response as cross-sectional correlates and prospective predictors of transdiagnostic fear and anxiety. Methods Fifty-two individuals with varying levels of internalizing psychopathology (31 female) performed the no-threat, predictable threat, and unpredictable threat task. Transdiagnostic fear and anxiety were assessed at baseline (time 1) and approximately 1.5 years later (time 2). We used event-related potential, the stimulus-preceding negativity, as a measure of threat anticipation and startle eyeblink as a measure of defensive reactivity during the no-threat, predictable threat, and unpredictable threat task. These probes were assessed as cross-sectional correlates and prospective predictors of fear and anxiety. Results Participants with larger time 1 stimulus-preceding negativities to predictable threat were characterized by greater time 1 fear. Larger time 1 stimulus-preceding negativities to unpredictable threat were associated with greater increases in time 2 anxiety. Heightened time 1 startle to predictable threat predicted larger increases in time 2 fear. Conclusions Results validate predictable and unpredictable threat responding as dimensional correlates of transdiagnostic fear versus anxiety and suggest that psychophysiological measures of predictable and unpredictable threat response hold promise as prospective predictors of trajectories of fear and anxiety.
Collapse
Affiliation(s)
- Kayla A. Wilson
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
| | - Annmarie MacNamara
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, Texas
- Institute for Neuroscience, Texas A&M University, College Station, Texas
| |
Collapse
|
4
|
Bai D, Li X, Wang S, Zhang T, Wei Y, Wang Q, Dong W, Song J, Gao P, Li Y, Wang S, Dai L. Advances in extraction methods, chemical constituents, pharmacological activities, molecular targets and toxicology of volatile oil from Acorus calamus var. angustatus Besser. Front Pharmacol 2022; 13:1004529. [PMID: 36545308 PMCID: PMC9761896 DOI: 10.3389/fphar.2022.1004529] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/10/2022] [Indexed: 12/04/2022] Open
Abstract
Acorus calamus var. angustatus Besser (ATT) is a traditional herb with a long medicinal history. The volatile oil of ATT (VOA) does possess many pharmacological activities. It can restore the vitality of the brain, nervous system and myocardial cells. It is used to treat various central system, cardiovascular and cerebrovascular diseases. It also showed antibacterial and antioxidant activity. Many studies have explored the benefits of VOA scientifically. This paper reviews the extraction methods, chemical components, pharmacological activities and toxicology of VOA. The molecular mechanism of VOA was elucidated. This paper will serve as a comprehensive resource for further carrying the VOA on improving its medicinal value and clinical use.
Collapse
Affiliation(s)
- Daoming Bai
- School of Pharmacy, Binzhou Medical University, Yantai, China,School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xiaoyu Li
- School of Pharmacy, Binzhou Medical University, Yantai, China,School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shengguang Wang
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Tianyi Zhang
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yumin Wei
- School of Pharmacy, Binzhou Medical University, Yantai, China,School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Qingquan Wang
- School of Pharmacy, Binzhou Medical University, Yantai, China,School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Weichao Dong
- School of Pharmacy, Binzhou Medical University, Yantai, China,School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jing Song
- Shandong Yuze Pharmaceutical Industry Technology Research Institute Co., Ltd, Dezhou, China
| | - Peng Gao
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yanan Li
- School of Pharmacy, Shandong University of Traditional Chinese Medicine, Jinan, China,*Correspondence: Long Dai, ; Shaoping Wang, ; Yanan Li,
| | - Shaoping Wang
- School of Pharmacy, Binzhou Medical University, Yantai, China,*Correspondence: Long Dai, ; Shaoping Wang, ; Yanan Li,
| | - Long Dai
- School of Pharmacy, Binzhou Medical University, Yantai, China,*Correspondence: Long Dai, ; Shaoping Wang, ; Yanan Li,
| |
Collapse
|