1
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Hyde J, Farrell LJ, Waters AM. Extinction of negative conditioned stimulus valence in human fear conditioning. Behav Res Ther 2024; 174:104477. [PMID: 38281443 DOI: 10.1016/j.brat.2024.104477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 12/11/2023] [Accepted: 01/05/2024] [Indexed: 01/30/2024]
Abstract
Fear conditioning is a common experimental paradigm for modelling the development, and exposure-based treatment, of anxiety disorders. Measures of fear such as threat-expectancy, physiological arousal, and fear ratings typically extinguish, however feared stimuli may still be evaluated negatively (i.e. retain negative valence). This systematic review provides the first investigation of the relationship between fear conditioning methodology and extinction of negative stimulus valence. Principal findings were that type of CS (conditioned stimulus) and the CS-US pairing (i.e. specific combination of CS and unconditioned stimulus) predicted extinction outcome. Extinction of absolute negative CS valence was always achieved with shape CSs; often achieved with low fear-relevant animals as CSs, and less frequently achieved with faces as CSs - particularly neutral faces paired with a shock US. Modified extinction procedures typically achieved the same outcome as standard extinction procedures, except for partially-reinforced extinction, which was less effective than standard extinction, and positive imagery training, which was more effective than standard extinction. Further studies are warranted to evaluate the influence of fear conditioning methodology on extinction of absolute negative CS valence.
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Affiliation(s)
- Jamiah Hyde
- School of Applied Psychology, Griffith University, Australia.
| | - Lara J Farrell
- School of Applied Psychology, Griffith University, Australia
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2
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Lin TY, Zhang YH, Zhang YN, Yang Y, Du L, Li QY, He Y, Liu FC, Tang XY, Tang LL, Sun YS. Resting state functional connectome in breast cancer patients with fear of cancer recurrence. Cereb Cortex 2024; 34:bhae062. [PMID: 38436464 DOI: 10.1093/cercor/bhae062] [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: 12/18/2023] [Revised: 01/31/2024] [Accepted: 02/02/2024] [Indexed: 03/05/2024] Open
Abstract
This study aimed to investigate network-level brain functional changes in breast cancer patients and their relationship with fear of cancer recurrence (FCR). Resting-state functional MRI was collected from 43 patients with breast cancer and 40 healthy controls (HCs). Graph theory analyses, whole-brain voxel-wise functional connectivity strength (FCS) analyses and seed-based functional connectivity (FC) analyses were performed to identify connection alterations in breast cancer patients. Correlations between brain functional connections (i.e. FCS and FC) and FCR level were assessed to further reveal the neural mechanisms of FCR in breast cancer patients. Graph theory analyses indicated a decreased clustering coefficient in breast cancer patients compared to HCs (P = 0.04). Patients with breast cancer exhibited significantly higher FCS in both higher-order function networks (frontoparietal, default mode, and dorsal attention systems) and primary somatomotor networks. Among the hyperconnected regions in breast cancer, the left inferior frontal operculum demonstrated a significant positive correlation with FCR. Our findings suggest that breast cancer patients exhibit less segregation of brain function, and the left inferior frontal operculum is a key region associated with FCR. This study offers insights into the neural mechanisms of FCR in breast cancer patients at the level of brain connectome.
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Affiliation(s)
- Tian-Ye Lin
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Yi-He Zhang
- School of Artificial Intelligence, Beijing University of Posts and Telecommunications, No. 10 Xitucheng Road, Haidian District, Beijing, 100876, China
| | - Ye-Ning Zhang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Yang Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Breast Center, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Lei Du
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Qing-Yang Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Yi He
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Fu-Chao Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Xiao-Yu Tang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Li-Li Tang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Psycho-Oncology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
| | - Ying-Shi Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiology, Peking University Cancer Hospital & Institute, No. 52 Fu Cheng Road, Hai Dian District, Beijing 100142, China
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3
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Webler RD, Oathes DJ, van Rooij SJH, Gewirtz JC, Nahas Z, Lissek SM, Widge AS. Causally mapping human threat extinction relevant circuits with depolarizing brain stimulation methods. Neurosci Biobehav Rev 2023; 144:105005. [PMID: 36549377 DOI: 10.1016/j.neubiorev.2022.105005] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/17/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022]
Abstract
Laboratory threat extinction paradigms and exposure-based therapy both involve repeated, safe confrontation with stimuli previously experienced as threatening. This fundamental procedural overlap supports laboratory threat extinction as a compelling analogue of exposure-based therapy. Threat extinction impairments have been detected in clinical anxiety and may contribute to exposure-based therapy non-response and relapse. However, efforts to improve exposure outcomes using techniques that boost extinction - primarily rodent extinction - have largely failed to date, potentially due to fundamental differences between rodent and human neurobiology. In this review, we articulate a comprehensive pre-clinical human research agenda designed to overcome these failures. We describe how connectivity guided depolarizing brain stimulation methods (i.e., TMS and DBS) can be applied concurrently with threat extinction and dual threat reconsolidation-extinction paradigms to causally map human extinction relevant circuits and inform the optimal integration of these methods with exposure-based therapy. We highlight candidate targets including the amygdala, hippocampus, ventromedial prefrontal cortex, dorsal anterior cingulate cortex, and mesolimbic structures, and propose hypotheses about how stimulation delivered at specific learning phases could strengthen threat extinction.
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Affiliation(s)
- Ryan D Webler
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
| | - Desmond J Oathes
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jonathan C Gewirtz
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA; Department of Psychology, Arizona State University, AZ, USA
| | - Ziad Nahas
- Department of Psychology, Arizona State University, AZ, USA
| | - Shmuel M Lissek
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Alik S Widge
- Department of Psychiatry and Medical Discovery Team on Addictions, University of Minnesota Medical School, MN, USA
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4
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Li X, Chen LM, Kumar G, Zhang SJ, Zhong QH, Zhang HY, Gui G, Wu LL, Fan HZ, Sheng JW. Therapeutic Interventions of Gut-Brain Axis as Novel Strategies for Treatment of Alcohol Use Disorder Associated Cognitive and Mood Dysfunction. Front Neurosci 2022; 16:820106. [PMID: 35185459 PMCID: PMC8847450 DOI: 10.3389/fnins.2022.820106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 01/10/2022] [Indexed: 11/25/2022] Open
Abstract
Alcohol use disorders (AUD) is characterized by persistent or intermittent alcohol cravings and compulsive drinking. The functional changes in the central nervous system (CNS) after alcohol consumption are alcohol-associated cognitive impairment and mood disorders, which are major health issues reported in AUDs. Studies have shown that transferring the intestinal microbiota from AUDs patients to germ-free animals causes learning and memory dysfunction, depression and anxiety-like behavior, indicating the vital role of intestinal microbiota in development of neuropsychiatric disorders in AUD. Intestinal flora composition of AUD patients are significantly different from normal people, suggesting that intestinal flora imbalance orchestrate the development of neuropsychiatric disorders in AUD. Studies suggests that gut microbiome links bidirectional signaling network of the enteric nervous system (ENS) to central nervous system (CNS), forming gut-microbe-brain axis (brain-gut axis). In this review, we discussed pathogenesis and possible treatment of AUD-induced cognitive deficits, anxiety, and depression disorders. Further, we described the mechanism of intestinal flora imbalance and dysfunction of hippocampus-amygdala-frontal cortex (gut-limbic circuit system dysfunction). Therefore, we postulate therapeutic interventions of gut-brain axis as novel strategies for treatment of AUD-induced neuropsychiatric disorders.
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Affiliation(s)
- Xin Li
- Department of Gastroenterology, The People’s Hospital of Zhangshu City, Jiangxi, China
| | - Le-Mei Chen
- Department of Pharmacy, Guangdong Provincial People’s Hospital Ganzhou Hospital, Ganzhou Municipal Hospital, Jiangxi, China
| | - Gajendra Kumar
- Department of Neuroscience, City University of Hong Kong, Kowloon Tong, Hong Kong SAR, China
| | - Shan-Jin Zhang
- Department of Gastroenterology, The People’s Hospital of Yichun City, Jiangxi, China
| | - Quan-hai Zhong
- School of Chemistry and Bioengineering, Yichun University, Jiangxi, China
| | - Hong-Yan Zhang
- School of Chemistry and Bioengineering, Yichun University, Jiangxi, China
| | - Guan Gui
- Department of Gastroenterology, The People’s Hospital of Yichun City, Jiangxi, China
| | - Lv-Le Wu
- Department of Gastroenterology, The People’s Hospital of Yichun City, Jiangxi, China
| | - Hui-Zhen Fan
- Department of Gastroenterology, The People’s Hospital of Yichun City, Jiangxi, China
- School of Chemistry and Bioengineering, Yichun University, Jiangxi, China
- *Correspondence: Hui-Zhen Fan,
| | - Jian-Wen Sheng
- Department of Gastroenterology, The People’s Hospital of Yichun City, Jiangxi, China
- Jian-Wen Sheng,
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5
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Liu Y, Lai CH. The alterations of degree centrality in the frontal lobe of patients with panic disorder. Int J Med Sci 2022; 19:105-111. [PMID: 34975304 PMCID: PMC8692120 DOI: 10.7150/ijms.65367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/02/2021] [Indexed: 01/10/2023] Open
Abstract
Objective: The brain network in panic disorder (PD) is still an intriguing issue for research. In this study, we hoped to investigate the role of DC (degree centrality) for the pathophysiology of PD, especially for the fear network. Methods: We enrolled 60 patients with PD and 60 controls in the current study. The gender and age were matched for two groups. All participants received the resting-state functional magnetic resonance imaging to survey the baseline brain activity. Then the DC values of all participants were using REST toolbox. We also compared the DC values between PD and controls. The statistical threshold was set as FDR (false discovery rate) < 0.05. Results: The DC values were significantly lower in the right superior frontal gyrus of PD patients compared to controls (FDR < 0.05). In addition, a negative correlation between the DC values and panic severity was observed in the right superior frontal gyrus and left inferior frontal gyrus. However, there was no significant association between the DC values and illness duration. Conclusion: The DC seemed significantly altered in the frontal lobe of PD patients. The role of the frontal lobe might be more emphasized in the pathophysiology research for PD.
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Affiliation(s)
- Yongbao Liu
- Department of Imaging, The First People's Hospital of LianYun Gang, Lianyungang City, Jiangsu Province, 222000, China
| | - Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,PhD Psychiatry & Neuroscience Clinic, Taoyuan, Taiwan
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6
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Offline tDCS modulates prefrontal-cortical-subcortical-cerebellar fear pathways in delayed fear extinction. Exp Brain Res 2021; 240:221-235. [PMID: 34694466 DOI: 10.1007/s00221-021-06248-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 10/15/2021] [Indexed: 11/27/2022]
Abstract
Transcranial direct current stimulation (tDCS) has been studied to enhance extinction-based treatments for anxiety disorders. However, the field shows conflicting results about its anxiolytic effect and only a few studies have observed the extinction of consolidated memories. We looked to study the effect of offline 1 mA tDCS over the right dorsolateral pre-frontal cortex across the fear pathways, in consolidated fear response during delayed extinction. Participants (N = 34 women) underwent in a two-day fear conditioning procedure. On day 1, participants were assigned to the control group (N = 18) or the tDCS group (N = 16) and went through a fear acquisition procedure. On day 2, the tDCS group received 20 min tDCS before extinction and while inside the MRI scanner. The control group completed the extinction procedure only. The tDCS session (for the tDCS group) and the fMRI scan (for both groups) were completed just on the second day. Univariate fMRI analysis showed stimulation-dependent activity during late extinction with the tDCS group showing decreased neural activity during the processing of threat cues (CS +) and increased activity during the processing of safety cues (CS -), in prefrontal, postcentral and paracentral regions, during late extinction. ROI to whole-brain psychophysiological interaction (PPI) analysis showed the tDCS effect on the connectivity between the left dorsolateral prefrontal cortex three cortical-amygdalo-hippocampal-cerebellar pathway clusters during the processing of the CS + in late extinction (TFCE corrected; p < 0.05). Increased neuronal activity during the processing of safety cues and stronger coupling during the processing of threat cues might be the mechanisms by which tDCS contributes to stimuli discrimination.
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7
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Cooper SE, Dunsmoor JE. Fear conditioning and extinction in obsessive-compulsive disorder: A systematic review. Neurosci Biobehav Rev 2021; 129:75-94. [PMID: 34314751 PMCID: PMC8429207 DOI: 10.1016/j.neubiorev.2021.07.026] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 06/04/2021] [Accepted: 07/23/2021] [Indexed: 11/29/2022]
Abstract
Laboratory experiments using fear conditioning and extinction protocols help lay the groundwork for designing, testing, and optimizing innovative treatments for anxiety-related disorders. Yet, there is limited basic research on fear conditioning and extinction in obsessive-compulsive disorder (OCD). This is surprising because exposure-based treatments based on associative learning principles are among the most popular and effective treatment options for OCD. Here, we systematically review and critically assess existing aversive conditioning and extinction studies of OCD. Across 12 studies, there was moderate evidence that OCD is associated with abnormal acquisition of conditioned responses that differ from comparison groups. There was relatively stronger evidence of OCD's association with impaired extinction processes. This included multiple studies finding elevated conditioned responses during extinction learning and poorer threat/safety discrimination during recall, although a minority of studies yielded results inconsistent with this conclusion. Overall, the conditioning model holds value for OCD research, but more work is necessary to clarify emerging patterns of results and increase clinical translational utility to the level seen in other anxiety-related disorders. We detail limitations in the literature and suggest next steps, including modeling OCD with more complex conditioning methodology (e.g., semantic/conceptual generalization, avoidance) and improving individual-differences assessment with dimensional techniques.
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Affiliation(s)
- Samuel E Cooper
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
| | - Joseph E Dunsmoor
- Department of Psychiatry and Behavioral Sciences, University of Texas at Austin, Austin, TX, 78712, USA.
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8
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Ridderbusch IC, Wroblewski A, Yang Y, Richter J, Hollandt M, Hamm AO, Wittchen HU, Ströhle A, Arolt V, Margraf J, Lueken U, Herrmann MJ, Kircher T, Straube B. Neural adaptation of cingulate and insular activity during delayed fear extinction: A replicable pattern across assessment sites and repeated measurements. Neuroimage 2021; 237:118157. [PMID: 34020017 DOI: 10.1016/j.neuroimage.2021.118157] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/10/2021] [Accepted: 05/06/2021] [Indexed: 01/02/2023] Open
Abstract
Adapting threat-related memories towards changing environments is a fundamental ability of organisms. One central process of fear reduction is suggested to be extinction learning, experimentally modeled by extinction training that is repeated exposure to a previously conditioned stimulus (CS) without providing the expected negative consequence (unconditioned stimulus, US). Although extinction training is well investigated, evidence regarding process-related changes in neural activation over time is still missing. Using optimized delayed extinction training in a multicentric trial we tested whether: 1) extinction training elicited decreasing CS-specific neural activation and subjective ratings, 2) extinguished conditioned fear would return after presentation of the US (reinstatement), and 3) results are comparable across different assessment sites and repeated measures. We included 100 healthy subjects (measured twice, 13-week-interval) from six sites. 24 h after fear acquisition training, extinction training, including a reinstatement test, was applied during fMRI. Alongside, participants had to rate subjective US-expectancy, arousal and valence. In the course of the extinction training, we found decreasing neural activation in the insula and cingulate cortex as well as decreasing US-expectancy, arousal and negative valence towards CS+. Re-exposure to the US after extinction training was associated with a temporary increase in neural activation in the anterior cingulate cortex (exploratory analysis) and changes in US-expectancy and arousal ratings. While ICCs-values were low, findings from small groups suggest highly consistent effects across time-points and sites. Therefore, this delayed extinction fMRI-paradigm provides a solid basis for the investigation of differences in neural fear-related mechanisms as a function of anxiety-pathology and exposure-based treatment.
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Affiliation(s)
- Isabelle C Ridderbusch
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Germany.
| | - Adrian Wroblewski
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Germany
| | - Yunbo Yang
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Germany
| | - Jan Richter
- Institute for Psychology, University of Greifswald, Germany
| | - Maike Hollandt
- Institute for Psychology, University of Greifswald, Germany
| | - Alfons O Hamm
- Institute for Psychology, University of Greifswald, Germany
| | - Hans-Ulrich Wittchen
- Institute for Clinical Psychology and Psychotherapie, Technichal University of Dresden, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University (LMU) Muenchen, Germany
| | - Andreas Ströhle
- Klinik für Psychiatrie und Psychotherapie, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berliner Institut für Gesundheitsforschung, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University Hospital Muenster, Germany
| | - Jürgen Margraf
- Chair in Psychiatry and Psychotherapy, Ruhr University Bochum (RUB), Germany
| | - Ulrike Lueken
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Wuerzburg, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Germany
| | - Martin J Herrmann
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Wuerzburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy and Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Germany
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Cheng CH, Hsu SC, Liu CY. Dysfunctional frontal activation of mismatch negativity in panic disorder: A magnetoencephalographic study. J Affect Disord 2021; 280:211-218. [PMID: 33220556 DOI: 10.1016/j.jad.2020.11.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/13/2020] [Accepted: 11/07/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND Mismatch negativity (MMN) or its magnetic counterpart (MMNm) is a neurophysiological signal to reflect the automatic change-detection ability. However, MMN studies in patients with panic disorder (PD) showed contrasting results using electroencephalographic (EEG) recordings. The present study attempted to overcome the limitations of EEG methodology by means of a whole-head magnetoencephalography (MEG) combined with the depth-weighted minimum norm estimate method to conduct an in-depth investigation on the MMNm at the cortical level in patients with PD. METHODS We recruited 22 healthy controls (HC) and 20 patients with PD to perform auditory oddball paradigm during MEG recordings. The cortical MMNm amplitudes and latencies in the superior temporal gyrus, inferior parietal lobule, and inferior frontal gyrus (IFG) were compared between the HC and PD groups. The correlations between MMNm responses and clinical measurement were also examined. RESULTS Compared with the HC group, the PD group demonstrated significantly reduced MMNm amplitudes in the IFG. Furthermore, higher trait scores of the State-Trait Anxiety Inventory were associated with lower MMNm amplitudes of the right IFG among patients with PD. LIMITATIONS Generalization of the current results to other settings or samples should be made cautiously due to the use of different medication regimens and presence of comorbidities in our patients. CONCLUSIONS Our data suggest dysfunctional pre-attentive change-detection ability in patients with PD, particularly in the IFG.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan.
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, New Taipei Municipal TuCheng Hospital (Built and Operated by Chang Gung Medical Foundation), Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
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10
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Lai CH. Biomarkers in Panic Disorder. CURRENT PSYCHIATRY RESEARCH AND REVIEWS 2021. [DOI: 10.2174/2666082216999200918163245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Panic disorder (PD) is a kind of anxiety disorder that impacts the life quality
and functional perspectives in patients. However, the pathophysiological study of PD seems still
inadequate and many unresolved issues need to be clarified.
Objectives:
In this review article of biomarkers in PD, the investigator will focus on the findings of
magnetic resonance imaging (MRI) of the brain in the pathophysiology study. The MRI biomarkers
would be divided into several categories, on the basis of structural and functional perspectives.
Methods:
The structural category would include the gray matter and white matter tract studies. The
functional category would consist of functional MRI (fMRI), resting-state fMRI (Rs-fMRI), and
magnetic resonance spectroscopy (MRS). The PD biomarkers revealed by the above methodologies
would be discussed in this article.
Results:
For the gray matter perspectives, the PD patients would have alterations in the volumes of
fear network structures, such as the amygdala, parahippocampal gyrus, thalamus, anterior cingulate
cortex, insula, and frontal regions. For the white matter tract studies, the PD patients seemed to have
alterations in the fasciculus linking the fear network regions, such as the anterior thalamic radiation,
uncinate fasciculus, fronto-occipital fasciculus, and superior longitudinal fasciculus. For the fMRI
studies in PD, the significant results also focused on the fear network regions, such as the amygdala,
hippocampus, thalamus, insula, and frontal regions. For the Rs-fMRI studies, PD patients seemed to
have alterations in the regions of the default mode network and fear network model. At last, the
MRS results showed alterations in neuron metabolites of the hippocampus, amygdala, occipital
cortex, and frontal regions.
Conclusion:
The MRI biomarkers in PD might be compatible with the extended fear network model
hypothesis in PD, which included the amygdala, hippocampus, thalamus, insula, frontal regions, and
sensory-related cortex.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
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11
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Yu N, Cai J, Xu X, Yang Y, Sun J. Masking effects on subjective annoyance to aircraft flyover noise: An fMRI study. Hum Brain Mapp 2020; 41:3284-3294. [PMID: 32379391 PMCID: PMC7375093 DOI: 10.1002/hbm.25016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/06/2020] [Accepted: 04/08/2020] [Indexed: 12/16/2022] Open
Abstract
Sound masking, a new noise control technology, has been applied to improve subjective perception of noise in recent years. However, the neural mechanisms underlying this technology are still unclear. In this study, 18 healthy subjects were recurited to take subjective annoyance assessments and fMRI scanning with the aircraft noise and the masked aircraft noise. The results showed that the noise annoyance was associated with deficient functional connectivity between anterior cingulate cortex (ACC) and prefrontal cortex and exceeded brain activation in ACC, which might be explained as compensation. The sound masking led to significantly strong activation in the left medial frontal cortex and right medial orbital frontal cortex, which were associated with happy emotion induced by sound masking. This study offered new insights on the underlying neural mechanisms of sound masking effects.
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Affiliation(s)
- Nishuai Yu
- School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jun Cai
- School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Xuanyue Xu
- School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yining Yang
- School of Environmental Science and Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Junfeng Sun
- Shanghai Med-X Engineering Research Center, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China.,Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China
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12
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Ridderbusch IC, Yang Y, Weber H, Reif A, Herterich S, Ströhle A, Pfleiderer B, Arolt V, Wittchen HU, Lueken U, Kircher T, Straube B. Neural correlates of NOS1 ex1f-VNTR allelic variation in panic disorder and agoraphobia during fear conditioning and extinction in fMRI. NEUROIMAGE-CLINICAL 2020; 27:102268. [PMID: 32361414 PMCID: PMC7200443 DOI: 10.1016/j.nicl.2020.102268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 04/02/2020] [Accepted: 04/03/2020] [Indexed: 12/04/2022]
Abstract
NOS1 ex1f-VNTR is associated with neural correlates during fear extinction learning. Differential effects are prominent in amygdala and hippocampus. Patients with panic disorder and agoraphobia differ from healthy controls. Genotype associated effects were not altered after cognitive behavioral therapy.
Neuronal nitric oxide synthase (NOS-I) impacts on fear/anxiety-like behavior in animals. In humans, the short (S) allele of a functional promotor polymorphism of NOS1 (NOS1 ex1f-VNTR) has been shown to be associated with higher anxiety and altered fear conditioning in healthy subjects in the amygdala and hippocampus (AMY/HIPP). Here, we explore the role of NOS1 ex1f-VNTR as a pathophysiological correlate of panic disorder and agoraphobia (PD/AG). In a sub-sample of a multicenter cognitive behavioral therapy (CBT) randomized controlled trial in patients with PD/AG (n = 48: S/S-genotype n=15, S/L-genotype n=21, L/L-genotype n=12) and healthy control subjects, HS (n = 34: S/S-genotype n=7, S/L-genotype n=17, L/L-genotype=10), a differential fear conditioning and extinction fMRI-paradigm was used to investigate how NOS1 ex1f-VNTR genotypes are associated with differential neural activation in AMY/HIPP. Prior to CBT, L/L-allele carriers showed higher activation than S/S-allele carriers in AMY/HIPP. A genotype × diagnosis interaction revealed that the S-allele in HS was associated with a pronounced deactivation in AMY/HIPP, while patients showed contrary effects. The interaction of genotype × stimulus type (CS+, conditioned stimulus associated with an aversive stimulus vs. CS-, unassociated) showed effects on differential learning in AMY/HIPP. All effects were predominately found during extinction. Genotype associated effects in patients were not altered after CBT. Low statistical power due to small sample size in each subgroup is a major limitation. However, our findings provide first preliminary evidence for dysfunctional neural fear conditioning/extinction associated with NOS1 ex1f-VNTR genotype in the context of PD/AG, shedding new light on the complex interaction between genetic risk, current psychopathology and treatment-related effects.
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Affiliation(s)
- Isabelle C Ridderbusch
- Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany.
| | - Yunbo Yang
- Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany
| | - Heike Weber
- Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Würzburg, Germany; Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Sabine Herterich
- Clinical Chemistry and Laboratory Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Bettina Pfleiderer
- Medical Faculty, University of Münster and Department Clinical Radiology, University Hospital Münster, Münster, Germany
| | - Volker Arolt
- Department of Psychiatry and Psychotherapy, University Hospital Münster, Münster, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany; Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität (LMU), München, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy & Center for Mind, Brain and Behavior - CMBB, Philipps-Universität Marburg, Marburg, Germany
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13
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Ebrahimi C, Gechter J, Lueken U, Schlagenhauf F, Wittchen HU, Hamm AO, Ströhle A. Augmenting extinction learning with D-cycloserine reduces return of fear: a randomized, placebo-controlled fMRI study. Neuropsychopharmacology 2020; 45:499-506. [PMID: 31634897 PMCID: PMC6969173 DOI: 10.1038/s41386-019-0552-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2019] [Revised: 09/22/2019] [Accepted: 10/14/2019] [Indexed: 11/08/2022]
Abstract
D-cycloserine (DCS), a partial NMDA-receptor agonist, seems to be a promising enhancer for exposure therapy in anxiety disorders. It has been tested successfully in animal models of fear extinction, where DCS enhanced extinction learning. Applied in clinical studies, results of DCS-augmented exposure therapy remain ambiguous, calling for a deeper understanding of the underlying mechanisms of DCS and its exact effect on extinction learning and return of fear (ROF) in humans. In the present study, we investigated the effect of DCS-augmented extinction learning on behavioral, psychophysiological, and neural indices of ROF during a 24-h delayed recall test. Thirty-seven participants entered a randomized, placebo-controlled, double-blind, 3-day fear conditioning and delayed extinction fMRI design. One hour before extinction training, participants received an oral dose of 50 mg of DCS or a placebo. Behavioral arousal ratings revealed a generalized ROF during extinction recall in the placebo but not DCS group. Furthermore, participants receiving DCS compared to placebo showed attenuated differential BOLD responses in left posterior hippocampus and amygdala from extinction learning to extinction recall, due to increased hippocampal recruitment in placebo and trendwise decreased amygdala responding in DCS subjects. Our finding that DCS reduces ROF in arousal ratings and neural structures subserving defensive reactions support a role for NMDA receptors in extinction memory consolidation and encourage further translational research.
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Affiliation(s)
- Claudia Ebrahimi
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
| | - Johanna Gechter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Ulrike Lueken
- Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Florian Schlagenhauf
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität Munich, Munich, Germany
| | - Alfons O Hamm
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Andreas Ströhle
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
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14
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Task MRI-Based Functional Brain Network of Anxiety. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1191:3-20. [PMID: 32002919 DOI: 10.1007/978-981-32-9705-0_1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Magnetic resonance imaging (MRI) is a good tool for researchers to understand the biological mechanisms and pathophysiology of the brain due to the translational characteristics of MRI methods. For the psychiatric illness, this kind of mental disorders usually have minor alterations when compared to traditional neurological disorders. Therefore the functional study, such as functional connectivity, would play a significant role for understanding the pathophysiology of mental disorders. This chapter would focus on the discussion of task MRI-based functional network studies in anxiety. For social anxiety disorder, the limbic system, such as the temporal lobe, amygdala, and hippocampus, would show alterations in the functional connectivity with frontal regions, such as anterior cingulate, prefrontal, and orbitofrontal cortices. PD has anterior cingulate cortex-amygdala alterations in fear conditioning, frontoparietal alterations in attention network task, and limbic-prefrontal alterations in emotional task. A similar amygdala-based aberrant functional connectivity in specific phobia is observed. The mesocorticolimbic and limbic-prefrontal functional alterations are found in generalized anxiety disorder. The major components of task MRI-based functional connectivity in anxiety include limbic and frontal regions which might play a vital role for the origination of anxiety under different scenarios and tasks.
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