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Wiemer J, Leimeister F, Gamer M, Pauli P. The ventromedial prefrontal cortex in response to threat omission is associated with subsequent explicit safety memory. Sci Rep 2024; 14:7378. [PMID: 38548770 PMCID: PMC10979006 DOI: 10.1038/s41598-024-57432-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
In order to memorize and discriminate threatening and safe stimuli, the processing of the actual absence of threat seems crucial. Here, we measured brain activity with fMRI in response to both threat conditioned stimuli and their outcomes by combining threat learning with a subsequent memory paradigm. Participants (N = 38) repeatedly saw a variety of faces, half of which (CS+) were associated with an aversive unconditioned stimulus (US) and half of which were not (CS-). When an association was later remembered, the hippocampus had been more active (than when forgotten). However, the ventromedial prefrontal cortex predicted subsequent memory specifically during safe associations (CS- and US omission responses) and the left dorsolateral prefrontal cortex during outcomes in general (US and US omissions). In exploratory analyses of the theoretically important US omission, we found extended involvement of the medial prefrontal cortex and an enhanced functional connectivity to visual and somatosensory cortices, suggesting a possible function in sustaining sensory information for an integration with semantic memory. Activity in visual and somatosensory cortices together with the inferior frontal gyrus also predicted memory performance one week after learning. The findings imply the importance of a close interplay between prefrontal and sensory areas during the processing of safe outcomes-or 'nothing'-to establish declarative safety memory.
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Affiliation(s)
- Julian Wiemer
- Institute of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany.
| | - Franziska Leimeister
- Institute of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Matthias Gamer
- Institute of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Institute of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
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2
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Roesmann K, Toelle J, Leehr EJ, Wessing I, Böhnlein J, Seeger F, Schwarzmeier H, Siminski N, Herrmann MJ, Dannlowski U, Lueken U, Klucken T, Straube T, Junghöfer M. Neural correlates of fear conditioning are associated with treatment-outcomes to behavioral exposure in spider phobia - Evidence from magnetoencephalography. Neuroimage Clin 2022; 35:103046. [PMID: 35609411 PMCID: PMC9125677 DOI: 10.1016/j.nicl.2022.103046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 12/02/2022]
Abstract
Magnetoencephalographic effects of fear conditioning predict exposure outcomes. No associations between fear ratings of conditioned stimuli and exposure outcomes. Prefrontal correlates of safety processing and/or fear inhibition are treatment-relevant. 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.
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Affiliation(s)
- Kati Roesmann
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany; Institute for Clinical Psychology and Psychotherapy, University of Siegen, Germany.
| | - Julius Toelle
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany
| | | | - Ida Wessing
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany; Department of Child and Adolescent Psychiatry, University of Münster, Germany
| | - Joscha Böhnlein
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Fabian Seeger
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany; Department of General Psychiatry, University of Heidelberg, Germany
| | - Hanna Schwarzmeier
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany
| | - Niklas Siminski
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany
| | - Martin J Herrmann
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Germany
| | - Ulrike Lueken
- Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Germany
| | - Tim Klucken
- Institute for Clinical Psychology and Psychotherapy, University of Siegen, Germany
| | - Thomas Straube
- Institute of Medical Psychology and Systems Neuroscience, University of Münster, Germany
| | - Markus Junghöfer
- Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany
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3
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Namkung H, Thomas KL, Hall J, Sawa A. Parsing neural circuits of fear learning and extinction across basic and clinical neuroscience: Towards better translation. Neurosci Biobehav Rev 2022; 134:104502. [PMID: 34921863 DOI: 10.1016/j.neubiorev.2021.12.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 12/13/2021] [Accepted: 12/14/2021] [Indexed: 12/22/2022]
Abstract
Over the past decades, studies of fear learning and extinction have advanced our understanding of the neurobiology of threat and safety learning. Animal studies can provide mechanistic/causal insights into human brain regions and their functional connectivity involved in fear learning and extinction. Findings in humans, conversely, may further enrich our understanding of neural circuits in animals by providing macroscopic insights at the level of brain-wide networks. Nevertheless, there is still much room for improvement in translation between basic and clinical research on fear learning and extinction. Through the lens of neural circuits, in this article, we aim to review the current knowledge of fear learning and extinction in both animals and humans, and to propose strategies to fill in the current knowledge gap for the purpose of enhancing clinical benefits.
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Affiliation(s)
- Ho Namkung
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Kerrie L Thomas
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK; School of Biosciences, Cardiff University, Cardiff, UK
| | - Jeremy Hall
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK; School of Medicine, Cardiff University, Cardiff, UK
| | - Akira Sawa
- Department of Biomedical Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21287, USA.
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4
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Bas‐Hoogendam JM, Groenewold NA, Aghajani M, Freitag GF, Harrewijn A, Hilbert K, Jahanshad N, Thomopoulos SI, Thompson PM, Veltman DJ, Winkler AM, Lueken U, Pine DS, Wee NJA, Stein DJ, Agosta F, Åhs F, An I, Alberton BAV, Andreescu C, Asami T, Assaf M, Avery SN, Nicholas L, Balderston, Barber JP, Battaglia M, Bayram A, Beesdo‐Baum K, Benedetti F, Berta R, Björkstrand J, Blackford JU, Blair JR, Karina S, Blair, Boehme S, Brambilla P, Burkhouse K, Cano M, Canu E, Cardinale EM, Cardoner N, Clauss JA, Cividini C, Critchley HD, Udo, Dannlowski, Deckert J, Demiralp T, Diefenbach GJ, Domschke K, Doruyter A, Dresler T, Erhardt A, Fallgatter AJ, Fañanás L, Brandee, Feola, Filippi CA, Filippi M, Fonzo GA, Forbes EE, Fox NA, Fredrikson M, Furmark T, Ge T, Gerber AJ, Gosnell SN, Grabe HJ, Grotegerd D, Gur RE, Gur RC, Harmer CJ, Harper J, Heeren A, Hettema J, Hofmann D, Hofmann SG, Jackowski AP, Andreas, Jansen, Kaczkurkin AN, Kingsley E, Kircher T, Kosti c M, Kreifelts B, Krug A, Larsen B, Lee S, Leehr EJ, Leibenluft E, Lochner C, Maggioni E, Makovac E, Mancini M, Manfro GG, Månsson KNT, Meeten F, Michałowski J, Milrod BL, Mühlberger A, Lilianne R, Mujica‐Parodi, Munjiza A, Mwangi B, Myers M, Igor Nenadi C, Neufang S, Nielsen JA, Oh H, Ottaviani C, Pan PM, Pantazatos SP, Martin P, Paulus, Perez‐Edgar K, Peñate W, Perino MT, Peterburs J, Pfleiderer B, Phan KL, Poletti S, Porta‐Casteràs D, Price RB, Pujol J, Andrea, Reinecke, Rivero F, Roelofs K, Rosso I, Saemann P, Salas R, Salum GA, Satterthwaite TD, Schneier F, Schruers KRJ, Schulz SM, Schwarzmeier H, Seeger FR, Smoller JW, Soares JC, Stark R, Stein MB, Straube B, Straube T, Strawn JR, Suarez‐Jimenez B, Boris, Suchan, Sylvester CM, Talati A, Tamburo E, Tükel R, Heuvel OA, Van der Auwera S, Nieuwenhuizen H, Tol M, van Velzen LS, Bort CV, Vermeiren RRJM, Visser RM, Volman I, Wannemüller A, Wendt J, Werwath KE, Westenberg PM, Wiemer J, Katharina, Wittfeld, Wu M, Yang Y, Zilverstand A, Zugman A, Zwiebel HL. ENIGMA-anxiety working group: Rationale for and organization of large-scale neuroimaging studies of anxiety disorders. Hum Brain Mapp 2022; 43:83-112. [PMID: 32618421 PMCID: PMC8805695 DOI: 10.1002/hbm.25100] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/09/2020] [Accepted: 06/08/2020] [Indexed: 12/11/2022] Open
Abstract
Anxiety disorders are highly prevalent and disabling but seem particularly tractable to investigation with translational neuroscience methodologies. Neuroimaging has informed our understanding of the neurobiology of anxiety disorders, but research has been limited by small sample sizes and low statistical power, as well as heterogenous imaging methodology. The ENIGMA-Anxiety Working Group has brought together researchers from around the world, in a harmonized and coordinated effort to address these challenges and generate more robust and reproducible findings. This paper elaborates on the concepts and methods informing the work of the working group to date, and describes the initial approach of the four subgroups studying generalized anxiety disorder, panic disorder, social anxiety disorder, and specific phobia. At present, the ENIGMA-Anxiety database contains information about more than 100 unique samples, from 16 countries and 59 institutes. Future directions include examining additional imaging modalities, integrating imaging and genetic data, and collaborating with other ENIGMA working groups. The ENIGMA consortium creates synergy at the intersection of global mental health and clinical neuroscience, and the ENIGMA-Anxiety Working Group extends the promise of this approach to neuroimaging research on anxiety disorders.
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Affiliation(s)
- Janna Marie Bas‐Hoogendam
- Department of Developmental and Educational PsychologyLeiden University, Institute of Psychology Leiden The Netherlands
- Department of PsychiatryLeiden University Medical Center Leiden The Netherlands
- Leiden Institute for Brain and Cognition Leiden The Netherlands
| | - Nynke A. Groenewold
- Department of Psychiatry & Mental HealthUniversity of Cape Town Cape Town South Africa
| | - Moji Aghajani
- Department of PsychiatryAmsterdam UMC / VUMC Amsterdam The Netherlands
- Department of Research & InnovationGGZ inGeest Amsterdam The Netherlands
| | - Gabrielle F. Freitag
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Anita Harrewijn
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Kevin Hilbert
- Department of PsychologyHumboldt‐Universität zu Berlin Berlin Germany
| | - Neda Jahanshad
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Sophia I. Thomopoulos
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Paul M. Thompson
- University of Southern California Keck School of MedicineImaging Genetics Center, Mark and Mary Stevens Neuroimaging and Informatics Institute Los Angeles California USA
| | - Dick J. Veltman
- Department of PsychiatryAmsterdam UMC / VUMC Amsterdam The Netherlands
| | - Anderson M. Winkler
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Ulrike Lueken
- Department of PsychologyHumboldt‐Universität zu Berlin Berlin Germany
| | - Daniel S. Pine
- National Institute of Mental Health, Emotion and Development Branch Bethesda Maryland USA
| | - Nic J. A. Wee
- Department of PsychiatryLeiden University Medical Center Leiden The Netherlands
- Leiden Institute for Brain and Cognition Leiden The Netherlands
| | - Dan J. Stein
- Department of Psychiatry & Mental HealthUniversity of Cape Town Cape Town South Africa
- University of Cape TownSouth African MRC Unit on Risk & Resilience in Mental Disorders Cape Town South Africa
- University of Cape TownNeuroscience Institute Cape Town South Africa
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5
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Abstract
AbstractCatastrophizing thoughts may contribute to the development of anxiety, but functional emotion regulation may help to improve treatment. No study so far directly compared up- and down-regulation of fear by cognitive reappraisal. Here, healthy individuals took part in a cued fear experiment, in which multiple pictures of faces were paired twice with an unpleasant scream or presented as safety stimuli. Participants (N = 47) were asked (within-subjects) to down-regulate, to up-regulate and to maintain their natural emotional response. Valence and arousal ratings indicated successful up- and down-regulation of the emotional experience, while heart rate and pupil dilation increased during up-regulation, but showed no reduction in down-regulation. State and trait anxiety correlated with evaluations of safety but not threat stimuli, which supports the role of deficient safety learning in anxiety. Reappraisal did not modulate this effect. In conclusion, this study reveals evidence for up-regulation effects in fear, which might be even more efficient than down-regulation on a physiological level and highlights the importance of catastrophizing thoughts for the maintenance of fear and anxiety.
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6
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Boeke EA, Holmes AJ, Phelps EA. Toward Robust Anxiety Biomarkers: A Machine Learning Approach in a Large-Scale Sample. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 5:799-807. [PMID: 31447329 PMCID: PMC6925354 DOI: 10.1016/j.bpsc.2019.05.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 05/20/2019] [Accepted: 05/28/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND The field of psychiatry has long sought biomarkers that can objectively diagnose patients, predict treatment response, or identify individuals at risk of illness onset. However, reliable psychiatric biomarkers have yet to emerge. The recent application of machine learning techniques to develop neuroimaging-based biomarkers has yielded promising preliminary results. However, much of the work in this domain has not met best practice standards from the field of machine learning. This is especially true for studies of anxiety, creating uncertainty about the potential for anxiety biomarker development. METHODS We applied machine learning tools to predict trait anxiety from neuroimaging measurements in humans. Using publicly available data from the Brain Genomics Superstruct Project, we compared a suite of neuroimaging-based machine learning models predicting anxiety within a discovery sample (n = 531, 307 women) via k-fold cross-validation, and we tested the final model (a stacked model incorporating region-to-region functional connectivity, amygdala seed-to-voxel connectivity, and volumetric and cortical thickness data) in a held-out, unseen test sample (n = 348, 209 women). RESULTS Though the best model was able to predict anxiety within the discovery sample (cross-validated R2 of .06, permutation test p < .001), the generalization test within the holdout sample failed (R2 of -.04, permutation test p > .05). CONCLUSIONS In this study, we did not find evidence of a generalizable anxiety biomarker. However, we encourage other researchers to investigate this topic, utilizing large samples and proper methodology, to clarify the potential of neuroimaging-based anxiety biomarkers.
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Affiliation(s)
- Emily A Boeke
- Department of Psychology, New York University, New York, New York
| | - Avram J Holmes
- Department of Psychology, Yale University, New Haven, Connecticut; Department of Psychiatry, Yale University, New Haven, Connecticut
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7
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Stonawski S, Wiemer J, Wurst C, Reitz J, Hommers L, Menke A, Domschke K, Schiele MA, Pauli P. Covariation bias in depression - a predictor of treatment response? J Neural Transm (Vienna) 2019; 126:1653-1665. [PMID: 31630255 DOI: 10.1007/s00702-019-02091-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 10/06/2019] [Indexed: 10/25/2022]
Abstract
Covariation bias, defined as an overestimation of the relationship between fear-relevant stimuli and aversive consequences, is a well-investigated cognitive bias in anxiety disorders. As patients with affective disorders also show biased information processing, the aim of the present study was to investigate whether depressed patients also display a covariation bias between negative stimuli and aversive consequences. Covariation estimates of 62 inpatients with a current severe depressive episode were assessed at admission (n = 31) or after 6 weeks of treatment (n = 31) and were compared in a between-group design with 31 age- and sex-matched healthy controls. All participants showed a covariation bias for the relationship between negative stimuli and aversive consequences. Moreover, covariation bias at admission was significantly associated with various clinician- and self-reported dimensional measures of treatment response assessed 6 weeks later (Global Assessment of Functioning, Clinical Global Impression Scale, and Beck Depression Inventory), i.e., patients with a stronger bias showed greater impairment after 6 weeks of treatment. Categorical analyses revealed that overall, treatment non-responders-but not responders-were characterized by a covariation bias. The naturalistic study design without standardized pharmacological and psychotherapeutic treatments is a central limitation. We conclude that the covariation bias may constitute a possible marker in the field of emotional information processing in the search for effective predictors of therapy outcome.
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Affiliation(s)
- Saskia Stonawski
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Julian Wiemer
- Department of Biological Psychology, Clinical Psychology and Psychotherapy, Center of Mental Health, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany
| | - Catherina Wurst
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Jannika Reitz
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany
| | - Leif Hommers
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany.,Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Comprehensive Hearth Failure Center (CHFC), University Hospital of Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany
| | - Andreas Menke
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, Margarete-Höppel-Platz 1, 97080, Würzburg, Germany.,Interdisciplinary Center for Clinical Research, University Hospital of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany.,Comprehensive Hearth Failure Center (CHFC), University Hospital of Würzburg, Am Schwarzenberg 15, 97078, Würzburg, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, Hauptstr. 5, 79104, Freiburg, Germany
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Faculty of Medicine, Hauptstr. 5, 79104, Freiburg, Germany
| | - Paul Pauli
- Department of Biological Psychology, Clinical Psychology and Psychotherapy, Center of Mental Health, University of Würzburg, Marcusstr. 9-11, 97070, Würzburg, Germany.
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8
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Gentili C, Messerotti Benvenuti S, Lettieri G, Costa C, Cecchetti L. ROI and phobias: The effect of ROI approach on an ALE meta-analysis of specific phobias. Hum Brain Mapp 2019; 40:1814-1828. [PMID: 30548734 PMCID: PMC6865604 DOI: 10.1002/hbm.24492] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 11/23/2018] [Accepted: 11/28/2018] [Indexed: 12/22/2022] Open
Abstract
About 90% of fMRI findings on specific phobias (SP) include analysis of region of interest (ROI). This approach characterized by higher sensitivity may produce inflated results, particularly when findings are aggregated in meta-analytic maps. Here, we conducted a systematic review and activation likelihood estimation (ALE) meta-analysis on SP, testing the impact of the inclusion of ROI-based studies. ALE meta-analyses were carried out either including ROI-based results or focusing on whole-brain voxelwise studies exclusively. To assess the risk of bias in the neuroimaging field, we modified the Newcastle-Ottawa Scale (NOS) and measured the reliability of fMRI findings. Of the 31 selected investigations (564 patients and 485 controls) one-third did not motivate ROI selection: five studies did not report an explicit rationale, whereas four did not cite any specific reference in this regard. Analyses including ROI-based studies revealed differences between phobics and healthy subjects in several regions of the limbic circuit. However, when focusing on whole-brain analysis, only the anterior midcingulate cortex differentiated SP from controls. Notably, 13 studies were labeled with low risk of bias according to the adapted NOS. The inclusion of ROI-based results artificially inflates group differences in fMRI meta-analyses. Moreover, a priori, well-motivated selection of ROIs is desirable to improve quality and reproducibility in SP neuroimaging studies. Lastly, the use of modified NOS may represent a valuable way to assess and evaluate biases in fMRI studies: "low risk" of bias was reported for less than half of the included studies, indicating the need for better practices in fMRI.
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Affiliation(s)
- Claudio Gentili
- Department of General PsychologyUniversity of PadovaPadovaItaly
| | | | | | - Cristiano Costa
- Department of General PsychologyUniversity of PadovaPadovaItaly
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Reicherts P, Wiemer J, Gerdes AB, Schulz SM, Pauli P, Wieser MJ. Anxious anticipation and pain: the influence of instructed vs conditioned threat on pain. Soc Cogn Affect Neurosci 2017; 12:544-554. [PMID: 28008077 PMCID: PMC5390728 DOI: 10.1093/scan/nsw181] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Revised: 10/19/2016] [Accepted: 12/05/2016] [Indexed: 12/20/2022] Open
Abstract
Negative emotions such as anxiety enhance pain perception. However, certain threat characteristics are discussed to have different or even divergent effects on pain (hypoalgesia vs hyperalgesia). In order to investigate the neurobiological basis of different threats, we compared the impact of conditioned threat (CT) vs instructed threat (IT) on pain using fMRI. In two groups, participants underwent either Pavlovian threat conditioning or an instructed threat procedure. Afterwards, in an identical test phase participants watched the same visual cues from the previous phase indicating potential threat or safety, and received painful thermal stimulation. In the test phase, pain ratings were increased in both groups under threat. Group comparisons show elevated responses in amygdala and hippocampus for pain under threat in the CT group, and higher activation of the mid-cingulate gyrus (MCC) in the IT group. Psychophysiological interaction analyses in CT demonstrated elevated connectivity of the amygdala and the insula for the comparison of pain under threat vs safety. In IT, the same comparison revealed elevated functional connectivity of the MCC and the insula. The results suggest a similar pain augmenting effect of CT and IT, which, however, seems to rely on different networks mediating the impact of threat on pain.
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Affiliation(s)
| | - Julian Wiemer
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | | | - Stefan M. Schulz
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology, University of Würzburg, Würzburg, Germany
| | - Matthias J. Wieser
- Department of Psychology, University of Würzburg, Würzburg, Germany
- Institute of Psychology, Erasmus University Rotterdam, Rotterdam, The Netherlands
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10
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Neubert J, Hillbrandt K, Weymar M, Hamm AO, Wendt J. Acquisition and inhibition of conditioned fear is modulated by individual stimulus fear-relevance. Neurobiol Learn Mem 2017; 137:114-122. [DOI: 10.1016/j.nlm.2016.11.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 11/21/2016] [Accepted: 11/25/2016] [Indexed: 10/20/2022]
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Wiemer J, Pauli P. How fear-relevant illusory correlations might develop and persist in anxiety disorders: A model of contributing factors. J Anxiety Disord 2016; 44:55-62. [PMID: 27771577 DOI: 10.1016/j.janxdis.2016.10.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 09/24/2016] [Accepted: 10/13/2016] [Indexed: 10/20/2022]
Abstract
Fear-relevant illusory correlations (ICs) are defined as the overestimation of the relationship between a fear-relevant stimulus and aversive consequences. ICs reflect biased cognitions affecting the learning and unlearning of fear in anxiety disorders, and a deeper understanding might help to improve treatment. A model for the maintenance of ICs is proposed that highlights the importance of amplified aversiveness and salience of fear-relevant outcomes, impaired executive contingency monitoring and an availability heuristic. The model explains why ICs are enhanced in high fearful individuals and allows for some implications that might be applied to augment the effectiveness of cognitive behavior therapy, such as emotion regulation and the direction of attention to non-aversive experiences. Finally, we suggest possible future research directions and an alternative measure of ICs.
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Affiliation(s)
- Julian Wiemer
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany; Center of Mental Health, Medical Faculty, University of Würzburg, Germany.
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Enhanced functional connectivity between sensorimotor and visual cortex predicts covariation bias in spider phobia. Biol Psychol 2016; 121:128-137. [DOI: 10.1016/j.biopsycho.2016.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 01/13/2016] [Accepted: 01/15/2016] [Indexed: 11/19/2022]
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Wiemer J, Pauli P. Fear-relevant illusory correlations in different fears and anxiety disorders: A review of the literature. J Anxiety Disord 2016; 42:113-28. [PMID: 27454587 DOI: 10.1016/j.janxdis.2016.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 06/05/2016] [Accepted: 07/07/2016] [Indexed: 01/21/2023]
Abstract
Fearful individuals often overestimate the relationship between fear-relevant stimuli and aversive consequences. Such fear-relevant illusory correlations (ICs) might be involved in the maintenance of anxiety disorders. In this literature review, we found clear evidence that ICs are present and enhanced in fear of animals. We also revealed some evidence for ICs related to fear of flying, social anxiety, contamination fear, panic disorder, and post-traumatic stress disorder, but with considerably less clarity. Fear-relevant ICs seem to be best explained by both a priori expectancies and biased encoding of the experienced associations. Studies to date suggest that one important biased encoding process is the enhanced aversiveness/salience of fear-relevant outcomes. Future studies may improve insight by developing more reliable IC measures and testing the effect of encoding processes on treatment outcomes.
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Affiliation(s)
- Julian Wiemer
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany
| | - Paul Pauli
- Department of Psychology (Biological Psychology, Clinical Psychology, and Psychotherapy), University of Würzburg, Würzburg, Germany; Center of Mental Health, Medical Faculty, University of Würzburg, Germany.
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Greco JA, Liberzon I. Neuroimaging of Fear-Associated Learning. Neuropsychopharmacology 2016; 41:320-34. [PMID: 26294108 PMCID: PMC4677141 DOI: 10.1038/npp.2015.255] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 08/14/2015] [Accepted: 08/16/2015] [Indexed: 01/08/2023]
Abstract
Fear conditioning has been commonly used as a model of emotional learning in animals and, with the introduction of functional neuroimaging techniques, has proven useful in establishing the neurocircuitry of emotional learning in humans. Studies of fear acquisition suggest that regions such as amygdala, insula, anterior cingulate cortex, and hippocampus play an important role in acquisition of fear, whereas studies of fear extinction suggest that the amygdala is also crucial for safety learning. Extinction retention testing points to the ventromedial prefrontal cortex as an essential region in the recall of the safety trace, and explicit learning of fear and safety associations recruits additional cortical and subcortical regions. Importantly, many of these findings have implications in our understanding of the pathophysiology of psychiatric disease. Recent studies using clinical populations have lent insight into the changes in regional activity in specific disorders, and treatment studies have shown how pharmaceutical and other therapeutic interventions modulate brain activation during emotional learning. Finally, research investigating individual differences in neurotransmitter receptor genotypes has highlighted the contribution of these systems in fear-associated learning.
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Affiliation(s)
- John A Greco
- Neuroscience Graduate Program, University of Michigan, Ann Arbor, MI, USA
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
| | - Israel Liberzon
- VA Ann Arbor Healthcare System, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
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