Fear conditioned potentiation of the acoustic blink reflex in patients with cerebellar lesions

Mild Deficits in Fear Learning: Evidence from Humans and Mice with Cerebellar Cortical Degeneration

Functional brain imaging studies in humans suggest involvement of the cerebellum in fear conditioning but do not allow conclusions about the functional significance. The main aim of the present study was to examine whether patients with cerebellar degeneration show impaired fear conditioning and whether this is accompanied by alterations in cerebellar cortical activations. To this end, a 2 d differential fear conditioning study was conducted in 20 cerebellar patients and 21 control subjects using a 7 tesla (7 T) MRI system. Fear acquisition and extinction training were performed on day 1, followed by recall on day 2. Cerebellar patients learned to differentiate between the CS+ and CS-. Acquisition and consolidation of learned fear, however, was slowed. Additionally, extinction learning appeared to be delayed. The fMRI signal was reduced in relation to the prediction of the aversive stimulus and altered in relation to its unexpected omission. Similarly, mice with cerebellar cortical degeneration (spinocerebellar ataxia type 6, SCA6) were able to learn the fear association, but retrieval of fear memory was reduced. In sum, cerebellar cortical degeneration led to mild abnormalities in the acquisition of learned fear responses in both humans and mice, particularly manifesting postacquisition training. Future research is warranted to investigate the basis of altered fMRI signals related to fear learning.

The human cerebellum in reward anticipation and reward outcome processing: An activation likelihood estimation meta-analysis

The cerebellum generates internal prediction models and actively compares anticipated and actual outcomes in order to reach a desired end state. In this process, reward can serve as a reinforcer that shapes internal prediction models, enabling context-appropriate behavior. While the involvement of the cerebellum in reward processing has been established in animals, there is no detailed account of which cerebellar regions are involved in reward anticipation and reward outcome processing in humans. To this end, an activation likelihood estimation meta-analysis of functional neuroimaging studies was performed to investigate cerebellar functional activity patterns associated with reward anticipation and reward outcome processing in healthy adults. Results showed that reward anticipation (k=31) was associated with regional activity in the bilateral anterior lobe, bilateral lobule VI, left Crus I and the posterior vermis, while reward outcome (k=16) was associated with regional activity in the declive and left lobule VI. The findings of this meta-analysis show distinct involvement of the cerebellum in reward anticipation and reward outcome processing as part of a predictive coding routine.

Neuroimaging of Fear Extinction

Extinguishing fear and defensive responses to environmental threats when they are no longer warranted is a critical learning ability that can promote healthy self-regulation and, ultimately, reduce susceptibility to or maintenance of affective-, trauma-, stressor-,and anxiety-related disorders. Neuroimaging tools provide an important means to uncover the neural mechanisms of effective extinction learning that, in turn, can abate the return of fear. Here I review the promises and pitfalls of functional neuroimaging as a method to investigate fear extinction circuitry in the healthy human brain. I discuss the extent to which neuroimaging has validated the core circuits implicated in rodent models and has expanded the scope of the brain regions implicated in extinction processes. Finally, I present new advances made possible by multivariate data analysis tools that yield more refined insights into the brain-behavior relationships involved.

Proximal threats promote enhanced acquisition and persistence of reactive fear-learning circuits

Physical proximity to a traumatic event increases the severity of accompanying stress symptoms, an effect that is reminiscent of evolutionarily configured fear responses based on threat imminence. Despite being widely adopted as a model system for stress and anxiety disorders, fear-conditioning research has not yet characterized how threat proximity impacts the mechanisms of fear acquisition and extinction in the human brain. We used three-dimensional (3D) virtual reality technology to manipulate the egocentric distance of conspecific threats while healthy adult participants navigated virtual worlds during functional magnetic resonance imaging (fMRI). Consistent with theoretical predictions, proximal threats enhanced fear acquisition by shifting conditioned learning from cognitive to reactive fear circuits in the brain and reducing amygdala-cortical connectivity during both fear acquisition and extinction. With an analysis of representational pattern similarity between the acquisition and extinction phases, we further demonstrate that proximal threats impaired extinction efficacy via persistent multivariate representations of conditioned learning in the cerebellum, which predicted susceptibility to later fear reinstatement. These results show that conditioned threats encountered in close proximity are more resistant to extinction learning and suggest that the canonical neural circuitry typically associated with fear learning requires additional consideration of a more reactive neural fear system to fully account for this effect.

Threat vs control: Potentiation of the trigeminal blink reflex by threat proximity is overruled by self-stimulation

The magnitude of the defensive blink reflex is modulated by continuous assessment of its protective value. Here, we studied whether the trigeminal blink reflex (TBR) is modulated by a potentially offensive object close to the face, and, if so, whether self-stimulation or observation of the act of stimulus triggering counteracts such modulation. In all, 26 healthy volunteers participated in various experimental conditions. At baseline, an experimenter triggered supraorbital nerve stimuli remotely, unseen by the participants; in experimental conditions, the experimenter held a stimulation probe close to the participant's face but triggered the stimuli either remotely, "surprising" participants (S₁ ), or directly on the probe, observed by participants (S₂ ). In other conditions, participants triggered stimuli themselves on the probe held next to their body (S₃ ) or held in front of their face (S₄ ). The latter condition was repeated similarly, but pressing the button only randomly generated electrical stimuli (S5, "Russian roulette"). The size of the R2 component of the TBR (TBR-R2) was the main outcome measure. Compared to baseline, TBR-R2 area was significantly larger in S₁ when the "threatening" probe was close to the face and the participant had no control over stimulation. Conversely, TBR-R2 was suppressed when participants either saw the action of triggering, thus being aware (S₂ ), or had full initiative over stimulation (S₃ , S₄ ). Random self-generated stimuli (S₅ ) inhibited TBR-R2, but to a lesser extent than S₃ and S_4. Perceived threat close to the face facilitates TBR-R2, but knowledge about impending stimulation or self-agency overrules this effect.

Consensus Paper: Cerebellum and Emotion

Over the past three decades, insights into the role of the cerebellum in emotional processing have substantially increased. Indeed, methodological refinements in cerebellar lesion studies and major technological advancements in the field of neuroscience are in particular responsible to an exponential growth of knowledge on the topic. It is timely to review the available data and to critically evaluate the current status of the role of the cerebellum in emotion and related domains. The main aim of this article is to present an overview of current facts and ongoing debates relating to clinical, neuroimaging, and neurophysiological findings on the role of the cerebellum in key aspects of emotion. Experts in the field of cerebellar research discuss the range of cerebellar contributions to emotion in nine topics. Topics include the role of the cerebellum in perception and recognition, forwarding and encoding of emotional information, and the experience and regulation of emotional states in relation to motor, cognitive, and social behaviors. In addition, perspectives including cerebellar involvement in emotional learning, pain, emotional aspects of speech, and neuropsychiatric aspects of the cerebellum in mood disorders are briefly discussed. Results of this consensus paper illustrate how theory and empirical research have converged to produce a composite picture of brain topography, physiology, and function that establishes the role of the cerebellum in many aspects of emotional processing.

HPA Axis Interactions with Behavioral Systems

Perhaps the most salient behaviors that individuals engage in involve the avoidance of aversive experiences and the pursuit of pleasurable experiences. Engagement in these behaviors is regulated to a significant extent by an individual's hormonal milieu. For example, glucocorticoid hormones are produced by the hypothalamic-pituitary-adrenocortical (HPA) axis, and influence most aspects of behavior. In turn, many behaviors can influence HPA axis activity. These bidirectional interactions not only coordinate an individual's physiological and behavioral states to each other, but can also tune them to environmental conditions thereby optimizing survival. The present review details the influence of the HPA axis on many types of behavior, including appetitively-motivated behaviors (e.g., food intake and drug use), aversively-motivated behaviors (e.g., anxiety-related and depressive-like) and cognitive behaviors (e.g., learning and memory). Conversely, the manuscript also describes how engaging in various behaviors influences HPA axis activity. Our current understanding of the neuronal and/or hormonal mechanisms that underlie these interactions is also summarized. © 2016 American Physiological Society. Compr Physiol 6:1897-1934, 2016.

Classical Conditioning and Modification of the Rabbit's (Oryctolagus Cuniculus) Unconditioned Nictitating Membrane Response

A fundamental tenet of behavior is that a reflex is automatic, unconscious, involuntary, and relatively invariant. However, we have discovered that a reflex can change dramatically as a function of classical conditioning, and this change can be demonstrated independently of the conditioned stimulus. We have termed this phenomenon conditioning-specific reflex modification (CRM). Although the behavioral laws and neural substrates of nonassociative reflex changes have been identified, the behavioral laws and neural substrates of CRM are only now being revealed. For example, CRM is similar to classical conditioning in that (a) it is a function of both the strength of conditioning and (b) the strength of the unconditioned stimulus, (c) it can be extinguished, and (d) it can be generalized from one unconditioned stimulus to another. Preliminary analysis suggests that CRM may have some features in common with post-traumatic stress disorder and may provide insights into treatment of the disorder.

The anatomy of fear learning in the cerebellum: A systematic meta-analysis

Recent neuro-imaging studies have implicated the cerebellum in several higher-order functions. Its role in human fear conditioning has, however, received limited attention. The current meta-analysis examines the loci of cerebellar contributions to fear conditioning in healthy subjects, thus mapping, for the first time, the neural response to conditioned aversive stimuli onto the cerebellum. By using the activation likelihood estimation (ALE) technique for analyses, we identified several distinct regions in the cerebellum that activate in response to the presentation of the conditioned stimulus: the cerebellar tonsils, lobules HIV-VI, and the culmen. These regions have separately been implicated in fear acquisition, consolidation of fear memories and expression of conditioned fear responses. Their specific role in these processes may be attributed to the general contribution of cerebellar cortical networks to timing and prediction. Our meta-analysis highlights the potential role of the cerebellum in human cognition and emotion in general, and addresses the possibility how deficits in associative cerebellar learning may play a role in the pathogenesis of anxiety disorders. Future studies are needed to further clarify the mechanistic role of the cerebellum in higher order functions and neuropsychiatric disorders.

Thalamocortical interactions underlying visual fear conditioning in humans

Despite a strong focus on the role of the amygdala in fear conditioning, recent works point to a more distributed network supporting fear conditioning. We aimed to elucidate interactions between subcortical and cortical regions in fear conditioning in humans. To do this, we used two fearful faces as conditioned stimuli (CS) and an electrical stimulation at the left hand, paired with one of the CS, as unconditioned stimulus (US). The luminance of the CS was rhythmically modulated leading to "entrainment" of brain oscillations at a predefined modulation frequency. Steady-state responses (SSR) were recorded by MEG. In addition to occipital regions, spectral analysis of SSR revealed increased power during fear conditioning particularly for thalamus and cerebellum contralateral to the upcoming US. Using thalamus and amygdala as seed-regions, directed functional connectivity was calculated to capture the modulation of interactions that underlie fear conditioning. Importantly, this analysis showed that the thalamus drives the fusiform area during fear conditioning, while amygdala captures the more general effect of fearful faces perception. This study confirms ideas from the animal literature, and demonstrates for the first time the central role of the thalamus in fear conditioning in humans.

Involvement of the human cerebellum in short-term and long-term habituation of the acoustic startle response: a serial PET study

OBJECTIVE

Numerous studies have shown an involvement of the human cerebellum in motor learning, but little is known about the role of the cerebellum in learning of unspecific aversive reactions. The present study sought to distinguish which areas of the human cerebellum and brain-stem are involved in short-term habituation (STH) and long-term habituation (LTH) of the acoustic startle response.

METHODS

On 5 consecutive days 42 acoustic startle stimuli were applied each day in 8 male healthy subjects. On the first and on the fifth day of the experiment [15O]H2O PET scans were performed.

RESULTS

Electromyographic recordings revealed a significant decrease of the startle response within each day (STH) and across the 5 days of the experiment (LTH). On both days a decrease of regional cerebral blood flow (rCBF) across PET scans was found in the medial cerebellum most probably reflecting reduced sensory feedback during STH. Between days an increase of rCBF in the dorsomedial pons, in the mesencephalon and in an area of the medial cerebellum was observed. These activations may reflect increased inhibition of the startle response during LTH and correspond to previous animal lesion studies. Furthermore, during LTH an increase of rCBF within the lateral cerebellum in lobule HVI/Crus I was detected.

CONCLUSIONS

These results suggest that distinct parts of the medial and lateral cerebellum are involved in habituation of the acoustic startle response. Lobule HVI/Crus I most likely plays a more general role in implicit learning processes considering its involvement in several conditioning paradigms.

SIGNIFICANCE

The results of the present study contribute to the understanding of cerebellar involvement in learning of unspecific aversive reactions.

The role of the human cerebellum in short- and long-term habituation of postural responses

The aim of the present study was to investigate the role of the human cerebellum in short-term (STH) and long-term habituation (LTH) of postural responses to repeated platform perturbations. Ten cerebellar patients and ten age- and sex-matched healthy controls participated. Twenty backward platform translations were applied on each of 5 consecutive days. Changes of postural response size within each day were assessed to determine STH and changes across days to determine LTH. Both controls and cerebellar patients showed a significant reduction of postural response size within each day (i.e. STH). No significant reduction of postural response size was observed across days (i.e. no LTH). Both controls and cerebellar patients, however, showed a tendency of response size to increase across days suggesting long-term sensitization. The amount of changes within and across days did not significantly differ between groups. The present findings suggest that changes of postural response size to repeated perturbations do not depend upon the integrity of the cerebellum.

Time-dependent neural activations related to recognition of people's names in emotional and neutral face-name associative learning:

Previous data have indicated that the left anterior temporal lobe contributes to the retrieval of familiar people's names, and that the extended network including the bilateral anterior temporal lobe plays an important role in the retrieval of newly learned people's names. However, there has been no direct evidence for time-dependent change in brain activation in face-name associations. In addition, previous studies have demonstrated that emotional information such as emotional faces may contribute to the organization of long-lasting episodic memory. In the present study, we investigated the activations related to the recognition of people's names in the context of emotional and neutral face-name associative learning. Before fMRI scanning, subjects learned face-name associations that included emotionally positive and neutral facial expressions. In immediate (5 min later) and delayed (2 weeks later) recognition with fMRI scanning, subjects were presented with studied faces with two names, and were asked to choose the correct associative name learned previously. Recognition-related activations were identified in the anterior part of bilateral temporal lobe for immediate recognition and only in the left temporal lobe for delayed recognition. Further analysis confirmed the time-dependent change in activation of the right anterior temporal lobe. Activation related to the processing of faces with positive expressions were observed in the left periamygdaloid area and temporal pole, although emotional information did not have an influence on task performance in this study. These findings suggest that the neural network involving the bilateral temporal lobe contributes to the retrieval of newly learned people's names, and that the left temporal lobe has a crucial and stable role in retrieval of people's names from faces, whereas the role of the right temporal lobe in retrieval of people's names may decrease with the time course.

Cerebellar responses evoked by nociceptive leg withdrawal reflex as revealed by event-related FMRI

The aim of the present study was to examine nociceptive leg withdrawal reflex-related areas in the human cerebellum using event-related functional brain imaging (fMRI). Knowledge about cerebellar areas involved in unconditioned limb withdrawal reflex control has some relevance in understanding data of limb withdrawal reflex conditioning studies. Sixteen healthy adult subjects participated. Nociceptive leg withdrawal reflexes were evoked by electrical stimulation of the left tibial nerve behind the medial malleolus. An event-related fMRI paradigm was applied with a total of 30 stimuli being delivered pseudorandomly during 500 consecutive MR scans. Surface electromyographic (EMG) recordings were performed from the left anterior tibial muscle. Only trials with significant reflex EMG activity were used as active events in fMRI statistical analysis. The specified contrasts compared the active event condition with rest. Leg withdrawal reflex-related areas were located within the vermis, paravermis, and lateral posterior cerebellar hemispheres bilaterally. Vermal and paravermal areas in lobules III/IV in the anterior lobe and in lobule VIII in the posterior lobe agree with the cerebellar representation of climbing and mossy fiber hindlimb afferents and voluntary leg movements. They are likely related to efferent modulation of the leg withdrawal reflex and/or sensory processing of afferent inputs from the reflex and/or the noxious stimulus. Additional activation within vermal lobule VI and hemispheral lobules VI/Crus I may be related to other pain-related processes (e.g., facial grimacing, fear, and startlelike reactions).

Involvement of the human cerebellum in fear-conditioned potentiation of the acoustic startle response: a PET study

Fear-conditioned potentiation of the startle response was used to study the role of the cerebellum in associative learning of non-specific aversive reactions in healthy human subjects using PET. Prior PET scanning initially neutral light stimuli were paired with painful electric shocks (fear-conditioning phase). Four PET-scans each were performed with presentation of acoustic startle stimuli (T), fear-conditioned light stimuli (L) or acoustic stimuli paired with light (LT, potentation phase). As a measure of fear-conditioning subtraction of condition T from LT revealed an increase of regional cerebellar blood flow (rCBF) in the left cerebellar hemisphere. Subtraction of condition L from LT, as a measure of fear-conditioned potentiation, revealed an increase of rCBF in the medial cerebellum. Different parts of the cerebellum appear to be involved in this form of motor associative learning.

Psychiatric consequences of vestibular dysfunction

Anxiety and dizziness are co-morbid symptoms in a larger percentage of patients than would be expected from chance alone. Such patients have an increased handicap and poorer prognosis. In this review, we discuss the interface between vestibular disorders and anxiety disorders. The two conditions are functionally related via both somatopsychic and psychosomatic mechanisms, and are linked via overlapping neural circuits that include monoaminergic pathways and the parabrachial nucleus network. An alternative conceptualization to the common notion of 'psychogenic' dizziness is presented. Implications for patient management are discussed.