Temporal dynamics of fMRI signal changes during conditioned interoceptive pain-related fear and safety acquisition and extinction

Associative learning and memory mechanisms drive interoceptive signaling along the gut-brain axis, thus shaping affective-emotional reactions and behavior. Specifically, learning to predict potentially harmful, visceral pain is assumed to succeed within very few trials. However, the temporal dynamics of cerebellar and cerebral fMRI signal changes underlying early acquisition and extinction of learned fear signals and the concomitant evolvement of safety learning remain incompletely understood. 3T fMRI data of healthy individuals from three studies were uniformly processed across the whole brain and the cerebellum including an advanced normalizing method of the cerebellum. All studies employed differential delay conditioning (N=94) with one visual cue (CS⁺) being repeatedly paired with visceral pain as unconditioned stimulus (US) while a second cue remained unpaired (CS^-). During subsequent extinction (N=51), all CS were presented without US. Behavioral results revealed increased CS⁺-aversiveness and CS^--pleasantness after conditioning and diminished valence ratings for both CS following extinction. During early acquisition, the CS^- induced linearly increasing neural activation in the insula, midcingulate cortex, hippocampus, precuneus as well as cerebral and cerebellar somatomotor regions. The comparison between acquisition and extinction phases yielded a CS^--induced linear increase in the posterior cingulate cortex and precuneus during early acquisition, while there was no evidence for linear fMRI signal changes for the CS⁺ during acquisition and for both CS during extinction. Based on theoretical accounts of discrimination and temporal difference learning, these results suggest a gradual evolvement of learned safety cues that engage emotional arousal, memory, and cortical modulatory networks. As safety signals are presumably more difficult to learn and to discriminate from learned threat cues, the underlying temporal dynamics may reflect enhanced salience and prediction processing as well as increasing demands for attentional resources and the integration of multisensory information. Maladaptive responses to learned safety signals are a clinically relevant phenotype in multiple conditions, including chronic visceral pain, and can be exceptionally resistant to modification or extinction. Through sustained hypervigilance, safety seeking constitutes one key component in pain and stress-related avoidance behavior, calling for future studies targeting the mechanisms of safety learning and extinction to advance current cognitive-behavioral treatment approaches.

Psychophysiological evidence for fear extinction learning via mental imagery

Imagery-based extinction procedures have long been used in the treatments of fear-related conditions. The assumption is that imagery can substitute for the perceptual stimuli in the extinction process. Yet, experimental validations of this assumption have been limited in number and some have relied exclusively on measures of autonomic reactivity without consideration of conscious feelings of fear. The current investigation sought to assess whether imagery-based exposure could lead to extinction of conditioned fear to the corresponding perceptual stimulus. Conditioned fear responses were measured by both a physiological (i.e., skin conductance response [SCR]) and a subjective (i.e., self-reported fear) measure. Participants (N = 56) first underwent perceptual differential fear conditioning, then imagery extinction, then perceptual extinction. SCR evidence was found for successful fear conditioning, generalization of fear from viewing to imagery, and most importantly, the absence of differential fear after imagery extinction upon re-exposure to the conditioned perceptual stimulus. Self-reported fear confirmed the acquisition and generalization of fear and provided evidence of a significant reduction in differential fear conditioning across extinction. Consistent with clinical evidence of the efficacy of imagery extinction and the existing limited experimental literature, this study offers support for fear extinction to perceptual stimuli via imagery exposure.

Complete the triangulation: Quantifying differential fear conditioning with a noninterfering and sensitive behavioral measure along with self-report and physiological measures

According to the multicomponent view, emotion is expressed through subjective feelings and thoughts, physiological activation, and behavioral responses. In human fear conditioning research, the former two are much more popular than the third category. One concern is that concurrent behavioral probes may interfere with the conditioning process. To allow triangulation of emotion research through simultaneous employment of subjective, physiological, and behavioral measurement, it is necessary to find behavioral measures that meet the criteria of causing no interference while being sensitive to conditioning. In this study, a basic visual attention task was examined in terms of its impact on differential fear conditioning as measured by both subjective (i.e., self-reported fear and shock estimation) and physiological (i.e., skin conductance response/SCR) expression; and its ability to detect fear conditioning indicated by a reaction time (RT) or accuracy difference between the two conditioned stimuli (CS+ vs. CS-). While participants in the probe group (n = 86) completed differential fear conditioning with the behavioral task, those in the no-probe group (n = 76) underwent conditioning by itself. Based on self-reported fear, shock estimation, and SCR, both groups successfully acquired differential fear with no apparent between-group difference in the degree of conditioning. In the probe group, RT but not accuracy exhibited a difference between CS+ and CS-. These findings suggest that the selected visual attention task does not interfere with differential fear conditioning measured via SCR and self-report and is a sensitive measure of differential conditioning. Exploratory individual analyses also revealed significant relationships between the above measures.

A Central Amygdala CRF Circuit Facilitates Learning about Weak Threats

Fear is a graded central motive state ranging from mild to intense. As threat intensity increases, fear transitions from discriminative to generalized. The circuit mechanisms that process threats of different intensity are not well resolved. Here, we isolate a unique population of locally projecting neurons in the central nucleus of the amygdala (CeA) that produce the neuropeptide corticotropin-releasing factor (CRF). CRF-producing neurons and CRF in the CeA are required for discriminative fear, but both are dispensable for generalized fear at high US intensities. Consistent with a role in discriminative fear, CRF neurons undergo plasticity following threat conditioning and selectively respond to threat-predictive cues. We further show that excitability of genetically isolated CRF-receptive (CRFR1) neurons in the CeA is potently enhanced by CRF and that CRFR1 signaling in the CeA is critical for discriminative fear. These findings demonstrate a novel CRF gain-control circuit and show separable pathways for graded fear processing.

Enhanced discriminative fear learning of phobia-irrelevant stimuli in spider-fearful individuals

Avoidance is considered as a central hallmark of all anxiety disorders. The acquisition and expression of avoidance, which leads to the maintenance and exacerbation of pathological fear is closely linked to Pavlovian and operant conditioning processes. Changes in conditionability might represent a key feature of all anxiety disorders but the exact nature of these alterations might vary across different disorders. To date, no information is available on specific changes in conditionability for disorder-irrelevant stimuli in specific phobia (SP). The first aim of this study was to investigate changes in fear acquisition and extinction in spider-fearful individuals as compared to non-fearful participants by using the de novo fear conditioning paradigm. Secondly, we aimed to determine whether differences in the magnitude of context-dependent fear retrieval exist between spider-fearful and non-fearful individuals. Our findings point to an enhanced fear discrimination in spider-fearful individuals as compared to non-fearful individuals at both the physiological and subjective level. The enhanced fear discrimination in spider-fearful individuals was neither mediated by increased state anxiety, depression, nor stress tension. Spider-fearful individuals displayed no changes in extinction learning and/or fear retrieval. Surprisingly, we found no evidence for context-dependent modulation of fear retrieval in either group. Here, we provide first evidence that spider-fearful individuals show an enhanced discriminative fear learning of phobia-irrelevant (de novo) stimuli. Our findings provide novel insights into the role of fear acquisition and expression for the development and maintenance of maladaptive responses in the course of SP.

Luminance, but not chromatic visual pathways, mediate amplification of conditioned danger signals in human visual cortex

Complex organisms rely on experience to optimize the function of perceptual and motor systems in situations relevant to survival. It is well established that visual cues reliably paired with danger are processed more efficiently than neutral cues, and that such facilitated sensory processing extends to low levels of the visual system. The neurophysiological mechanisms mediating biased sensory processing, however, are not well understood. Here we used grating stimuli specifically designed to engage luminance or chromatic pathways of the human visual system in a differential classical conditioning paradigm. Behavioral ratings and visual electroencephalographic steady-state potentials were recorded in healthy human participants. Our findings indicate that the visuocortical response to high-spatial-frequency isoluminant (red-green) grating stimuli was not modulated by fear conditioning, but low-contrast, low-spatial-frequency reversal of grayscale gratings resulted in pronounced conditioning effects. We conclude that sensory input conducted via the chromatic pathways into retinotopic visual cortex has limited access to the bi-directional connectivity with brain networks mediating the acquisition and expression of fear, such as the amygdaloid complex. Conversely, luminance information is necessary to establish amplification of learned danger signals in hierarchically early regions of the visual system.

Inactivation of the medial prefrontal cortex interferes with the expression but not the acquisition of differential fear conditioning in rats

The medial prefrontal cortex (mPFC) has been implicated in the processing of emotionally significant stimuli, particularly the inhibition of inappropriate responses. We examined the role of the mPFC in regulation of fear responses using a differential fear conditioning procedure in which the excitatory conditioned stimulus (CS+) was paired with an aversive footshock and intermixed with the inhibitory conditioned stimulus (CS-). In the first experiment, using rats as subjects, muscimol, a gamma-amino-butyric acid type A (GABAA) receptor agonist, or artificial cerebrospinal fluid (aCSF) was infused intracranially into the mPFC across three conditioning sessions. Twenty-four hours after the last conditioning session, freezing response of the rats was tested in a drug-free state. Neither the muscimol nor the aCSF infusion had any effect on differential responding. In the second experiment, the same experimental procedure was used except that the infusion was made before the testing session rather than the conditioning sessions. The results showed that muscimol infusion impaired differential responding: the level of freezing to CS- was indiscriminable from that to CS+. Taken together, these results suggest that the mPFC is responsible for the regulation of fear response by inhibiting inappropriate fear expressions.