SPIDER OR NO SPIDER? NEURAL CORRELATES OF SUSTAINED AND PHASIC FEAR IN SPIDER PHOBIA

Background Processes of phasic fear responses to threatening stimuli are thought to be distinct from sustained, anticipatory anxiety toward an unpredicted, potential threat. There is evidence for dissociable neural correlates of phasic fear and sustained anxiety. Whereas increased amygdala activity...

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Bibliographic Details
Published in:Depression and anxiety 2015-09, Vol.32 (9), p.656-663
Main Authors: Münsterkötter, Anna Luisa, Notzon, Swantje, Redlich, Ronny, Grotegerd, Dominik, Dohm, Katharina, Arolt, Volker, Kugel, Harald, Zwanzger, Peter, Dannlowski, Udo
Format: Article
Language:English
Subjects:
Adult
Amygdala - physiopathology
Animals
anticipatory anxiety
Anxiety
Anxiety - etiology
Anxiety - physiopathology
Anxiety - psychology
Anxiety Disorders - physiopathology
Araneae
Brain - physiopathology
Cerebral Cortex - physiopathology
Fear
Fear & phobias
fear network
Female
fMRI
Gyrus Cinguli - physiopathology
Humans
Magnetic Resonance Imaging
Male
neural correlates
NMR
Nuclear magnetic resonance
phobia
Phobic Disorders - physiopathology
Spiders
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Summary:Background Processes of phasic fear responses to threatening stimuli are thought to be distinct from sustained, anticipatory anxiety toward an unpredicted, potential threat. There is evidence for dissociable neural correlates of phasic fear and sustained anxiety. Whereas increased amygdala activity has been associated with phasic fear, sustained anxiety has been linked with activation of the bed nucleus of stria terminalis (BNST), anterior cingulate cortex (ACC), and the insula. So far, only a few studies have focused on the dissociation of neural processes related to both phasic and sustained fear in specific phobia. We suggested that first, conditions of phasic and sustained fear would involve different neural networks and, second, that overall neural activity would be enhanced in a sample of phobic compared to nonphobic participants. Methods Pictures of spiders and neutral stimuli under conditions of either predicted (phasic) or unpredicted (sustained) fear were presented to 28 subjects with spider phobia and 28 nonphobic control subjects during functional magnetic resonance imaging (fMRI) scanning. Results Phobic patients revealed significantly higher amygdala activation than controls under conditions of phasic fear. Sustained fear processing was significantly related to activation in the insula and ACC, and phobic patients showed a stronger activation than controls of the BNST and the right ACC under conditions of sustained fear. Functional connectivity analysis revealed enhanced connectivity of the BNST and the amygdala in phobic subjects. Conclusions Our findings support the idea of distinct neural correlates of phasic and sustained fear processes. Increased neural activity and functional connectivity in these networks might be crucial for the development and maintenance of anxiety disorders.
ISSN:1091-4269
1520-6394
DOI:10.1002/da.22382