Background: Although several neurophysiological models have been proposed for panic disorder with agoraphobia (PD/AG), there is limited evidence from functional magnetic resonance imaging (fMRI) studies on key neural networks in PD/AG. Fear conditioning has been proposed to represent a central pathway for the development and maintenance of this disorder; however, its neural substrates remain elusive. The present study aimed to investigate the neural correlates of fear conditioning in PD/AG patients.
Method: The blood oxygen level-dependent (BOLD) response was measured using fMRI during a fear conditioning task. Indicators of differential conditioning, simple conditioning and safety signal processing were investigated in 60 PD/AG patients and 60 matched healthy controls.
Results: Differential conditioning was associated with enhanced activation of the bilateral dorsal inferior frontal gyrus (IFG) whereas simple conditioning and safety signal processing were related to increased midbrain activation in PD/AG patients versus controls. Anxiety sensitivity was associated positively with the magnitude of midbrain activation.
Conclusions: The results suggest changes in top-down and bottom-up processes during fear conditioning in PD/AG that can be interpreted within a neural framework of defensive reactions mediating threat through distal (forebrain) versus proximal (midbrain) brain structures. Evidence is accumulating that this network plays a key role in the aetiopathogenesis of panic disorder.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:39007 |
| Date | 11 June 2020 |
| Creators | Lueken, U., Straube, B., Reinhardt, I., Maslowski, N. I., Wittchen, H.-U., Ströhle, A., Wittmann, A., Pfleiderer, B., Konrad, C., Ewert, A., Uhlmann, C., Arolt, V., Jansen, A., Kircher, T. |
| Publisher | Cambridge University Press |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 0033-2917, 1469-8978, 10.1017/S0033291713000792, info:eu-repo/grantAgreement/Ministerium für Bildung und Forschung/BMBF-Psychotherapie/01GV0611/ |
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