Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia.
Psychol Med
; 44(2): 381-94, 2014 Jan.
Article
em En
| MEDLINE
| ID: mdl-23611156
ABSTRACT
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.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transtorno de Pânico
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Condicionamento Psicológico
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Agorafobia
/
Medo
Tipo de estudo:
Clinical_trials
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Psychol Med
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Alemanha