Fear conditioning in panic disorder: Enhanced resistance to extinction.

Acquisition and extinction of fear responses conditioned to a visual stimulus were examined in rats with ablations of visual cortex. Visual cortex lesions did not interfere with acquisition, indicating that visual fear conditioning, like auditory fear conditioning, is mediated by sub-cortical, probably thalamo-amygdala, sensory pathways. In contrast to acquisition, extinction was greatly prolonged, if not prevented, by cortical ablation. This resistance to extinction of sub cortical emotional memories may explain certain aspects of emotional memory in man.

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P.4.b.001 Neural correlates of fear conditioning in panic disorder with agoraphobia

European Neuropsychopharmacology ◽

10.1016/s0924-977x(12)70569-2 ◽

2012 ◽

Vol 22 ◽

pp. S367

Author(s):

U. Lueken ◽

B. Straube ◽

A. Jansen ◽

N.I. Maslowski ◽

A. Strohle ◽

...

Keyword(s):

Panic Disorder ◽

Fear Conditioning ◽

Neural Correlates

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P.4.a.003 Association between neural correlates of fear conditioning and therapy response in patients with panic disorder and agoraphobia

European Neuropsychopharmacology ◽

10.1016/s0924-977x(11)70857-4 ◽

2011 ◽

Vol 21 ◽

pp. S527

Author(s):

U. Lueken ◽

H.U. Wittchen ◽

C. Konrad ◽

B. Straube ◽

A. Wittmann ◽

...

Keyword(s):

Panic Disorder ◽

Fear Conditioning ◽

Therapy Response ◽

Neural Correlates

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Effect of Cognitive-Behavioral Therapy on Neural Correlates of Fear Conditioning in Panic Disorder

Biological Psychiatry ◽

10.1016/j.biopsych.2012.07.026 ◽

2013 ◽

Vol 73 (1) ◽

pp. 93-101 ◽

Cited By ~ 96

Author(s):

Tilo Kircher ◽

Volker Arolt ◽

Andreas Jansen ◽

Martin Pyka ◽

Isabelle Reinhardt ◽

...

Keyword(s):

Panic Disorder ◽

Cognitive Behavioral Therapy ◽

Fear Conditioning ◽

Behavioral Therapy ◽

Neural Correlates ◽

Cognitive Behavioral

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Altered top-down and bottom-up processing of fear conditioning in panic disorder with agoraphobia

Psychological Medicine ◽

10.1017/s0033291713000792 ◽

2013 ◽

Vol 44 (2) ◽

pp. 381-394 ◽

Cited By ~ 34

Author(s):

U. Lueken ◽

B. Straube ◽

I. Reinhardt ◽

N. I. Maslowski ◽

H.-U. Wittchen ◽

...

Keyword(s):

Signal Processing ◽

Panic Disorder ◽

Fear Conditioning ◽

Differential Conditioning ◽

Inferior Frontal Gyrus ◽

Brain Structures ◽

Safety Signal ◽

Top Down ◽

Bottom Up ◽

Simple Conditioning

BackgroundAlthough 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.MethodThe 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.ResultsDifferential 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.ConclusionsThe 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.

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