Neural correlates of fear conditioning are associated with treatment-outcomes to behavioral exposure in spider phobia - Evidence from magnetoencephalography.

Animals Fear / physiology Magnetoencephalography Phobic Disorders / therapy Spiders Treatment Outcome
Anxiety disorders Exposure outcome Fear conditioning MEG/EEG Specific phobia Virtual reality exposure therapy

Journal

NeuroImage. Clinical
ISSN: 2213-1582
Titre abrégé: Neuroimage Clin
Pays: Netherlands
ID NLM: 101597070

Informations de publication

Date de publication:
2022
Historique:
received: 17 11 2021
revised: 09 05 2022
accepted: 11 05 2022
pubmed: 25 5 2022
medline: 25 8 2022
entrez: 24 5 2022
Statut: ppublish

Résumé

Models of anxiety disorders and the rationale of exposure therapy (ET) are grounded on classical fear conditioning. Yet, it is unclear whether lower fear ratings of conditioned safety versus threat cues and corresponding neural markers of safety-learning and/or fear inhibition assessed before treatment would predict better outcomes of behavioral exposure. Sixty-six patients with spider phobia completed pre-treatment clinical and experimental fear conditioning assessments, one session of virtual reality ET, a post-treatment clinical assessment, and a 6-month follow-up assessment. Tilted Gabor gratings served as conditioned stimuli (CS) that were either paired (CS+) or remained unpaired (CS-) with an aversive phobia-related and phobia-unrelated unconditioned stimulus (UCS). CS+/CS- differences in fear ratings and magnetoencephalographic event-related fields (ERFs) were related to percentual symptom reductions from pre- to post-treatment, as assessed via spider phobia questionnaire (SPQ), behavioral avoidance test (BAT), and remission status at 6-month follow-up. We observed no associations between pre-treatment CS+/CS- differences in fear ratings and any treatment outcome. CS+/CS- differences in source estimations of ERFs revealed that higher CS- activity in bilateral dorsolateral prefrontal cortex (dlPFC) was related with SPQ- and BAT-reductions. Associations between CS+/CS- differences and treatment outcomes were also observed in left ventromedial prefrontal cortex (vmPFC) regions, which additionally revealed associations with the follow-up remission status. Results provide initial evidence that neural pre-treatment CS+/CS- differences may hold predictive information regarding outcomes of behavioral exposure. Our findings highlight a key role of neural responses to safety cues with potentially inhibitory effects on affect-generating structures during fear conditioning.

Sections du résumé

BACKGROUND
Models of anxiety disorders and the rationale of exposure therapy (ET) are grounded on classical fear conditioning. Yet, it is unclear whether lower fear ratings of conditioned safety versus threat cues and corresponding neural markers of safety-learning and/or fear inhibition assessed before treatment would predict better outcomes of behavioral exposure.
METHODS
Sixty-six patients with spider phobia completed pre-treatment clinical and experimental fear conditioning assessments, one session of virtual reality ET, a post-treatment clinical assessment, and a 6-month follow-up assessment. Tilted Gabor gratings served as conditioned stimuli (CS) that were either paired (CS+) or remained unpaired (CS-) with an aversive phobia-related and phobia-unrelated unconditioned stimulus (UCS). CS+/CS- differences in fear ratings and magnetoencephalographic event-related fields (ERFs) were related to percentual symptom reductions from pre- to post-treatment, as assessed via spider phobia questionnaire (SPQ), behavioral avoidance test (BAT), and remission status at 6-month follow-up.
RESULTS
We observed no associations between pre-treatment CS+/CS- differences in fear ratings and any treatment outcome. CS+/CS- differences in source estimations of ERFs revealed that higher CS- activity in bilateral dorsolateral prefrontal cortex (dlPFC) was related with SPQ- and BAT-reductions. Associations between CS+/CS- differences and treatment outcomes were also observed in left ventromedial prefrontal cortex (vmPFC) regions, which additionally revealed associations with the follow-up remission status.
CONCLUSIONS
Results provide initial evidence that neural pre-treatment CS+/CS- differences may hold predictive information regarding outcomes of behavioral exposure. Our findings highlight a key role of neural responses to safety cues with potentially inhibitory effects on affect-generating structures during fear conditioning.

Identifiants

DOI: 10.1016/j.nicl.2022.103046 PMID: 35609411 PMC: PMC9125677
pubmed: 35609411
pii: S2213-1582(22)00111-5
doi: 10.1016/j.nicl.2022.103046
pmc: PMC9125677
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

103046

Informations de copyright

Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Kati Roesmann (K)

Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany; Institute for Clinical Psychology and Psychotherapy, University of Siegen, Germany. Electronic address: Kati.Roesmann@uni-siegen.de.

Julius Toelle (J)

Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany.

Elisabeth Johanna Leehr (EJ)

Institute for Translational Psychiatry, University of Münster, Germany.

Ida Wessing (I)

Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany; Department of Child and Adolescent Psychiatry, University of Münster, Germany.

Joscha Böhnlein (J)

Institute for Translational Psychiatry, University of Münster, Germany.

Fabian Seeger (F)

Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany; Department of General Psychiatry, University of Heidelberg, Germany.

Hanna Schwarzmeier (H)

Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany.

Niklas Siminski (N)

Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany.

Martin J Herrmann (MJ)

Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany.

Udo Dannlowski (U)

Institute for Translational Psychiatry, University of Münster, Germany.

Ulrike Lueken (U)

Center for Mental Health, Department of Psychiatry, Psychosomatics, and Psychotherapy, University Hospital of Würzburg, Germany; Department of Psychology, Humboldt-Universität zu Berlin, Germany.

Tim Klucken (T)

Institute for Clinical Psychology and Psychotherapy, University of Siegen, Germany.

Thomas Straube (T)

Institute of Medical Psychology and Systems Neuroscience, University of Münster, Germany.

Markus Junghöfer (M)

Institute for Biomagnetism and Biosignalanalysis, University of Münster, Germany.

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Classifications MeSH

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questionsmedicales.fr › Techniques d'investigation › Magnétométrie › Magnétoencéphalographie › Neural correlates of fear conditioning are...
questionsmedicales.fr › Troubles mentaux › Troubles anxieux › Troubles phobiques › Neural correlates of fear conditioning are...
questionsmedicales.fr › Eucaryotes › Animaux › Invertébrés › Arthropodes › Arachnida › Araignées › Neural correlates of fear conditioning are...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Qualité des soins de santé › Mécanismes d'évaluation des soins de santé › Évaluation des résultats et des processus en soins de santé › Évaluation de résultat (soins) › Résultat thérapeutique › Neural correlates of fear conditioning are...