Avoidant symptoms in PTSD predict fear circuit activation during multimodal fear extinction.
Avoidant symptoms in PTSD predict fear circuit activation during multimodal fear extinction.
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DOI：
10.3389/fnhum.2013.00672
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发表时间：
2013
影响因子：
2.9
通讯作者：
Liberzon I
中科院分区：
文献类型：
--
作者：
Sripada RK;Garfinkel SN;Liberzon I
一致的证据表明，创伤后应激障碍(PTSD)患者在巴甫洛尼亚恐惧条件反射中表现出夸大的回避行为和异常。然而，这种疾病的两个特征之间的联系还没有被很好地理解。为了探讨创伤后应激障碍患者异常消退学习的脑基础，我们实施了多模式经典恐惧条件/消退范式，在参与者接受fMRI扫描的同时，该范式结合了来自两个感觉通道(视觉和触觉)的情感相关信息。样本包括15名患有创伤后应激障碍的OEF/OIF退伍军人。作为对条件性线索和背景信息的反应，在恐惧获得和恐惧消退期间，更多的回避症状与杏仁核、海马体、vmPFC、dmPFC和脑岛的更大激活有关。患有更严重创伤后应激障碍的个体对先前条件刺激的高度反应可能表明安全学习不足，这与创伤后应激障碍症状学一致。回避症状和恐惧回路激活之间的密切联系表明，这一症状群可能是创伤后应激障碍中恐惧消退缺陷的关键组成部分，和/或可能特别容易通过基于消退的治疗来改变。
Convergent evidence suggests that individuals with posttraumatic stress disorder (PTSD) exhibit exaggerated avoidance behaviors as well as abnormalities in Pavlonian fear conditioning. However, the link between the two features of this disorder is not well understood. In order to probe the brain basis of aberrant extinction learning in PTSD, we administered a multimodal classical fear conditioning/extinction paradigm that incorporated affectively relevant information from two sensory channels (visual and tactile) while participants underwent fMRI scanning. The sample consisted of fifteen OEF/OIF veterans with PTSD. In response to conditioned cues and contextual information, greater avoidance symptomatology was associated with greater activation in amygdala, hippocampus, vmPFC, dmPFC, and insula, during both fear acquisition and fear extinction. Heightened responses to previously conditioned stimuli in individuals with more severe PTSD could indicate a deficiency in safety learning, consistent with PTSD symptomatology. The close link between avoidance symptoms and fear circuit activation suggests that this symptom cluster may be a key component of fear extinction deficits in PTSD and/or may be particularly amenable to change through extinction-based therapies.
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