Neural Mechanisms of Fear Extinction Across Anxiety Disorders

描述（由申请人提供）：焦虑障碍的特征是夸大和持续的恐惧反应，以前的特征是在一些大脑区域表现出功能障碍。这些脑区包括杏仁核、腹内侧前额皮质、前扣带背和海马体。重要的是，这些大脑区域涉及恐惧的学习、表达和随后的消失。在创伤后应激障碍中，这种恐惧消退网络的功能在新生恐惧消退中受损。这种恐惧消除网络的功能是否也在其他焦虑中受损

DESCRIPTION (provided by applicant): Anxiety disorders are characterized by exaggerated and perserverant fear responses and have been previously characterized to show functional impairment in a number of brain regions. These brain regions include the amygdala, ventromedial prefrontal cortex, dorsal anterior cingulate, and the hippocampus. Importantly, these brain regions are involved in fear learning, its expression, and its subsequent extinction. The function of this fear extinction network is impaired in PTSD within the context of de novo fear extinction. Is the function of this fear extinction network also impaired in the other anxiety disorders? If yes, is the functional impairment equivalent across all the disorders or is there a distinct pattern of dysfunction within the context of fear extinction that could help distinguish oe disorder from another? The research proposed in this application will employ state- of-the-art neuroimaging tools, psychophysiological tools, and a well-validated two- day fear conditioning and extinction paradigm to begin to answer the above stated questions. Specifically, patients diagnosed with social anxiety disorder (SAD), generalized anxiety disorders (GAD), specific phobia (SP), and panic disorder (PD) will undergo the fear conditioning and extinction paradigm while in a 3T fMRI scanner. Previously acquired data from posttraumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), and a large cohort of healthy controls will be used to compare across the anxiety disorders to compile a large matrix of data. This matrix will be used to conduct a conjunction analysis to examine the commonalities and differences between disorders regarding the dysfunction of the fear extinction network. These data could lead to better understanding of the psychopathology of the anxiety disorders within the context of one single paradigm.