Neural Mechanisms of Fear Extinction Across Anxiety Disorders

描述(由申请者提供)：焦虑症的特征是夸大和顽固的恐惧反应，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、腹内侧额前皮质、背侧前扣带回和海马体。重要的是，这些大脑区域参与了恐惧的学习、表达和随后的消亡。这种恐惧消退网络的功能在创伤后应激障碍中受到损害，在从头开始的恐惧消退的背景下。这种恐惧消退网络的功能是否也在其他焦虑中受损 精神障碍？如果是，功能障碍是否等同于所有的障碍，或者在恐惧消退的背景下，是否存在一种独特的功能障碍模式，这可以帮助区分OE障碍与另一种障碍？这项申请中提出的研究将使用最先进的神经成像工具、心理生理学工具和经过充分验证的两天恐惧条件反射和消退范式来开始回答上述问题。具体地说，在3T功能磁共振扫描仪中，被诊断为社交焦虑症(SAD)、广泛性焦虑症(GAD)、特定恐惧症(SP)和恐慌症(PD)的患者将接受恐惧条件反射和消退范式。以前从创伤后应激障碍(PTSD)、强迫症(OCD)和一大批健康对照中获得的数据将被用来比较焦虑障碍，以汇编一个大型数据矩阵。这个矩阵将被用来进行联合分析，以检验关于恐惧消退网络功能障碍的障碍之间的共性和差异。这些数据可能导致在一个单一范式的背景下更好地理解焦虑症的精神病理学。

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.