Neuroimaging in specific phobia disorder: a systematic review of the literature

Linares, Ila Marques Porto; Trzesniak, Clarissa; Chagas, Marcos Hortes Nisihara; Hallak, Jaime Eduardo Cecílio; Nardi, Antônio Egídio; Crippa, José Alexandre de Souza

doi:10.1590/s1516-44462012000100017

Cited by 28 publications

(16 citation statements)

References 70 publications

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“…Consistent with prior imaging studies of Specific Phobia [Del Casale et al, 2012;Linares et al, 2012], we expected both masked and visible exposure to spiders-VBE and CVE-to activate regions supporting subcortical fear (e.g., amygdala) and visual systems more strongly in phobic than in control participants. Because VBE involves focusing intently on repeated trains of masked phobic stimuli, we expected it to activate regions supporting attention (e.g., dorsolateral prefrontal cortex) in phobic versus control participants.…”

Section: Introductionsupporting

confidence: 78%

Less is more: Neural activity during very brief and clearly visible exposure to phobic stimuli

Siegel

Warren

Wang

et al. 2017

Human Brain Mapping

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Research on automatic processes in emotion has focused almost exclusively on the provocation of fear responses. We have shown, in contrast, that the repeated presentation of masked feared images reduces avoidance of a live tarantula by spider-phobic participants. We investigated the neural basis for these adaptive effects of masked exposure. We identified 21 spider-phobic and 21 control participants using a psychiatric interview, fear questionnaire, and approach behavior towards a live tarantula. They received each of three conditions: (1) very brief exposure (VBE) to masked images of spiders; (2) clearly visible exposure (CVE) to spiders; and (3) masked images of flowers (control). Only VBE to masked spiders generated neural activity more strongly in phobic than in control participants, within subcortical fear, attention, higher-order language, and vision systems. Counter-intuitively, CVE to the same spiders generated stronger neural activity in control rather than phobic participants within these and other systems. VBE activated regions that support fear processing in phobic participants without causing them to experience fear consciously. CVE, by contrast, deactivated regions supporting fear regulation and caused phobic participants to experience fear. Activations by CVE to spiders correlated with fear ratings - explicit fear. Activations by VBE to masked spiders correlated with color-naming interference of spider words – implicit fear. These multiple dissociations between the effects of VBE and CVE to spiders suggest that limiting awareness of exposure to phobic stimuli through visual masking paradoxically facilitates their processing, while simultaneously minimizing the experience of fear.

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Section: Introductionsupporting

confidence: 78%

Less is more: Neural activity during very brief and clearly visible exposure to phobic stimuli

Siegel

Warren

Wang

et al. 2017

Human Brain Mapping

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“…14,19,20 Such findings, which are similar to those observed in functional neuroimaging studies of phobic patients treated with antidepressants, 22,23 could support the efficacy of CBT in the treatment of phobias. 6,[12][13][14][15][16][17][18][19][20][21] Moreover, recent studies have observed that functional brain imaging may detect biomarkers that substantially improve predictions for the success of cognitive-behavioral interventions, suggesting that such biomarkers could offer personalized approaches for optimally selecting among treatment options for a patient. 24 Finally, a number of important limitations need to be considered, such as the reduced number of studies found in the literature and their small sample size.…”

Section: Discussionmentioning

confidence: 99%

“…[12][13][14][15][16][17][18][19][20][21] Further complementary and longitudinal studies with larger and homogeneous samples, comparing different functional neuroimaging techniques in the same sample, are needed to better understand the underlying pathogenesis of phobic disorders and the efficacy of CBT in this context. 6 …”

Section: Discussionmentioning

confidence: 99%

“…Fear and avoidance cause significant distress and/or impairment in occupational, academic, or social functioning. 4,5 SP and SAD appear to alter different neural circuits, 6 and data from neuroimaging studies and clinical trials suggest that pharmacotherapy and cognitive-behavioral therapy (CBT) have positive effects on SAD. In SP, CBT may be one of the few useful interventions.…”

Section: Introductionmentioning

confidence: 99%

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The impacts of cognitive-behavioral therapy on the treatment of phobic disorders measured by functional neuroimaging techniques: a systematic review

Almeida

Filho

Berberian

et al. 2013

Rev. Bras. Psiquiatr.

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Objective: Functional neuroimaging techniques represent fundamental tools in the context of translational research integrating neurobiology, psychopathology, neuropsychology, and therapeutics. In addition, cognitive-behavioral therapy (CBT) has proven its efficacy in the treatment of anxiety disorders and may be useful in phobias. The literature has shown that feelings and behaviors are mediated by specific brain circuits, and changes in patterns of interaction should be associated with cerebral alterations. Based on these concepts, a systematic review was conducted aiming to evaluate the impact of CBT on phobic disorders measured by functional neuroimaging techniques. Methods: A systematic review of the literature was conducted including studies published between January 1980 and April 2012. Studies written in English, Spanish or Portuguese evaluating changes in the pattern of functional neuroimaging before and after CBT in patients with phobic disorders were included. Results: The initial search strategy retrieved 45 studies. Six of these studies met all inclusion criteria. Significant deactivations in the amygdala, insula, thalamus and hippocampus, as well as activation of the medial orbitofrontal cortex, were observed after CBT in phobic patients when compared with controls. Conclusion: In spite of their technical limitations, neuroimaging techniques provide neurobiological support for the efficacy of CBT in the treatment of phobic disorders. Further studies are needed to confirm this conclusion.

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“…A fobia específica é o tipo de fobia mais comum na população em geral [1], [2]. Dentro da fobia específica relacionada a estímulos animais, existe a fobia de aranhas ou aracnofobia, que é um dos medos mais comuns em diferentes níveis [7].…”

Section: Introductionunclassified

Desafios Para Avaliação Da Atividade Cortical Em Indivíduos Com Sintomas De Aracnofobia

Santana¹,

Viana²,

Soares³

2018

Anais Do v Congresso Brasileiro De Eletromiografia E Cinesiologia E X Simpósio De Engenharia Biomédica

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Resumo: O artigo apresenta um estudo piloto para avaliação dos padrões corticais de indivíduos com alto grau de fobia a aranhas, por meio de eletroencefalografia além de uma análise acerca dos diversos desafios a serem enfrentados nesse tipo de estudo. Após a aplicação de um questionário, os indivíduos foram avaliados por um psicólogo, que definiu aqueles que apresentavam indícios de ansiedade em relação a aranhas. Estes indivíduos foram expostos à um experimento onde foram apresentadas imagens de aranhas e imagens classificadas como neutras com o objetivo de verificar se existia diferença significativa entre os dois tipos de imagens apresentadas. Os padrões corticais foram avaliados comparando-se a atividade durante a exposição à imagens neutras e durante à exposição à imagens contendo aranhas. Os resultados mostram que não houveram diferenças significativas e, portanto, dentro dos limites do atual estudo, ainda não foi possível confirmar a possibilidade de verificar distinções fortes nos padrões corticais. Palavras IntroduçãoFobia pode ser compreendida como um medo extremo e pode estar associada a diversos fatores, como aversão por lugares fechados, altura, animais ou até mesmo a pessoas. Portanto, é possível classificar as fobias em três grupos relacionados a desordem de ansiedade [1]: 1) fobias específicas: objetos ou situações que podem fazer com que um indivíduo desenvolva transtornos de ansiedade e que pode resultar em ataques de pânico; 2) agorafobia: basicamente é o medo de ter medo, ou seja, situações fora de sua familiaridade ou não confortáveis podem ocasionar nesta perturbação antecipatória e; 3) fobia social: caracteriza o transtorno gerado pelo medo do julgamento realizado por outras pessoas.Além de se classificar a fobia específica como uma subárea das fobias, é possível aumentar ainda mais sua granularidade e isso se fará necessário para identificar o objeto de estudo deste trabalho [1]. Assim, dentro da fobia específica é possível definir o que a estimula: a) animal: aranhas, insetos, etc., b) ambiente natural: altura, tempestades, etc., c) lesões relacionadas a sangue (bloodinjection-injury): classificadas em: c.1) medo de sangue; c.2) medo de injeções e transfusões; c.3) medo de cuidados médicos e; c.4) medo de lesões, d) situacional: aviões, elevadores, etc., e) outros: medo de fantasias, palhaços ou sons altos.A fobia específica é o tipo de fobia mais comum na população em geral [1], [2]. Dentro da fobia específica relacionada a estímulos animais, existe a fobia de aranhas ou aracnofobia, que é um dos medos mais comuns em diferentes níveis [7]. A aracnofobia é caracterizada pelo medo da exposição de aranhas ou até mesmo evitando lugares e ambientes onde esse aracnídeo pode existir.Uma das técnicas utilizadas para mensurar o que pode impactar em modificações comportamentais no cérebro como a fobia, é o Eletroencefalograma (EEG). O mesmo é utilizado como ferramenta para visualização da atividade gerada pelo córtex cerebral através da voltagem gerada pelas correntes que fluem devido estímulos...

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Neuroimaging in specific phobia disorder: a systematic review of the literature

Cited by 28 publications

References 70 publications

Less is more: Neural activity during very brief and clearly visible exposure to phobic stimuli

Less is more: Neural activity during very brief and clearly visible exposure to phobic stimuli

The impacts of cognitive-behavioral therapy on the treatment of phobic disorders measured by functional neuroimaging techniques: a systematic review

Desafios Para Avaliação Da Atividade Cortical Em Indivíduos Com Sintomas De Aracnofobia

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