Neural response patterns in spider, blood-injection-injury and social fearful individuals: new insights from a simultaneous EEG/ECG–fMRI study

Abstract

In the present simultaneous EEG/ECG-fMRI study we compared the temporal and spatial characteristics of the brain responses and the cardiac activity during fear picture processing between spider, blood-injection-injury (BII) and social fearful as well as healthy (non-fearful) volunteers. All participants were presented with two neutral and six fear-related blocks of pictures: two social, two spider and two blood/injection fear blocks. In a social fear block neutral images were occasionally interspersed with photographs of angry faces and social exposure scenes. In spider and blood/injection fear blocks neutral pictures were interspersed with spider fear-relevant and blood/injection pictures, respectively. When compared to healthy controls the social fear group responded with increased activations in the anterior orbital, middle/anterior cingulate and middle/superior temporal areas for pictures depicting angry faces and with a few elevated superior frontal activations for social exposure scenes. In the blood/injection fear group, heart rate was decreased and the activity in the middle/inferior frontal and visual processing regions was increased for blood/injection pictures. The HR decrease for blood/injection pictures correlated with increased frontal responses. In the spider fear group, spider fear-relevant pictures triggered increased activations within a broad subcortical and cortical neural fear network. The HR response for spider fear-relevant stimuli was increased and correlated with an increased insula and hippocampus activity. When compared to healthy controls, all fear groups showed higher LPP amplitudes for their feared cues and an overall greater P1 hypervigilance effect. Contrasts against the fear control groups showed that the increased responses for fear-specific stimuli are mostly related to specific fears and not to general anxiety proneness. The results suggest different engagement of cognitive evaluation and down-regulation strategies and an overall increased sensitization of the fear system in the three fear groups.

ROI and phobias: The effect of ROI approach on an ALE meta‐analysis of specific phobias

“…The 31 studies included 564 patients with SP and 485 HC (Brinkmann, Poller, Herrmann, Miltner, & Straube, ; Britton et al, ; Caseras, Giampietro, et al, ; Caseras, Mataix‐Cols, et al, ; Dilger et al, ; Goossens, Schruers, Peeters, Griez, & Sunaert, a; Goossens et al, 2007b Halsband & Wolf, ; Hermann et al, ; Hilbert, Evens, Maslowski, Wittchen, & Lueken, ; Killgore et al, ; Lipka et al, ; Lipka, Miltner, & Straube, ; Lueken et al, , ; Michalowski et al, ; Munsterkotter et al, ; Scharmuller et al, ; Schienle et al, ; Schienle, Schafer, Walter, Stark, & Vaitl, ; Schienle, Scharmuller, Leutgeb, Schafer, & Stark, ; Schweckendiek et al, ; Straube, Glauer, et al, ; Straube, Lipka, Sauer, Mothes‐Lasch, & Miltner, ; Straube et al, ; Straube, Mentzel, & Miltner, , ; Wendt, Lotze, Weike, Hosten, & Hamm, ; Wiemer et al, ; Wright et al, ; Zilverstand, Sorger, Kaemingk, & Goebel, ). In six studies, two different subtypes of phobias were considered, with the most studied (24 out of 31) subtype being spider phobia; dental phobia was evaluated in six studies, whereas small animal and blood/injection subtypes in four and three studies, respectively (Table ).…”

“…The inferior frontal gyrus (IFG) was found more active in individuals with phobias, and several studies contribute to the ALE cluster encompassing this region (Supporting Information Table S4). The pattern of activity of this brain area has been linked to different presentation modalities of phobic stimuli (e.g., words; Straube et al, ) and to different subtypes of phobias (e.g., spider phobia, blood, injury and injection phobia; Caseras, Giampietro, et al, ; Caseras, Mataix‐Cols, et al, ; Michalowski et al, ). It has been suggested that an increment in hemodynamic activity in the IFG and, more generally, in the prefrontal cortex, may be related to the reduction of emotional appraisal abilities in patients with specific phobia (Caseras, Giampietro, et al, ; Michalowski et al, ; Straube et al, ).…”

“…The pattern of activity of this brain area has been linked to different presentation modalities of phobic stimuli (e.g., words; Straube et al, ) and to different subtypes of phobias (e.g., spider phobia, blood, injury and injection phobia; Caseras, Giampietro, et al, ; Caseras, Mataix‐Cols, et al, ; Michalowski et al, ). It has been suggested that an increment in hemodynamic activity in the IFG and, more generally, in the prefrontal cortex, may be related to the reduction of emotional appraisal abilities in patients with specific phobia (Caseras, Giampietro, et al, ; Michalowski et al, ; Straube et al, ). In addition, the ventral part of the cingulate cortex and the orbitofrontal cortex was modulated by emotional valence of the presented stimuli in several studies, both in normal and pathological conditions (Courtin, Bienvenu, Einarsson, & Herry, ; Del Casale et al, ; Drevets, Savitz, & Trimble, ; Potegal, ).…”

Neuronal correlates of spider phobia in a combined fNIRS-EEG study

“…Our results with respect to ERPs are well in line with the existing literature. In previous studies, elevated P300 and LPP amplitudes have been observed in PP when confronted with phobic stimuli 8 , 9 , 11 , 12 . It has been suggested that the effect of psychotherapy might not influence early ERPs of attention allocation and attentional significance, but rather late potentials of cognitive control.…”

“…With respect to spider phobia, combined measurements of fMRI and EEG have been analyzed in a study of Michalowski et al, in which neural response patterns in spider phobic, blood-injection injury and socially fearful individuals in response to fear-specific, as well as neutral stimuli, were investigated 8 . Fear-specific stimuli elicited larger LPP’s than neutral pictures, especially in the respective fearful individuals.…”