Visual presentation of phobic stimuli: amygdala activation via an extrageniculostriate pathway?

In the present study, event-related functional magnetic resonance imaging (fMRI) was used to examine the neural correlates of phobic fear by exposing spider phobic subjects to a visual presentation of spiders. In contrast to control subjects, spider phobics showed significantly increased activation in the amygdala and the pulvinar nucleus of the thalamus on the basis of region of interest (ROI) analysis. Furthermore, voxelwise analysis revealed increased activation related to phobia-specific pictures bilaterally in the anterior cingulate cortex, the left insular cortex and bilaterally in the supplementary motor area. These findings confirm the involvement of the amygdala in the processing of phobia-relevant stimuli as found earlier in a recent study. Moreover, the thalamus findings support the involvement of an extrageniculostriate pathway in the process of phobic fear.