Brinkmann Leonie, Poller Hendrik, Herrmann Martin J, Miltner Wolfgang, Straube Thomas
Institute of Medical Psychology and Systems Neuroscience, University of Muenster, Von-Esmarch-Str. 52, D-48149 Muenster, Germany.
Department of Biological and Clinical Psychology, Friedrich-Schiller-University Jena, Am Steiger 3, D-07743 Jena, Germany.
Neuroimage Clin. 2016 Dec 18;13:320-329. doi: 10.1016/j.nicl.2016.12.015. eCollection 2017.
Blood-injection-injury (BII) phobia differs from other subtypes of specific phobia in that it is associated with elevated disgust-sensitivity as well as specific autonomic and brain responses during processing of phobia-relevant stimuli. To what extent these features play a role already during threat anticipation is unclear. In the current fMRI experiment, 16 female BII phobics and 16 female healthy controls anticipated the presentation of phobia-specific and neutral pictures. On the behavioral level, anxiety dominated the anticipatory period in BII phobics relative to controls, while both anxiety and disgust were elevated during picture presentation. By applying two different models for the analysis of brain responses to anticipation of phobia-specific versus neutral stimuli, we found initial and sustained increases of activation in anterior cingulate cortex (ACC), insula, lateral and medial prefrontal cortex (PFC), thalamus and visual areas, as well as initial activation in the amygdala for BII phobics as compared to healthy controls. These results suggest that BII phobia is characterized by activation of a typical neural defense network during threat anticipation, with anxiety as the predominant emotion.
血液-注射-损伤（BII）恐惧症与特定恐惧症的其他亚型不同，因为它与厌恶敏感性升高以及在处理与恐惧症相关的刺激时特定的自主神经和大脑反应有关。这些特征在威胁预期过程中在多大程度上发挥作用尚不清楚。在当前的功能磁共振成像（fMRI）实验中，16名女性BII恐惧症患者和16名女性健康对照者预期会出现特定恐惧症和中性的图片。在行为层面上，相对于对照组，焦虑在BII恐惧症患者的预期期占主导地位，而在图片呈现期间焦虑和厌恶情绪均升高。通过应用两种不同的模型来分析大脑对特定恐惧症与中性刺激预期的反应，我们发现与健康对照者相比，BII恐惧症患者的前扣带回皮质（ACC）、脑岛、外侧和内侧前额叶皮质（PFC）、丘脑和视觉区域的激活出现初始和持续增加，以及杏仁核出现初始激活。这些结果表明，BII恐惧症的特征是在威胁预期期间激活典型的神经防御网络，其中焦虑是主要情绪。
