Jehli Elisabeth, Denier Niklaus, Federspiel Andrea, Dierks Thomas, Strik Werner, Soravia Leila M, Grieder Matthias
Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
University Hospital of Zurich, Department of Neurosurgery, Zurich, Switzerland.
Brain Connect. 2024 Dec;14(10):527-541. doi: 10.1089/brain.2024.0031. Epub 2024 Oct 7.
Individuals with spider phobic (SP) fear show hypervigilance and amygdala hyperactivity toward fear-associated stimuli, which may promote the development of other anxiety disorders. The amygdala is a key region within the fear network, which is connected to the anxiety system, where the bed nucleus of the stria terminalis (BNST) plays a crucial role. However, the BNST's involvement in phobic fear is unknown. Therefore, this study investigated the association of phobic fear and anxiety on these regions' functional connectivity (FC) in SP compared to healthy controls (HC). 7T-functional MRI resting-state FC of 30 individuals with SP and 45 HC was assessed to detect network differences between these groups. The association of phobic fear severity, trait anxiety, and social anxiety on FC was explored using linear regressions combined with seed-to-voxel analyses with amygdala and BNST as primary seeds, corrected for age and sex. In SP, phobic fear was associated with reduced FC between the left amygdala and the right supramarginal gyrus. In contrast, anxiety severity was related to increased FC between the right BNST and the left inferior frontal gyrus. Moreover, social anxiety was related to decreased FC between bilateral BNST and left precuneus. These findings show changes in FC in SP, connecting fear with altered activity in the BNST and amygdala. The results suggest that persistent anxiety in phobic fear is associated with abnormal brain function in these regions, potentially explaining susceptibility to anxiety disorders and processes involved in phobic fear, such as threat perception, avoidance, and salience.
患有蜘蛛恐惧症（SP）的个体对与恐惧相关的刺激表现出过度警觉和杏仁核过度活跃，这可能会促进其他焦虑症的发展。杏仁核是恐惧网络中的一个关键区域，它与焦虑系统相连，终纹床核（BNST）在其中起着至关重要的作用。然而，BNST在恐惧症恐惧中的作用尚不清楚。因此，本研究调查了与健康对照者（HC）相比，恐惧症恐惧和焦虑与SP中这些区域的功能连接（FC）之间的关联。评估了30名患有SP的个体和45名HC的7T功能磁共振成像静息态FC，以检测这些组之间的网络差异。使用线性回归结合以杏仁核和BNST为主要种子的种子到体素分析，探索了FC上恐惧严重程度、特质焦虑和社交焦虑之间的关联，并对年龄和性别进行了校正。在SP中，恐惧与左杏仁核和右缘上回之间的FC降低有关。相反，焦虑严重程度与右BNST和左额下回之间的FC增加有关。此外，社交焦虑与双侧BNST和左楔前叶之间的FC降低有关。这些发现显示了SP中FC的变化，将恐惧与BNST和杏仁核中改变的活动联系起来。结果表明，恐惧症恐惧中的持续焦虑与这些区域的脑功能异常有关，这可能解释了对焦虑症的易感性以及恐惧症恐惧中涉及的过程，如威胁感知、回避和显著性。
