title: Cerebral blood flow in immediate and sustained anxiety.
abstract: The goal of this study was to compare cerebral blood flow (CBF) changes associated with phasic cued fear versus those associated with sustained contextual anxiety. Positron emission tomography images of CBF were acquired using [O-15]H2O in 17 healthy human subjects as they anticipated unpleasant electric shocks that were administered predictably (signaled by a visual cue) or unpredictably (threatened by the context). Presentation of the cue in either threat condition was associated with increased CBF in the left amygdala. A cue that specifically predicted the shock was associated with CBF increases in the ventral prefrontal cortex (PFC), hypothalamus, anterior cingulate cortex, left insula, and bilateral putamen. The sustained threat context increased CBF in the right hippocampus, mid-cingulate gyrus, subgenual PFC, midbrain periaqueductal gray, thalamus, bilateral ventral striatum, and parieto-occipital cortex. This study showed distinct neuronal networks involved in cued fear and contextual anxiety underlying the importance of this distinction for studies on the pathophysiology of anxiety disorders.
authors.affiliation: Psychiatric University Hospital, 8091 Zurich, Switzerland. g.hasler@bluewin.ch
authors.forename: Gregor
authors.initials: G
authors.lastname: Hasler
authors.forename: Stephen
authors.initials: S
authors.lastname: Fromm
authors.forename: Ruben P
authors.initials: RP
authors.lastname: Alvarez
authors.forename: David A
authors.initials: DA
authors.lastname: Luckenbaugh
authors.forename: Wayne C
authors.initials: WC
authors.lastname: Drevets
authors.forename: Christian
authors.initials: C
authors.lastname: Grillon
mesh_terms: D000328:Adult; D001007:Anxiety / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D001776:Blood Circulation Time / Q000379:methods; D001783:Blood Flow Velocity / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000000981:diagnostic imaging / Q000502:physiology; D049268:Positron-Emission Tomography / Q000379:methods; D013997:Time Factors