title: Fear processing in dental phobia during crossmodal symptom provocation: an fMRI study.
abstract: While previous studies successfully identified the core neural substrates of the animal subtype of specific phobia, only few and inconsistent research is available for dental phobia. These findings might partly relate to the fact that, typically, visual stimuli were employed. The current study aimed to investigate the influence of stimulus modality on neural fear processing in dental phobia. Thirteen dental phobics (DP) and thirteen healthy controls (HC) attended a block-design functional magnetic resonance imaging (fMRI) symptom provocation paradigm encompassing both visual and auditory stimuli. Drill sounds and matched neutral sinus tones served as auditory stimuli and dentist scenes and matched neutral videos as visual stimuli. Group comparisons showed increased activation in the insula, anterior cingulate cortex, orbitofrontal cortex, and thalamus in DP compared to HC during auditory but not visual stimulation. On the contrary, no differential autonomic reactions were observed in DP. Present results are largely comparable to brain areas identified in animal phobia, but also point towards a potential downregulation of autonomic outflow by neural fear circuits in this disorder. Findings enlarge our knowledge about neural correlates of dental phobia and may help to understand the neural underpinnings of the clinical and physiological characteristics of the disorder.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany ; Neuroimaging Center, Technische Universität Dresden, Chemnitzer Straße 46a, 01187 Dresden, Germany.
authors.forename: Kevin
authors.identifier: 0000-0002-7986-4113
authors.initials: K
authors.lastname: Hilbert
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany ; Neuroimaging Center, Technische Universität Dresden, Chemnitzer Straße 46a, 01187 Dresden, Germany.
authors.forename: Ricarda
authors.identifier: 0000-0001-9028-4497
authors.initials: R
authors.lastname: Evens
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany ; Neuroimaging Center, Technische Universität Dresden, Chemnitzer Straße 46a, 01187 Dresden, Germany.
authors.forename: Nina Isabel
authors.initials: NI
authors.lastname: Maslowski
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany ; Neuroimaging Center, Technische Universität Dresden, Chemnitzer Straße 46a, 01187 Dresden, Germany.
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Chemnitzer Straße 46, 01187 Dresden, Germany ; Neuroimaging Center, Technische Universität Dresden, Chemnitzer Straße 46a, 01187 Dresden, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lueken
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods; D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping / Q000379:methods; D016022:Case-Control Studies; D016854:Dental Anxiety / Q000503:physiopathology*; D003952:Diagnostic Imaging / Q000379:methods; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D010698:Phobic Disorders / Q000503:physiopathology*; D010775:Photic Stimulation / Q000379:methods; D055815:Young Adult
references.citation: Eur J Oral Sci. 2011 Feb;119(1):61-8
references.pmid: 21244513
references.citation: Neuron. 2003 Oct 30;40(3):655-64
references.pmid: 14642287
references.citation: Behav Res Ther. 1984;22(2):109-17
references.pmid: 6712553
references.citation: Hum Brain Mapp. 2013 Aug;34(8):1768-82
references.pmid: 22438199
references.citation: Hum Brain Mapp. 2013 May;34(5):1220-9
references.pmid: 22162203
references.citation: Brain Struct Funct. 2013 May;218(3):779-87
references.pmid: 22644919
references.citation: Brain Res Cogn Brain Res. 2003 Jun;17(1):75-82
references.pmid: 12763194
references.citation: Eur Neuropsychopharmacol. 2011 Sep;21(9):655-79
references.pmid: 21896369
references.citation: Eur J Neurosci. 2010 Oct;32(8):1414-22
references.pmid: 20950283
references.citation: Behav Res Ther. 1986;24(1):1-8
references.pmid: 3947307
references.citation: Neuroimage. 2011 May 1;56(1):363-72
references.pmid: 21316468
references.citation: Depress Anxiety. 2009;26(9):796-805
references.pmid: 19434621
references.citation: Nat Neurosci. 2004 Jun;7(6):664-72
references.pmid: 15156146
references.citation: Psychol Med. 2010 Jan;40(1):125-34
references.pmid: 19435544
references.citation: Depress Anxiety. 2010 Feb;27(2):148-67
references.pmid: 20099272
references.citation: Biol Mood Anxiety Disord. 2013 Aug 12;3(1):16
references.pmid: 23937792
references.citation: Cereb Cortex. 2000 Mar;10(3):206-19
references.pmid: 10731217
references.citation: Soc Cogn Affect Neurosci. 2014 Nov;9(11):1668-75
references.pmid: 24174207
references.citation: Behav Res Ther. 2002 Sep;40(9):1031-46
references.pmid: 12296488
references.citation: Brain Res. 2013 Feb 1;1493:40-7
references.pmid: 23200718
references.citation: Neuroimage. 2006 Jan 1;29(1):125-35
references.pmid: 16087353
references.citation: J Neurosci. 2010 Dec 1;30(48):16324-31
references.pmid: 21123578
references.citation: Eur J Oral Sci. 2008 Feb;116(1):44-51
references.pmid: 18186731
references.citation: Psychiatry Res. 2012 Jun 30;202(3):181-97
references.pmid: 22804970
references.citation: Psychophysiology. 2010 Jul 1;47(4):647-58
references.pmid: 20230512
references.citation: Biol Psychol. 2007 May;75(2):124-30
references.pmid: 17306437
references.citation: J Neurosci Methods. 2010 Jun 30;190(1):80-91
references.pmid: 20451556
references.citation: Am J Psychiatry. 2007 Oct;164(10):1476-88
references.pmid: 17898336
references.citation: Neuropsychopharmacology. 2010 Jan;35(1):169-91
references.pmid: 19625997
references.citation: Neuroimage. 2012 Nov 15;63(3):1162-70
references.pmid: 22922369
references.citation: Behav Res Ther. 1990;28(5):429-37
references.pmid: 2256902
references.citation: Neuroimage. 2003 Jun;19(2 Pt 1):430-41
references.pmid: 12814592
references.citation: Neuroimage. 2007 Oct 1;37(4):1427-36
references.pmid: 17681799
references.citation: Int J Methods Psychiatr Res. 2012 Sep;21(3):169-84
references.pmid: 22865617
references.citation: Science. 1999 Jun 18;284(5422):1979-81
references.pmid: 10373114
references.citation: J Clin Psychol. 1985 Jul;41(4):451-9
references.pmid: 4031083
references.citation: Biol Psychiatry. 2006 Jan 15;59(2):162-70
references.pmid: 16139812
references.citation: Neurosci Lett. 2011 Sep 26;503(1):48-51
references.pmid: 21862219
references.citation: Prog Brain Res. 1990;85:147-65; discussion 165-6
references.pmid: 2094892
references.citation: Pain. 2008 Jul;137(1):156-163
references.pmid: 17904289
references.citation: Eur J Oral Sci. 2001 Jun;109(3):172-7
references.pmid: 11456347
references.citation: Psychophysiology. 1972 May;9(3):373-9
references.pmid: 5034126