title: Transdiagnostic brain responses to disorder-related threat across four psychiatric disorders.
abstract: BACKGROUND
  There is an ongoing debate whether transdiagnostic neural mechanisms are shared by different anxiety-related disorders or whether different disorders show distinct neural correlates. To investigate this issue, studies controlling for design and stimuli across multiple anxiety-related disorders are needed.
  
  
  METHODS
  The present functional magnetic resonance imaging study investigated neural correlates of visual disorder-related threat processing across unmedicated patients suffering from panic disorder (n = 20), social anxiety disorder (n = 20), dental phobia (n = 16) and post-traumatic stress disorder (n = 11) relative to healthy controls (HC; n = 67). Each patient group and the corresponding HC group saw a tailor-made picture set with 50 disorder-related and 50 neutral scenes.
  
  
  RESULTS
  Across all patients, increased activation to disorder-related v. neutral scenes was found in subregions of the bilateral amygdala. In addition, activation of the lateral amygdala to disorder-related v. neutral scenes correlated positively with subjective anxiety ratings of scenes across patients. Furthermore, whole-brain analysis revealed increased responses to disorder-related threat across the four disorders in middle, medial and superior frontal regions, (para-)limbic regions, such as the insula and thalamus, as well as in the brainstem and occipital lobe. We found no disorder-specific brain responses.
  
  
  CONCLUSIONS
  The results suggest that pathologically heightened lateral amygdala activation is linked to experienced anxiety across anxiety disorders and trauma- and stressor-related disorders. Furthermore, the transdiagnostically shared activation network points to a common neural basis of abnormal responses to disorder-related threat stimuli across the four investigated disorders.
authors.affiliation: University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience,Muenster,Germany.
authors.forename: K
authors.initials: K
authors.lastname: Feldker
authors.affiliation: University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience,Muenster,Germany.
authors.forename: C Y
authors.initials: CY
authors.lastname: Heitmann
authors.affiliation: University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience,Muenster,Germany.
authors.forename: P
authors.initials: P
authors.lastname: Neumeister
authors.affiliation: University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience,Muenster,Germany.
authors.forename: S V
authors.initials: SV
authors.lastname: Tupak
authors.affiliation: University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience,Muenster,Germany.
authors.forename: E
authors.initials: E
authors.lastname: Schrammen
authors.affiliation: University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience,Muenster,Germany.
authors.forename: R
authors.initials: R
authors.lastname: Moeck
authors.affiliation: University of Muenster,Muenster,Germany.
authors.forename: P
authors.initials: P
authors.lastname: Zwitserlood
authors.affiliation: University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience,Muenster,Germany.
authors.forename: M
authors.initials: M
authors.lastname: Bruchmann
authors.affiliation: University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience,Muenster,Germany.
authors.forename: T
authors.initials: T
authors.lastname: Straube
mesh_terms: D000328:Adult; D000679:Amygdala / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016854:Dental Anxiety / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005239:Fear / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016584:Panic Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000072861:Phobia, Social / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013313:Stress Disorders, Post-Traumatic / Q000000981:diagnostic imaging / Q000503:physiopathology*; D014796:Visual Perception / Q000502:physiology; D055815:Young Adult
keywords: Amygdala; functional magnetic resonance imaging; panic disorder; social anxiety disorder; specific phobia