Commonalities and differences in the neural substrates of threat predictability in panic disorder and specific phobia.
Different degrees of threat predictability are thought to induce either phasic fear or sustained anxiety. Maladaptive, sustained anxious apprehension is thought to result in overgeneralization of anxiety and thereby to contribute to the development of anxiety disorders. Therefore, differences in threat predictability have been associated with pathological states of anxiety with specific phobia (SP) representing phasic fear as heightened response to predictable threat, while panic disorder (PD) is characterized by sustained anxiety (unpredictable threat) and, as a consequence, overgeneralization of fear. The present study aimed to delineate commonalities and differences in the neural substrates of the impact of threat predictability on affective processing in these two anxiety disorders. Twenty PD patients, 20 SP patients and 20 non-anxious control subjects were investigated with an adapted NPU-design (no, predictable, unpredictable threat) using whole-head magnetoencephalography (MEG). Group independent neural activity in the right dlPFC increased with decreasing threat predictability. PD patients showed a sustained hyperactivation of the vmPFC under threat and safety conditions. The magnitude of hyperactivation was inversely correlated with PDs subjective arousal and anxiety sensitivity. Both PD and SP patients revealed decreased parietal processing of affective stimuli. Findings indicate overgeneralization between threat and safety conditions and increased need for emotion regulation via the vmPFC in PD, but not SP patients. Both anxiety disorders showed decreased activation in parietal networks possibly indicating attentional avoidance of affective stimuli. Present results complement findings from fear conditioning studies and underline overgeneralization of fear, particularly in PD.
Department of Psychiatry and Psychotherapy, University Hospital Muenster, Germany.
Anna Luisa
AL
Klahn
Institute for Biogmagnetism and Biosignalanalysis, University of Muenster, Germany.
Isabelle A
IA
Klinkenberg
Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Wuerzburg, Germany.
Ulrike
U
Lueken
Department of Psychiatry and Psychotherapy, University Hospital Muenster, Germany.
Swantje
S
Notzon
Department of Psychiatry and Psychotherapy, University Hospital Muenster, Germany.
Volker
V
Arolt
Institute for Biogmagnetism and Biosignalanalysis, University of Muenster, Germany.
Christo
C
Pantev
Department of Psychiatry and Psychotherapy, University Hospital Muenster, Germany; kbo-Inn-Salzach-Hospital, Wasserburg am Inn, Germany; Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Germany.
Peter
P
Zwanzger
Institute for Biogmagnetism and Biosignalanalysis, University of Muenster, Germany.
Markus
M
Junghoefer
D000328:Adult; D001931:Brain Mapping; D005260:Female; D006801:Humans; D015225:Magnetoencephalography; D008297:Male; D016584:Panic Disorder / Q000473:pathology*; D010698:Phobic Disorders / Q000473:pathology*; D017397:Prefrontal Cortex / Q000473:pathology*; D057566:Self Report; D013223:Statistics as Topic; D055815:Young Adult
Anxiety; Dorsolateral prefrontal cortex; MEG; Panic disorder; Ventromedial prefrontal cortex