Specific amygdala response to masked fearful faces in post-traumatic stress relative to other anxiety disorders

Altered amygdala activation to fear-related stimuli has been proposed to be a potential neural correlate of heightened threat sensitivity in anxiety- and stress-related disorders. However, the role of stimulus awareness and disorder specificity remains widely unclear. Here we investigated amygdala r...

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Bibliographic Details
Published in:Psychological medicine 2018-05, Vol.48 (7), p.1209-1217
Main Authors: Neumeister, P., Feldker, K., Heitmann, C. Y., Buff, C., Brinkmann, L., Bruchmann, M., Straube, T.
Format: Article
Language:English
Subjects:
Amygdala
Anxiety disorders
Brain research
Clinical trials
Comorbidity
Cues
Fear
Fear & phobias
Functional magnetic resonance imaging
Generalized anxiety disorder
Hyperactivity
Masking
Neurosciences
NMR
Nuclear magnetic resonance
Original Articles
Panic attacks
Patients
Pattern recognition
Post traumatic stress disorder
Stimulus
Suffering
Trauma
Unconsciousness
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Summary:Altered amygdala activation to fear-related stimuli has been proposed to be a potential neural correlate of heightened threat sensitivity in anxiety- and stress-related disorders. However, the role of stimulus awareness and disorder specificity remains widely unclear. Here we investigated amygdala responses to conscious and unconscious fearful faces in patients suffering from panic disorder (PD), generalized anxiety disorder (GAD), or post-traumatic stress disorder (PTSD) and in a large sample of healthy controls (HC). During event-related functional magnetic resonance imaging participants (n = 120; 20 PD, 20 GAD, 20 PTSD, 60 HC) were confronted with briefly presented fearful faces, neutral faces, and non-faces in a backward masking paradigm. The design allowed for the analysis of trial-by-trial face detection performance and amygdala responses to fearful v. neutral faces. All participants exhibited increased amygdala activation to fearful v. neutral faces during conscious trials. Specifically during unconscious face processing, the PTSD, compared with all other groups, showed higher right basolateral (BLA) amygdala activity to fearful v. neutral faces. The present study shows that BLA amygdala hyperactivity during unconscious, but not conscious, processing of fearful faces differentiates PTSD from the investigated disorders. This finding suggests an automatic and specific neural hyper-responsivity to general fear cues in PTSD and supports the idea of categorical differences between PTSD and other anxiety-related disorders.
ISSN:0033-2917
1469-8978
DOI:10.1017/S0033291717002513