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Transdiagnostic brain responses to disorder-related threat across four psychiatric disorders

Published online by Cambridge University Press:  21 November 2016

K. Feldker ,
C. Y. Heitmann ,
P. Neumeister ,
S. V. Tupak ,
E. Schrammen ,
R. Moeck ,
P. Zwitserlood ,
M. Bruchmann  and
T. Straube
K. Feldker*
Affiliation:
University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience, Muenster, Germany
C. Y. Heitmann
Affiliation:
University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience, Muenster, Germany
P. Neumeister
Affiliation:
University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience, Muenster, Germany
S. V. Tupak
Affiliation:
University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience, Muenster, Germany
E. Schrammen
Affiliation:
University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience, Muenster, Germany
R. Moeck
Affiliation:
University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience, Muenster, Germany
P. Zwitserlood
Affiliation:
University of Muenster, Muenster, Germany
M. Bruchmann
Affiliation:
University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience, Muenster, Germany
T. Straube
Affiliation:
University Hospital Muenster, Institute of Medical Psychology and Systems Neuroscience, Muenster, Germany
*
*Address for correspondence: K. Feldker, Institute of Medical Psychology and Systems Neuroscience, Von-Esmarch-Straße 52, D-48149 Muenster, Germany. (Email: [email protected])
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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.

Method

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.

Keywords

Amygdalafunctional magnetic resonance imagingpanic disordersocial anxiety disorderspecific phobia
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 4 , March 2017 , pp. 730 - 743
Copyright
Copyright © Cambridge University Press 2016 

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Footnotes

† Both authors contributed equally to this work.

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