Glucocorticoid administration improves aberrant fear-processing networks in spider phobia

Nakataki, Masahito; Soravia, Leila M.; Schwab, Simon; Horn, Helge Joachim; Dierks, Thomas; Strik, Werner; Wiest, Roland; Heinrichs, Markus; de Quervain, Dominique J-F; Federspiel, Andrea; Morishima, Yosuke (2016). Glucocorticoid administration improves aberrant fear-processing networks in spider phobia. Neuropsychopharmacology, 42(2), pp. 485-494. Nature Publishing Group 10.1038/npp.2016.207

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Glucocorticoids reduce phobic fear in patients with anxiety disorders. Previous studies have shown that fear-related activation of the amygdala can be mediated through the visual cortical pathway, which includes the fusiform gyrus, or through other pathways. However, it is not clear which of the pathways that activate the amygdala is responsible for the pathophysiology of a specific phobia and how glucocorticoid treatment alleviates fear processing in these neural networks. We recorded the brain activity with functional magnetic resonance imaging in patients with spider phobia, who received either 20 mg of cortisol or a placebo while viewing pictures of spiders. We also tested healthy participants who did not receive any medication during the same task. We performed dynamic causal modelling (DCM), a connectivity analysis, to examine the effects of cortisol on the networks involved in processing fear and to examine if there was an association between these networks and the symptoms of the phobia. Cortisol administration suppressed the phobic stimuli-related amygdala activity to levels comparable to the healthy participants and reduced subjective phobic fear. The DCM analysis revealed that cortisol administration suppressed the aberrant inputs into the amygdala that did not originate from the visual cortical pathway, but rather from a fast subcortical pathway mediated by the pulvinar nucleus, and suppressed the interactions between the amygdala and fusiform gyrus. This network changes were distinguishable from healthy participants and considered the residual changes under cortisol administration. We also found that the strengths of the aberrant inputs into the amygdala were positively correlated with the severity of spider phobia. This study demonstrates that patients with spider phobia show an aberrant functional connectivity of the amygdala when they are exposed to phobia-related stimuli and that cortisol administration can alleviate this fear-specific neural connectivity.Neuropsychopharmacology advance online publication, 12 October 2016; doi:10.1038/npp.2016.207.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > University Psychiatric Services > University Hospital of Psychiatry and Psychotherapy > Translational Research Center 07 Faculty of Human Sciences > Institute of Psychology 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
UniBE Contributor:	Nakataki, Masahito, Soravia Bachofner, Leila Maria, Schwab, Simon Gabriel, Horn, Helge Joachim, Dierks, Thomas, Strik, Werner, Wiest, Roland Gerhard Rudi, Heinrichs, Markus, Federspiel, Andrea, Morishima, Yosuke
Subjects:	100 Philosophy > 150 Psychology 600 Technology > 610 Medicine & health
ISSN:	0893-133X
Publisher:	Nature Publishing Group
Language:	English
Submitter:	Martin Zbinden
Date Deposited:	25 Oct 2016 16:25
Last Modified:	02 Mar 2023 23:28
Publisher DOI:	10.1038/npp.2016.207
PubMed ID:	27644128
URI:	https://boris.unibe.ch/id/eprint/89336