关键词：
Fear Learning
Neuroanatomical Correlates
Fear Conditioning and Extinction
Anxiety
Prediction of Treatment Outcome
摘要：
Background: Major theories implicate slower extinction of threat associations in pathological anxiety and limited treatment response. However, we previously found that anxious and healthy individuals exhibit comparable extinction as indexed by skin conductance response (SCR) to threat and safety cues. We now examine whether extinction of fear-potentiated startle (FPS) differentiates anxious and healthy individuals, correlates with neuroanatomy, and predicts treatment outcomes. Methods: 306 participants (178 females, 8-50 years; 133 anxiety patients, 173 healthy comparisons [HC]) completed a threat-conditioning and extinction task while SCR and electromyography indexed conditioned responses to cues. A subset (n=119) completed whole-brain structural MRI. SCR and FPS were analyzed to: 1) compare threat extinction between HC and patients; 2) link neuroanatomy to extinction, as moderated by anxiety; 3) predict exposure-based treatment outcomes. SCR from a larger sample were previously reported. Results: ANOVA indicated that anxiety did not moderate threat conditioning in either SCR or FPS, ps>0.4. As previously reported, patients and HC comparably extinguished conditioned SCR. However, FPS during threat cue presentations remained elevated in patients, F(1,304)=4.937, p=0.027. Attenuated extinction also manifested in greater self-reported fear to threat cues post-extinction, F(1,216)=6.735, p=0.010. FPS during threat cues in extinction negatively correlated with bilateral ventral-diencephalon gray-matter volume, p<0.05 (FWE-corrected); no effects were noted for SCR. FPS, but not SCR, to threat during extinction trended towards negatively predicting treatment-response, F062=1.145, p=0.107. Conclusions: While anxiety patients extinguish SCR, FPS-indexed threat associations persist. These findings suggest distinct psychophysiological threat-anticipatory learning mechanisms with potential relevance to anxiety disorders, neuroanatomy, and exposure-based treatment progress. Sup
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详细信息
中文科技期刊
