Functional Neuroimaging of Anxiety Disorders

Anxiety and fear are evolutionary beneficial emotions that help an organism to avoid danger and threat, but anxiety becomes pathological when it significantly impairs daily functioning. Anxiety disorders are among the most prevalent psychiatric disorders, and both etiology (fear learning) and involved neural circuitry are relatively well understood. In this chapter, we discuss the potential of functional MRI in understanding and detecting pathological anxiety, with a specific focus on the role of fear conditioning and extinction as a prevailing experimental and etiological model. We first address the neural (and psychophysiological) correlates of fear conditioning and extinction, which include the amygdala, hippocampus, dorsal anterior cingulate, and medial prefrontal cortex, among others. Then, we compare the sensitivity and specificity of this functional approach by discussing overlap and differences between anxiety disorders such as specific phobias, social anxiety disorder, and posttraumatic stress disorder. Furthermore, a brief overview of emerging evidence on panic disorder and obsessive-compulsive disorder is provided, although the latter is technically not an anxiety disorder according to the DSM-5. Finally, we discuss potential implications of functional MRI for anxiety disorders, including but not limited to presymptomatic detection, treatment selection, and tracking of progress.

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Reference: 
Spoormaker V,Vermetten E,Czisch M,Wilhelm F, | 2014
In: Christoph Mulert, Martha E. Shenton: MRI in Psychiatry | 289-301 | Berlin Heidelberg: Springer
http://dx.doi.org/10.1007/978-3-642-54542-9_15
Affiliation author(s): 
ARQ Nationaal Psychotrauma Centrum