More than fear? Brain activation patterns of dental phobic patients before and after an exposure-based treatment.

Autor: Wannemueller A; Center for the Study and Treatment of Mental Health, Ruhr University Bochum, Massenbergstr. 9-13, 44787, Bochum, Germany. andre.wannemueller@rub.de., Margraf J; Center for the Study and Treatment of Mental Health, Ruhr University Bochum, Massenbergstr. 9-13, 44787, Bochum, Germany., Busch M; Grönemeyer-Institut for Microtherapy, Bochum, Germany., Jöhren HP; Dental Clinic Bochum, Bochum, Germany., Suchan B; Clinical Neuropsychology, Neuropsychological Therapy Centre, Ruhr University, Bochum, Germany.
Jazyk: angličtina
Zdroj: Journal of neural transmission (Vienna, Austria : 1996) [J Neural Transm (Vienna)] 2024 Apr; Vol. 131 (4), pp. 393-404. Date of Electronic Publication: 2024 Mar 01.
DOI: 10.1007/s00702-024-02754-6
Abstrakt: Hyperactivation of brain networks conferring defensive mobilization is assumed to underlie inappropriate defensive-preparation in patients with Specific Phobia. However, studies targeting Dental Phobia (DP) yielded quite heterogeneous results and research concerning the effects of exposure treatments on phobic brain activation so far is missing. This functional Magnetic Resonance Imaging (fMRI) study aimed to investigate activation patterns in DP patients during exposure to phobia-related stimuli and the effects of an exposure-based fear treatment on phobia-related activation. Seventeen patients with DP and seventeen non-phobic, healthy controls participated in this fMRI experiment presenting dental-related and neutral auditory and visual stimuli. After completing a short exposure-based CBT program, patients were scanned a second time to illustrate treatment-related changes in brain activation patterns. Pre-treatment fMRI results demonstrate enhanced activation in DP-patients mainly in the precuneus and lateral parietal cortex. Moreover, a small activation focus was observed in the amygdala and anterior cingulate cortex (ACC) as parts of classically fear-related structures. Activation in all these clusters decreased significantly from pre- to post-treatment assessment and in the case of the ACC was correlated with dental fear reduction. Activation changes in the precuneus and lateral parietal cortex suggest a pronounced first-person perspective memory processing including a vivid recall of contextual information from an egocentric perspective triggered by exposure to phobia-related stimuli. Besides a treatment-sensitive hyperactivity of fear-sensitive structures, DP may also be characterized by a disturbed memory retrieval that can be reorganized by successful exposure treatment.
(© 2024. The Author(s).)
Databáze: MEDLINE
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