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Journal of Neural Transmission
Published in: Journal of Neural Transmission 4/2024

Open Access 01-03-2024 | Phobia | Psychiatry and Preclinical Psychiatric Studies - Original Article

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

Authors: André Wannemueller, Jürgen Margraf, Martin Busch, Hans-Peter Jöhren, Boris Suchan

Published in: Journal of Neural Transmission | Issue 4/2024

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Abstract

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.
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Metadata
Title
More than fear? Brain activation patterns of dental phobic patients before and after an exposure-based treatment
Authors
André Wannemueller
Jürgen Margraf
Martin Busch
Hans-Peter Jöhren
Boris Suchan
Publication date
01-03-2024
Publisher
Springer Vienna
Published in
Journal of Neural Transmission / Issue 4/2024
Print ISSN: 0300-9564
Electronic ISSN: 1435-1463
DOI
https://doi.org/10.1007/s00702-024-02754-6

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