Functional Imaging in Anxiety Disorders

Functional Imaging in Anxiety Disorders The development of functional magnetic resonance imaging (fMRI) has led to new scientific insights into the neurobiological mechanisms of anxiety disorders. In this review, we will first present the neural basis of the 'fear circuit' in healthy subjects. This knowledge is based on studies of fear conditioning. Afterwards, we describe cognitive biases that are typical for patients with anxiety disorders, and discuss their relations to neural correlates. Findings of recent fMRI studies of patients with anxiety disorders point to a hyper-activation of the amygdala and a regulation deficit between limbic and prefrontal areas in these patients. The relation between neurobiological abnormalities and biased cognitive mechanisms may therefore account for the development and maintenance of anxiety disorders. First fMRI studies by our group on the effects of a cognitive-behavioral intervention in patients with panic disorder show a normalization of neural activations after therapy. We conclude with an outlook on possible strategies in future fMRI studies.