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In JoVE (1)
Other Publications (16)
- Behavioral Neuroscience
- Proceedings of the National Academy of Sciences of the United States of America
- The Journal of Neuroscience : the Official Journal of the Society for Neuroscience
- Cognitive, Affective & Behavioral Neuroscience
- NeuroImage
- Maturitas
- Cognitive, Affective & Behavioral Neuroscience
- Behavioral Neuroscience
- Behavioral Neuroscience
- Bulletin of the American College of Surgeons
- NeuroImage
- NeuroImage
- NeuroImage
- Behavioral Neuroscience
- International Journal of Behavioral Medicine
- NeuroImage
Articles by David C. Knight in JoVE
JoVE Neuroscience
Investigating the Neural Mechanisms of Aware and Unaware Fear Memory with fMRI
Department of Psychology, University of Alabama at Birmingham
A methodology to investigate the neural mechanisms that support aware and unaware memory processes during fear conditioning is described. This method monitors blood oxygen level dependent (BOLD) functional magnetic resonance imaging, skin conductance response, and unconditioned stimulus expectancy during Pavlovian fear conditioning to assess the neural correlates of distinct memory processes.
Other articles by David C. Knight on PubMed
Functional MRI of Human Amygdala Activity During Pavlovian Fear Conditioning: Stimulus Processing Versus Response Expression
Although laboratory animal studies have shown that the amygdala plays multiple roles in conditional fear, less is known about the human amygdala. Human subjects were trained in a Pavlovian fear conditioning paradigm during functional magnetic resonance imaging (fMRI). Brain activity maps correlated with reference waveforms representing the temporal pattern of visual conditional stimuli (CSs) and subject-derived autonomic responses were compared. Subjects receiving paired CS-shock presentations showed greater amygdala activity than subjects receiving unpaired CS-shock presentations when their brain activity was correlated with a waveform generated from their behavioral responses. Stimulus-based waveforms revealed learning differences in the visual cortex, but not in the amygdala. These data support the view that the amygdala is important for the expression of learned behavioral responses during Pavlovian fear conditioning.
Expression of Conditional Fear with and Without Awareness
Conditional responding during simple Pavlovian conditioning is often characterized as a form of implicit memory. The extent to which this type of associative learning is independent of awareness is an issue of continuing debate. Previous studies have demonstrated conditioning in the absence of awareness. However, their results have been questioned based on methodological concerns with postexperimental questionnaires. In the present study, skin conductance response (SCR) and unconditioned stimulus (UCS) expectancy were measured concurrently as participants were exposed to a differential delay fear conditioning procedure in which one tone (CS+) predicted a loud white noise, whereas a second tone (CS-) was presented alone. UCS predictability was varied on a trial-by-trial basis by presenting conditioned stimuli (CSs) at volumes just above or below the perceptual threshold. Differential UCS expectancy (awareness) was observed only on perceived trials, whereas differential SCR developed on both perceived and unperceived trials. Although perceived stimuli elicited larger SCRs, the magnitude of conditioning, indexed by differential conditioned response expression (conditioned SCR to CS+ minus the SCR to CS-), was not influenced by stimulus perception. These data indicate that conditional fear can be expressed when individuals are unaware of fear-eliciting stimuli and suggest that the degree of conditioning is independent of awareness during differential Pavlovian fear conditioning.
Neural Substrates Mediating Human Delay and Trace Fear Conditioning
Previous functional magnetic resonance imaging (fMRI) studies with human subjects have explored the neural substrates involved in forming associations in Pavlovian fear conditioning. Most of these studies used delay procedures, in which the conditioned stimulus (CS) and unconditioned stimulus (UCS) coterminate. Less is known about brain regions that support trace conditioning, a procedure in which an interval of time (trace interval) elapses between CS termination and UCS onset. Previous work suggests significant overlap in the neural circuitry supporting delay and trace fear conditioning, although trace conditioning requires recruitment of additional brain regions. In the present event-related fMRI study, skin conductance and continuous measures of UCS expectancy were recorded concurrently with whole-brain blood oxygenation level-dependent (BOLD) imaging during direct comparison of delay and trace discrimination learning. Significant activation was observed within the visual cortex for all CSs. Anterior cingulate and medial thalamic activity reflected associative learning common to both delay and trace procedures. Activations within the supplementary motor area (SMA), frontal operculum, middle frontal gyri, and inferior parietal lobule were specifically associated with trace interval processing. The hippocampus displayed BOLD signal increases early in training during all conditions; however, differences were observed in hippocampal response magnitude related to the accuracy of predicting UCS presentations. These results demonstrate overlapping patterns of activation within the anterior cingulate, medial thalamus, and visual cortex during delay and trace procedures, with additional recruitment of the hippocampus, SMA, frontal operculum, middle frontal gyrus, and inferior parietal lobule during trace conditioning. These data suggest that the hippocampus codes temporal information during trace conditioning, whereas brain regions supporting working memory processes maintain the CS-UCS representation during the trace interval.
Amygdala and Hippocampal Activity During Acquisition and Extinction of Human Fear Conditioning
Previous functional magnetic resonance imaging (fMRI) studies have characterized brain systems involved in conditional response acquisition during Pavlovian fear conditioning. However, the functional neuroanatomy underlying the extinction of human conditional fear remains largely undetermined. The present study used fMRI to examine brain activity during acquisition and extinction of fear conditioning. During the acquisition phase, participants were either exposed to light (CS) presentations that signaled a brief electrical stimulation (paired group) or received light presentations that did not serve as a warning signal (control group). During the extinction phase, half of the paired group subjects continued to receive the same treatment, whereas the remainder received light alone. Control subjects also received light alone during the extinction phase. Changes in metabolic activity within the amygdala and hippocampus support the involvement of these regions in each of the procedural phases of fear conditioning. Hippocampal activity developed during acquisition of the fear response. Amygdala activity increased whenever experimental contingencies were altered, suggesting that this region is involved in processing changes in environmental relationships. The present data show learning-related amygdala and hippocampal activity during human Pavlovian fear conditioning and suggest that the amygdala is particularly important for forming new associations as relationships between stimuli change.
The Role of the Human Amygdala in the Production of Conditioned Fear Responses
The amygdala plays a central role in the acquisition and expression of fear memories. Laboratory animal studies indicate that the amygdala both receives sensory information and produces learned behavioral and autonomic fear responses. However, prior functional imaging research in humans has largely focused on amygdala activity elicited by fearful stimuli, giving less attention to this region's role in the production of fear responses. In contrast, the present study used functional magnetic resonance imaging to investigate the amygdala's influence on the generation of conditional fear responses. Significant increases in amygdala activity were observed during the production of conditioned (learning-related), but not orienting, nonspecific, and unconditioned (nonlearning-related) skin conductance responses. Further, greater amygdala activity was demonstrated during conditioned response production than during conditioned stimulus presentation. These results suggest the amygdala not only responds to fearful stimuli, but also generates learning-related changes in human autonomic fear expression.
Isoflavone Therapy for Menopausal Flushes: a Systematic Review and Meta-analysis
To perform a systematic review and meta-analysis of all randomized, controlled trials of isoflavone supplementation to determine the efficacy of isoflavone therapy in reducing the number of daily menopausal flushes.
The Role of Awareness in Delay and Trace Fear Conditioning in Humans
Expression of conditional fear without awareness has been previously demonstrated during delay conditioning, a procedure in which the conditioned stimulus (CS) and unconditioned stimulus (UCS) overlap. However, less is known about the role of awareness in trace fear conditioning, where an interval of time separates the CS and UCS. The present study assessed skin conductance response (SCR) and UCS expectancy during delay and trace conditioning. UCS predictability was varied on a trial-by-trial basis by presenting perithreshold auditory CSs. Differential UCS expectancies were demonstrated only on perceived delay and trace trials. Learning-related SCRs were observed during both perceived and unperceived delay CSs. In contrast, differential SCRs were demonstrated only for perceived trace CSs. These data suggest that awareness is necessary for conditional responding during trace, but not delay, fear conditioning.
Human Amygdala Activity During the Expression of Fear Responses
The initial learning and subsequent behavioral expression of fear are often viewed as independent processes with potentially unique neural substrates. Laboratory animal studies of Pavlovian fear conditioning suggest that the amygdala is important for both forming stimulus associations and for subsequently expressing learned behavioral responses. In the present article, human amygdala activity was studied during the autonomic expression of conditional fear in two differential conditioning experiments with event-related functional magnetic resonance imaging and concurrent recording of skin conductance responses (SCRs). Trials were classified on the basis of individual participants' SCRs. Significant amygdala responding was detected only during trials on which a signal both predicted shock and elicited significant conditional SCR. Conditional stimulus presentation or autonomic activity alone was not sufficient. These results indicate that amygdala activity may specifically reflect the expression of learned fear responses and support the position that this region plays a central role in the expression of emotional reactions.
Impact of Continuous Versus Intermittent CS-UCS Pairing on Human Brain Activation During Pavlovian Fear Conditioning
During Pavlovian fear conditioning a conditioned stimulus (CS) is repeatedly paired with an aversive unconditioned stimulus (UCS). In many studies the CS and UCS are paired on every trial, whereas in others the CS and UCS are paired intermittently. To better understand the influence of the CS-UCS pairing rate on brain activity, the experimenters presented continuously, intermittently, and non-paired CSs during fear conditioning. Amygdala, anterior cingulate, and fusiform gyrus activity increased linearly with the CS-UCS pairing rate. In contrast, insula and left dorsolateral prefrontal cortex responses were larger during intermittently paired CS presentations relative to continuously and non-paired CSs. These results demonstrate two distinct patterns of activity in disparate brain regions. Amygdala, anterior cingulate, and fusiform gyrus activity paralleled the CS-UCS pairing rate, whereas the insula and dorsolateral prefrontal cortex appeared to respond to the uncertainty inherent in intermittent CS-UCS pairing procedures. These findings may further clarify the role of these brain regions in Pavlovian fear conditioning.
Neural Correlates of Unconditioned Response Diminution During Pavlovian Conditioning
Pavlovian conditioning research has shown that unconditioned responses (UCR) to aversive unconditioned stimuli (UCS) are reduced when a UCS is predictable. This effect is known as UCR diminution. In the present study, we examined UCR diminution in the functional magnetic resonance imaging (fMRI) signal by varying the rate at which a neutral conditioned stimulus (CS) was paired with an aversive UCS. UCR diminution was observed within several brain regions associated with fear learning, including the amygdala, anterior cingulate, auditory cortex, and dorsolateral prefrontal cortex when a CS continuously relative to intermittently predicted the UCS. In addition, an inverse relationship between UCS expectancy and UCR magnitude was observed within the amygdala, anterior cingulate, and dorsolateral prefrontal cortex, such that as UCS expectancy increased the UCR decreased. These findings demonstrate UCR diminution within the fMRI signal, and suggest that UCS expectancies modulate UCR magnitude.
Neural Substrates of Explicit and Implicit Fear Memory
Distinct aspects of our fearful experiences appear to be mediated by separate explicit and implicit memory processes. To identify brain regions that support these separate memory processes, we measured contingency awareness, conditional fear expression, and functional magnetic resonance imaging signal during a Pavlovian fear conditioning procedure in which tones that predicted an aversive event were presented at supra and sub-threshold volumes. Contingency awareness developed in conjunction with learning-related hippocampal and parahippocampal activity on perceived conditioning trials only. In contrast, conditional fear and differential amygdala activity developed on both perceived and unperceived trials, regardless of whether contingency awareness was expressed. These findings demonstrate the distinct roles of these brain regions in explicit and implicit fear memory processes.
Learning-related Diminution of Unconditioned SCR and FMRI Signal Responses
During Pavlovian conditioning the expression of a conditioned response is typically taken as evidence that an association between a conditioned stimulus (CS) and an unconditioned stimulus (UCS) has been formed. However, learning-related changes in the unconditioned response (UCR) produced by a predictable UCS can also develop. Learning-related reductions in UCR magnitude are often referred to as UCR diminution. In the present study, we examined UCR diminution in the functional magnetic resonance imaging (fMRI) signal by pairing supra- and sub-threshold CS presentations with a UCS. UCR diminution was observed within several brain regions associated with fear learning and memory including the insula, inferior parietal lobe, ventromedial prefrontal cortex (PFC), dorsomedial PFC, and dorsolateral PFC. CS perception appeared to mediate UCR diminution within the ventromedial PFC and posterior cingulate cortex. UCRs within these regions were larger when the UCS followed an unperceived compared to a perceived CS. UCS expectancies appeared to modulate UCRs within the dorsomedial PFC, dorsolateral PFC, insula, and inferior parietal lobe. Activity within these regions showed an inverse relationship with participants' UCS expectancies, such that as UCS expectancy increased UCR magnitude decreased. In addition, activity within the dorsomedial PFC, dorsolateral PFC, and insula showed a linear relationship with unconditioned skin conductance response (SCR) expression. These findings demonstrate UCR diminution within the fMRI signal, and suggest that UCS expectancies modulate prefrontal cortex responses to aversive stimuli. In turn, prefrontal cortex activity appears to modulate the expression of unconditioned SCRs.
Conditioned Diminution of the Unconditioned Skin Conductance Response
During Pavlovian conditioning the expression of a conditioned response typically serves as evidence that an association between a conditioned stimulus (CS) and an unconditioned stimulus (UCS) has been learned. However, learning-related changes in the unconditioned response (UCR) produced by a predictable UCS can also develop. In the present study, we investigated learning-related reductions in the magnitude of the unconditioned skin conductance response (SCR). Healthy volunteers participated in a differential conditioning study in which one tone (CS+) was paired with a loud white-noise UCS and a second tone (CS-) was presented alone. In addition, probe trials that consisted of UCS presentations paired with the CS+ (CS + UCS) and CS- (CS - UCS), as well as presentations of the UCS alone were included to assess UCR diminution. SCR and participants' expectations of UCS presentation were monitored during conditioning. Greater diminution of the UCR was observed to the UCS when it followed the CS+ compared to when it followed the CS- or was presented alone. Further, UCR amplitude showed an inverse relationship with the participants' ratings of UCS expectancy. However, conditioned UCR diminution was also observed independent of differential UCS expectancies. Our findings demonstrate conditioned diminution of the unconditioned SCR. Further, these findings suggest that although UCR amplitude is modified by conscious expectations of the UCS, conditioned diminution of the UCR can be expressed independent of learning-related changes in these expectations.
Abnormal ECG Patterns in Chronic Post-War PTSD Patients: A Pilot Study
BACKGROUND: Posttraumatic stress disorder (PTSD) is a psychiatric syndrome associated with high levels of sympathetic activation of the autonomic nervous system. Individuals diagnosed with PTSD have a high propensity for electrocardiogram (ECG) abnormalities, atrioventricular conductive defects, and cerebrovascular incidents. PURPOSE: The aim of this study was to investigate ECG abnormalities in post-war PTSD patients. METHOD: This pilot study compared patients diagnosed with chronic post-war PTSD (n = 30) to patients diagnosed with major depressive disorder (MDD; n = 24) and healthy controls (n = 20). Following the completion of the Structured Clinical Interview for the DSM (SCID), participants were assessed with a standard 12-lead ECG. RESULTS: ECG abnormalities were observed in 66.7% of PTSD patients and 70.8% of MDD patients. In contrast, only 28.6% of the healthy control group showed ECG abnormalities. Multivariate logistic regression was used to adjust for participants' sex, smoking rate, education level, disease duration, and marital status. The results indicated that PTSD and MDD patients were more likely to have ECG abnormalities than the normal population (odds ratio for PTSD = 12.7, 95% confidence interval 1.9-83.9; and odds ratio for MDD = 14.9, 95% confidence interval 1.3-170.5). CONCLUSION: PTSD and MDD patients showed elevated rates of ECG abnormalities compared to healthy controls. These findings have important implications for the medical treatment of PTSD and MDD given that both of these patient groups appear to be at increased risk of cardiovascular disorder.
Neural Mechanisms Underlying the Conditioned Diminution of the Unconditioned Fear Response
Recognizing cues that predict an aversive event allows one to react more effectively under threatening conditions, and minimizes the reaction to the threat itself. This is demonstrated during Pavlovian fear conditioning when the unconditioned response (UCR) to a predictable unconditioned stimulus (UCS) is diminished compared to the UCR to an unpredictable UCS. The present study investigated the functional magnetic resonance imaging (fMRI) signal response associated with Pavlovian conditioned UCR diminution to better understand the relationship between individual differences in behavior and the neural mechanisms of the threat-related emotional response. Healthy volunteers participated in a fear conditioning study in which trait anxiety, skin conductance response (SCR), UCS expectancy, and the fMRI signal were assessed. During acquisition trials, a tone (CS+) was paired with a white noise UCS and a second tone (CS-) was presented without the UCS. Test trials consisted of the CS+ paired with the UCS, CS- paired with the UCS, and presentations of the UCS alone to assess conditioned UCR diminution. UCR diminution was observed within the dorsolateral PFC, dorsomedial PFC, cingulate cortex, inferior parietal lobule (IPL), anterior insula, and amygdala. The threat-related activity within the dorsolateral PFC, dorsomedial PFC, posterior cingulate cortex, and IPL varied with individual differences in trait anxiety. In addition, anticipatory (i.e. CS elicited) activity within the PFC showed an inverse relationship with threat-related (i.e. UCS elicited) activity within the PFC, IPL, and amygdala. Further, the emotional response (indexed via SCR) elicited by the threat was closely linked to amygdala activity. These findings are consistent with the view that the amygdala and PFC support learning-related processes that influence the emotional response evoked by a threat.
