腹内侧前额叶在消退回忆中的活动提示心理意象可完成恐惧消退学习

Mental imagery is an important element of psychological therapies for fear-related disorders. The present study evaluated the efficacy of imagery extinction using a within-subject design allowing for the comparison of a conditioned stimulus extinguished via mental imagery (CS+Ei) to an unextinguished conditioned stimulus (CS+U) during extinction recall. Twenty-eight human participants underwent differential fear conditioning during functional magnetic resonance imagining. Successful acquisition of differential fear conditioning was confirmed by self-reported fear, skin conductance response (SCR), and activation the anterior insula and dorsal anterior cingulate cortex. Next, participants imagined the CS+Ei without mild shock and the CS− during the imagery extinction learning phase, in which fear transfer was confirmed with self-reported fear and SCR. Lastly, all stimuli were again visually presented in the visual extinction recall phase. Significantly greater ventromedial prefrontal cortex (vmPFC) activity was observed for the CS+Ei compared to the CS+U, suggestive of successful extinction recall following imagery extinction. Moreover, a vmPFC seed-based psychophysiological interaction analysis indicated that unlike the CS+Ei, the CS+U was positively connected with bilateral amygdala during extinction recall. The present study highlights dissociable vmPFC involvement during extinction recall when viewing the CS+Ei following fear extinction using mental imagery as compared to the unextinguished CS+.

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