神经科学情感讲座

Emotion&

Motivation

ChristopherT.Sege,Ph.D.

AssistantProfessor

DepartmentofPsychiatry&BehavioralSciences

Sleep&AnxietyTreatment&Research

LisaM.McTeague,Ph.D.

AssociateProfessor

DepartmentofPsychiatry&BehavioralSciences

BrainStimulationDivision

RalphH.JohnsonVAMC,PTSDClinicalTeam

FundamentalsofNeuroscience3/28/22ClinicalpsychologistsExperimentalcognitiveandaffectiveneuroscienceEvidenced-basedcognitive-behavioraltherapy,neuropsychologicalassessment,behavioralmedicine,primarycareBrain-stimulation-basedadjunctsforcognitive-behavioraltherapytargetingcircuitsintegraltocognitiveandaffectiveprocessingAlittlebitaboutus….AutonomicmeasuresEMGEEG&ERPsfMRIspTMS-fMRIOutline:PartIIHumanstudyofemotionLaboratoryparadigmsPictureviewing,imagery,fearconditioningObjectivemeasuresofemotionalprocessingPeripheralphysiologyandneurocircuitryInfluenceofIndividualdifferencesandpsychopathologyinEmotionalProcessingPTSDDepressionSummaryObjectiveAssessmentofEmotion&MotivationLaboratoryParadigmsWhatCircuitsDriveEmotionalExperience?ActiveAreaofInvestigationPapezCircuithippocampalformation(subiculum)→fornix→mammillarybodies→mammillothalamictract→anteriorthalamicnucleus→cingulum→entorhinalcortex→hippocampalformation.ExtendedLimbicsystemPaulMacLeanandothers.Itnowencompassesadditionalinterconnectedbrainareas.Amygdala:keycoordinator,linkingcorticalprocessingtothehypothalamusandothersubcorticalbrainstructuresimportantforemotionalbehavior.PrefrontalCortexMedialLateralWorkingMemorySFG/dACCWorkingMemorydlPFC(MFG)ActionControlPre-SMAInhibitoryControlvlPFCConflict/ErrordACCConflict/ErrordlPFC&vlPFC(IFG)EmotionalArousalmPFC(rACC)NoveltyDetectionvlPFCEmotionDecisionMakingmedialOFCLTMdlPFCEmotionRegulationMesulam;Dolan.TheNewYorkAcademyofSciences:Vol.1121;2007“UniquelyHuman”CorticalExpansionTheBrain:AnintegratedorganNatureReviewsNeuroscience,2015.TheDefenseCascade:MultipleSystemsandMultipleTypesofThreatDysfunctionThreatThreatBradleyetal.(2000).Emotion.Lang&Davis(2006).ProgressinBrainResearchVigilanceFreezingFight/FlightElicitingandMeasuringEmotionintheLaboratory:PictureViewingElicitingandMeasuringEmotionintheLaboratory:PictureViewingTranslationofanimaltechniquestohumansOrbicularisEMGChange:BlinkingtoanacousticprobeTassinary&Cacioppo.(2017).HandbookofPsychophysiology.

PotentiatedStartleispositivelycorrelatedwithunpleasantemotionalarousal

.ForUnpleasantpicturesratedHIGHinemotionalarousal(e.g.,attackinganimalsorhumans)thestartleprobereflexisPOTENTIATED.

OtherreflexmeasuresarealsoarealsoactivateddirectlybyemotionalpicturestimuliHouseholdobjPollutionLossIllnessContaminationAccidentsMutilationsAnimalattackHumanattackArousalr=.86BlinkMagnitude

4648505254Bradley,M.M.,Codispoti,M.,Cuthbert,B.N.,&Lang,P.J.(2001).Emotion.Costa,McTeagueetal.(2010).HumanBrainMapping

PotentiatedStartleisassociatedwithamygdalaactivation

.ForUnpleasantpicturesratedHIGHinemotionalarousal(e.g.,attackinganimalsorhumans)thestartleprobereflexisPOTENTIATED.

OtherreflexmeasuresarealsoarealsoactivateddirectlybyemotionalpicturestimuliHouseholdobjPollutionLossIllnessContaminationAccidentsMutilationsAnimalattackHumanattackArousalr=.86BlinkMagnitude

4648505254Bradley,M.M.,Codispoti,M.,Cuthbert,B.N.,&Lang,P.J.(2001).Emotion.Costa,McTeagueetal.(2010).HumanBrainMappingRatedArousal

PotentiatedStartleisassociatedwithamygdalaactivationduringconcurrentfMRI-EMGrecording

.ForUnpleasantpicturesratedHIGHinemotionalarousal(e.g.,attackinganimalsorhumans)thestartleprobereflexisPOTENTIATED.

OtherreflexmeasuresarealsoarealsoactivateddirectlybyemotionalpicturestimuliHouseholdobjPollutionLossIllnessContaminationAccidentsMutilationsAnimalattackHumanattackArousalr=.86BlinkMagnitude

4648505254Lonsdorfetal.(2020).BiologicalPsychiatry

Pictureviewingmodulatesemotionalengagementacrossphysiologicalmeasures

.

OtherreflexmeasuresarealsoarealsoactivateddirectlybyemotionalpicturestimuliHouseholdobjPollutionLossIllnessContaminationAccidentsMutilationsAnimalattackHumanattackArousalr=.86BlinkMagnitude

4648505254Meta-analysistodistilltheextantliterature

.HouseholdobjPollutionLossIllnessContaminationAccidentsMutilationsAnimalattackHumanattackArousalr=.86BlinkMagnitude

4648505254TherevisedALEalgorithm(Eickhoffetal.,2012),implementedinMATLAB,identifiedareasofconvergenceofreportedcoordinatesthatarehigherthanexpectedunderarandomspatialassociation.

WithALEwearetestingforconvergentevidenceornot.Thisisnotthesameasperformingamega-analysiswithtensofthousandsofsubjectsperdisorder.TheALEapproachallowsustointegrateandhenceconsolidatetheentireextantliterature.Modulationofneurocircuitryduringpictureviewing:IAPSandfaces

.HouseholdobjPollutionLossIllnessContaminationAccidentsMutilationsAnimalattackHumanattackArousalr=.86BlinkMagnitude

4648505254Sabatinellietal.,2011.Neuroimage.MentalImageryMentalImageryDon’tthinkabout

whitebears!It’saquietdaywithoutmuchtodo.You’resittingaroundyourplace,resting,reading,andlookingoutthewindow—whereleavesswirlgentlyinthewind.VerbalEvaluationofImageryExperience:

BiphasicAffectiveSpaceN=57;30femaleTheregisteredlettersaysthat“Youhavejustwontenmilliondollars!”It’samazing—Youboughtthewinningticketinthelottery.Youcry,scream,jumpwithjoy!It’saquietdaywithoutmuchtodo.You’resittingaroundyourplace,resting,reading,andlookingoutthewindow—whereleavesswirlgentlyinthewind.VerbalEvaluationofImageryExperience:

BiphasicAffectiveSpaceN=57;30femaleTheregisteredlettersaysthat“Youhavejustwontenmilliondollars!”It’samazing—Youboughtthewinningticketinthelottery.Youcry,scream,jumpwithjoy!Withoutthinking,yousteppedoffthecurbintotraffic.Breaksscreech.Youlookup,frozen,heartjumpinginyourchest.Atruckisskidding,hurtlingtowardsyou.It’saquietdaywithoutmuchtodo.You’resittingaroundyourplace,resting,reading,andlookingoutthewindow—whereleavesswirlgentlyinthewind.VerbalEvaluationofImageryExperience:

BiphasicAffectiveSpaceN=57;30femaleEmotionalImagery:ArousalsensitivityinmultipleregionsCosta,Lang,Sabatinelli,Versace,&Bradley.(2010).HumBrainMappRLateralposteriorcerebellumHeightenedactivationinleftposteriorinsulaforthecontrastofpleasantandunpleasantimagerybutdidnotmeetthresholdcriteriaformultiplecomparisonscorrection(t=-2.8).EmotionalImagery:ArousalSensitivityinMultipleResponseChannelsCosta,Lang,Sabatinelli,Versace,&Bradley.(2010).HumBrainMappAutonomicMobilizationAffectiveCommunicationNarrativeImagery:TrialStructureVerbalEvaluationActionReadinessListen6sImagine(12sec)95dbstartleprobesRecoverNeutral“Attheendofalongdayofworking,IamsittingonthecouchwatchingadocumentaryonTV.”

PersonalThreat“Ifeeltensealloverasmymombeginsbeatingmewithherfist.ItishappeningagainandIwanttoscream.”Self-assessmentManikin:ArousalRatings(1-9)IncreasingAversionIncreasingArousalBlinkMagnitudetoAcousticProbesIncreasingAversiveArousalT-score(ITI=50)SkinConductanceLevelHeartRateCorrugatorEMGAttentionalDeploymentMcTeague&Lang,2012.Dep&Anx.ProbeP3EmotionalImagery:ArousalsensitivityinmultipleregionsSabatinelli,Lang,Bradley,&Flaisch(2006).ProgressinBrainresearchCosta,Lang,Sabatinelli,Versace,&Bradley.(2010).HumBrainMappEmotionalImagery:HedonicsensitivitynotcorrespondenttoarousalsensitivityAmeta-analysisofnarrativeemotionalimageryCosta,McTeague,Bradley&Lang(inpreparation)ImaginedNarrativesImagingMethodologyAmeta-analysisofnarrativeemotionalimagery:ArousalSensitivityCosta,McTeague,Bradley&Lang(inpreparation)ImaginedNarrativesAmeta-analysisofnarrativeemotionalimagery:HedonicSensitivityCosta,McTeague,Bradley&Lang(inpreparation)ImaginedNarrativesAmeta-analysisoffearconditioning:OverlapincircuitryofemotionalprocessingFullanaetal.,2016.Neuroscience&BiobehavioralReviewsImaginedNarrativesActivationCS+vCS-DeactivationCS+vCS-DisruptionsofEmotion&MotivationIndividualDifferencesandPsychopathologyTraumarecurrence&defensivephysiology:Hypotheticaldose-responserelationshipsDefensivereactivityTraumaticExposureDefensivereactivityTraumaticExposureDefensivereactivityTraumaticExposureMcTeagueetal.(2010).BiologicalPsychiatryExemplarDisruptionsofEmotion&Motivation:PTSDThepersonwasexposedto:death,threateneddeath,actualorthreatenedseriousinjury,oractualorthreatenedsexualviolenceThetraumaticeventispersistentlyre-experiencedAvoidanceoftrauma-relatedstimuliafterthetraumaNegativethoughtsorfeelingsthatbeganorworsenedafterthetrauma,Trauma-relatedarousalandreactivitythatbeganorworsenedafterthetrauma,Symptomslastformorethan1month.Symptomscreatedistressorfunctionalimpairment(e.g.,social,occupational).Symptomsarenotduetomedication,substanceuse,orotherillness.DiagnosticCriteriaforMentalIllness:PTSD“Diagnosticclassificationsarenotsimpleorspecific”ControlPTSDMcTeagueetal.(2010).BiologicalPsychiatryNon-exposedCONTROL

“Onstagesinging,Ibegintoshakeandmyheartbeatsfaster.Itremblethinkingthattheaudienceisstaringatme.”“Exaggeratedstartle”inPTSDOrbicularisControlPTSDTrauma-exposedCONTROL

“Inthemiddleofthenight,Iawaketothefirealarm.IfeelsweatyasmyroommateandIescapetheburninghouse.”“Exaggeratedstartle”inPTSDMcTeagueetal.(2010).BiologicalPsychiatryOrbicularisControlPTSDSingle-traumaPTSD

“Mylegistrappedbetweentheseats.Thisisit,thevanisfullofsmokeandIamgoingtodieinthisfire.”“Exaggeratedstartle”inPTSDMcTeagueetal.(2010).BiologicalPsychiatryOrbicularisControlPTSDMultiple-traumaPTSD

“Ifeeltensealloverasmymombeginsbeatingmewithherfist.ItishappeningagainandIwanttoscream.”“Exaggeratedstartle”inSingle-traumabutnotmultiple-traumaPTSDMcTeagueetal.(2010).BiologicalPsychiatryOrbicularisNotonly“blunting”:ResponseSystemDiscordancewithTraumaAccumulationMcTeagueetal.(2010).BiologicalPsychiatryTraumaSubtypesControlPTSDDurationofDysfunctionDiagnosticComorbidityDimensionalSymptomsMcTeagueetal.(2010).BiologicalPsychiatryMultiple-traumaPTSDSingle-traumaPTSDIndexTraumabyExposureGroupTrauma-exposedControlAdulthoodWitnessInjury/DeathAdulthoodAccident/InjuryCSA&/CPAAdulthoodPhysical&/SexualAssaultMcTeagueetal.(2010).BiologicalPsychiatryOngoingtraumaticcontext&posttraumatichyperarousal010203040Years0102030401stTraumaMostRecentTraumaIndexTraumaIndexTraumaPTSDOnsetAssessmentAssessmentSingle-traumaPTSDMultiple-traumaPTSDPTSDOnsetMcTeagueetal.(2010).BiologicalPsychiatryLaniusetal.(2012).AmJofPsychiatryHeterogeneityinPTSDFINALPESession12:

DramaticGainsover6sessionsSUDs(0-100)60MinutesPRINCIPALDISORDERDoespronounced“objective”defensiveengagementpredicttreatmentresponse?ControlSingleTraumaMultipleTraumaPTSDPTSDResponderNon-ResponderSabatinellietal.,2014.BrainConnectivityDisruptionsofEmotion&MotivationareoftenBROADCopingintheClinic

EffectsofClinicalAnxietyonDynamicMechanismsofEscapeandAvoidancePreparationChristopherSege,Ph.D.CopingintheClinic

EffectsofClinicalAnxietyonDynamicMechanismsofEscapeandAvoidancePreparationChristopherSege,Ph.D.ChristopherSege,Ph.D.SeveredepressionProbeP3:ActivedemandStudiesofEmotionalCognition/Competition“Indirect”testsEmotional“stroop”testDotprobePerformancemonitoringtestsIsthis“emotion”?“Emotional”PerformanceMonitoring:TheFlankersTaskError-relatedelectricalpotentialgeneratedinACCComparinghealthycontrolparticipantstoapatientgroupprovidesnoinformationaboutdiagnosticspecificity.Healthycontrolparticipantsareoften“super”controls.Wecannotestablishdistinctandcommonaspectsofagivendisorderwithoutcomparingacrossdisorders.Comorbidityistheruleratherthantheexception.Whyaretransdiagnosticprocessespertinent?dorsomedialthalamusdorsalanteriorcingulateventromedialprefrontalcortexTransdiagnosticMeta-analysisof

FunctionalNeuroimagingofEmotionalProcessingMcTeagueetal.,(inpress)AmJPsychiatrydorsomedialthalamusdorsalanteriorcingulateventromedialprefrontalcortexdorsomedialthalamusdorsalanteriorcingulateventromedialprefrontalcortexMeta-analysisAcrossMentalIllness:TransdiagnosticAberrantActivationduringEmotionalProcessingdorsomedialthalamusdorsalanteriorcingulateventromedialprefrontalcortexdorsomedialthalamusbilateralamygdalabilateralamygdala/hippocampus/parahippocampalgyrusthalamusrightventrolateralprefrontalcortex0246ZAberrantActivationAcrossPatientGroupsandTasksinferioroccipitalcortexdorsalanteriorcingulaterightventrolateralprefrontalcortexventromedialprefrontalcortexventromedialprefrontalcortexMeta-analysisAcrossMentalIllness:TransdiagnosticAberrantActivationbyEmotionalProcessMcTeagueetal.,(inpress)AmJPsychiatryMeta-analysisAcrossMentalIllness:TransdiagnosticPatientHyper-andHypo-activationduringEmotionalProcessingdorsomedialthalamusamygdalarightventrolateralprefrontalcortexdorsalanteriorcingulaterightventrolateralprefrontalcortex0246ZHyper-activationHypo-activationMcTeagueetal.,(inpress)AmJPsychiatryPuttingitalltogether:OverlappingTransdiagnosticAberrationsinNeurocircuitStructureandFunctionrightanteriorinsula/ventrolateralprefrontalcortexdorsalanteriorcingulateRED=EmotionalProcessingBLUE

=CognitiveProcessingYELLOW

=GraymatterreductionMcTeagueetal.,(2017)AmJPsychiatryGoodkindetal.,(2015)JAMAPsych;McTeagueetal.(2016)JPsychiatricResVentrolateralprefrontalcortexhasbothafferentandefferentconnectionstotheamygdalaandsensorycortices,aswellasafferentconnectionsfromanteriorinsula.Additionally,itisheavilyinterconnectedtoregionsinvolvedinemotionalexpression(e.g.,frontalpole)andregulation(dorsolateralprefrontalcortex).Highfrequencyelectricalstimulationofthisareasuppressedthetaandalphapower,correspondingtoimmediatelyimprovedmood,inepilepsypatientswithdepression(Raoetal.,2018).Therapeuticrepetitivetranscranialmagneticstimulation(rTMS)toventrolateralprefrontalcortexhasimprovedsymptomsinarangeofdisordersincludingOCDanddepression(e.g.,Ruffinietal.,2009;Nauczycieletal.,2014).OverlappingStructuralandFunctionalDysfunctioninConnectionalHubs:ventrolateralprefrontalcortexGraymatterlossinthecingulatewasobserved,specifically,attheintersectionofregionsofemotionalandcognitivedisruption.Haberandcolleagues(Tang,2019)recentlyusedretrogradetracinginmacaquestoassessafferentinputsfromallareasofthefrontalcortextosixsitesintheanteriorcingulateandfoundthisareatobethesole,prominentconnectionalhub.Haberandcolleaguesobservedasimilarhubinhumandiffusionimagingdata.mPFCrTMSeffectiveforarangeofdisorders(Dunlopetal.,2015;Marquesetal.,2019).OverlappingStructural