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The question to what extent emotion-related brain activation depends upon the presentation design (block design vs. event-related design) and the stimulus type (scene pictures vs. pictures with facial mimic) has hardly been addressed in previous functional magnetic resonance imaging (fMRI) research. In the present fMRI experiment, 40 right-handed subjects viewed pictures with fear-inducing and disgust-inducing content as well as facial expressions of fear and disgust. Pictures of neutral objects and neutral facial mimic were used as control stimuli. The pictures were presented in a block design for half of the subjects; the other half viewed the same stimuli as singular events in randomized sequence. The participants had been instructed to passively view the pictures. Disgust-evoking scenes provoked activation in the amygdala, the insula and the orbitofrontal cortex (OFC). This applied to the blocked as well as to the event-related design. Fear-relevant scenes were associated with activity in the insula, the OFC and the middle temporal gyri in the event-related design. The presentation in a block design only led to activation in the middle temporal gyri. Facial expressions of disgust and fear did not trigger significant activation neither in the blocked nor event-related design. This surprising outcome may be a result of context and task effects. The face stimuli which were presented together with the more complex scenes in a passive viewing paradigm possibly were not salient enough to trigger emotional processing.

Functional magnetic resonance imaging studies have examined neural correlates of disgust imagery, but have never taken into account the moderating effects of personality traits. Twenty-four women first viewed and subsequently visualized pictures with disgust-inducing and happiness-inducing content. Relative to the picture perception, disgust, and happiness imagery provoked activation of the insula, anterior cingulate cortex, and parietal cortex. Trait disgust was negatively correlated with localized brain activation (e.g. insula, amygdala, parietal cortex, anterior cingulate cortex) during disgust imagery. This study provides first evidence that disgust propensity is associated with brain activation during imagery of repulsive scenes.

This study investigated whether bulimia nervosa (BN) and binge-eating disorder (BED) are associated with structural brain abnormalities. Both disorders share the main symptom binge-eating, but are considered differential diagnoses. We attempted to identify alterations in grey matter volume (GMV) that are present in both psychopathologies as well as disorder-specific GMV characteristics. Such information can help to improve neurobiological models of eating disorders and their classification. A total of 50 participants (patients suffering from BN (purge type), BED, and normal-weight controls) underwent structural MRI scanning. GMV for specific brain regions involved in food/reinforcement processing was analyzed by means of voxel-based morphometry. Both patient groups were characterized by greater volumes of the medial orbitofrontal cortex (OFC) compared to healthy controls. In BN patients, who had increased ventral striatum volumes, body mass index and purging severity were correlated with striatal grey matter volume. Altogether, our data implicate a crucial role of the medial OFC in the studied eating disorders. The structural abnormality might be associated with dysfunctions in food reward processing and/or self-regulation. The bulimia-specific volume enlargement of the ventral striatum is discussed in the framework of negative reinforcement through purging and associated weight regulation.

This functional magnetic resonance imaging study investigated long-term effects of cognitive behavior therapy (CBT) in individuals suffering from spider phobia. Ten female patients who had shown positive immediate CBT effects were invited to take part in a 6-month follow-up investigation. Here, the patients, along with eight non-phobic females, were presented with the same pictures depicting spiders, generally disgust-inducing, generally fear-inducing and neutral content, which they had viewed 6 months earlier. Patients' self-report and overt behavior indicated a positive long-term clinical improvement. Related hemodynamic changes included an increase in medial orbitofrontal cortex (OFC) activity. As the medial OFC is involved in emotion-related learning, especially in the representation of positive stimulus-outcome associations, we conclude that the medial OFC effect constitutes the neuronal basis of the lasting positive CBT outcome. Activity to disorder-irrelevant pictures decreased across the sessions in the lateral OFC and in the insula, which most likely reflects general habituation.

BACKGROUND: The underlying neurobiological mechanisms that account for the onset and maintenance of binge-eating disorder (BED) are not sufficiently understood. This functional magnetic resonance imaging (fMRI) study explored the neural correlates of visually induced food reward and loathing. METHOD: Sixty-seven female participants assigned to one of four groups (overweight BED patients, overweight healthy control subjects, normal-weight healthy control subjects, and normal-weight patients with bulimia nervosa) participated in the experiment. After an overnight fast, the participants' brain activation was recorded during each of the following three conditions: visual exposure to high-caloric food, to disgust-inducing pictures, and to affectively neutral pictures. After the fMRI experiment, the participants rated the affective value of the pictures. RESULTS: Each of the groups experienced the food pictures as very pleasant. Relative to the neutral pictures, the visual food stimuli provoked increased activation in the orbitofrontal cortex (OFC), anterior cingulate cortex (ACC), and insula across all participants. The BED patients reported enhanced reward sensitivity and showed stronger medial OFC responses while viewing food pictures than all other groups. The bulimic patients displayed greater arousal, ACC activation, and insula activation than the other groups. Neural responses to the disgust-inducing pictures as well as trait disgust did not differ between the groups. CONCLUSIONS: This study provides first evidence of differential brain activation to visual food stimuli in patients suffering from BED and bulimia nervosa.

Because of its abstract nature, worrying might function as an avoidance response in order to cognitively disengage from fearful imagery. The present functional magnetic resonance imaging study investigated neural correlates of aversive imagery and their association with worry tendencies, as measured by the Penn State Worry Questionnaire (PSWQ). Nineteen healthy women first viewed, and subsequently imagined pictures from two categories, 'threat' and 'happiness'. Worry tendencies were negatively correlated with brain activation in the anterior cingulate cortex, the prefrontal cortex (dorsolateral, dorsomedial, ventrolateral), the parietal cortex and the insula. These negative correlations between PSWQ scores and localized brain activation were specific for aversive imagery. Moreover, activation in the above mentioned regions was positively associated with the experienced vividness of both pleasant and unpleasant mental pictures. As the identified brain regions are involved in emotion regulation, vivid imagery and memory retrieval, a lowered activity in high PSWQ scorers might be associated with cognitive disengagement from aversive imagery as well as insufficient refresh rates of mental pictures. Our preliminary findings encourage future imagery studies on generalized anxiety disorder patients, as one of the main symptoms of this disorder is excessive worrying.

We examined whether males and females differ in the intensity and laterality of their hemodynamic responses towards visual disgust and fear stimuli. Forty-one female, and 51 male subjects viewed disgust-inducing, fear-inducing and neutral pictures in an fMRI block design. Self-report data indicated that the target emotions had been elicited successfully with women responding stronger than men. While viewing the fear pictures, which depicted attacks by humans or animals, men exhibited greater activation in the bilateral amygdala and the left fusiform gyrus than women. This response pattern may reflect greater attention from males to cues of aggression in their environment. Further, the lateralization of brain activation was comparable in the two genders during both aversive picture conditions.

We examined the influence of disgust sensitivity and trait anxiety on disgust processing via functional magnetic resonance imaging. Data of 63 healthy females were combined across four studies, where the same disgusting and affectively neutral pictures had been presented. The disgust pictures, rated as highly repulsive, provoked activation in the occipital cortex, the left prefrontal cortex and both amygdalae. Disgust sensitivity and trait anxiety were positively, and independently from each other, correlated with the activation of the right amygdala. This points to the role of the amygdala as an integrative brain structure, whose activation can be modulated by different affective styles.

This functional magnetic resonance imaging study investigated the disgust- and fear-reactivity of patients suffering from obsessive-compulsive disorder (OCD). Ten OCD patients were scanned while viewing blocks of pictures showing OCD triggers from their personal environment and OCD-irrelevant disgust-inducing, fear-inducing and neutral scenes. Afterwards, the patients rated the intensity of the induced disgust, fear and OCD symptoms. The responses were compared with those of 10 healthy control subjects. The disorder-relevant pictures provoked intense OCD symptoms in the clinical group associated with increased activation in the bilateral prefrontal cortex, the left insula, the right supramarginal gyrus, the left caudate nucleus and the right thalamus. The patients gave higher disgust and fear ratings than the controls for all aversive picture categories. Neural responses towards the disorder-irrelevant disgusting and fear-inducing material included more pronounced insula activation in patients than controls. Summarizing, photos of individual OCD-triggers are an effective means of symptom provocation and activation of the fronto-striato-thalamo-parietal network. The increased insular reactivity of OCD patients during all aversive picture conditions might mirror their susceptibility to experience negative somatic states.

The present functional magnetic resonance imaging study investigated the fear and disgust reactivity of patients suffering from spider phobia. Ten phobics and 13 control subjects were scanned while viewing alternating blocks of phobia-relevant, generally fear-inducing, disgust-inducing and affectively neutral pictures. The patient group rated the spider pictures as being more disgust and fear evoking than the control group, and showed greater activation of the visual association cortex, the amygdalae, the right dorsolateral prefrontal cortex and the right hippocampus. Specific phobia-related activation occurred in the supplementary motor area. The patients also showed greater amygdala activation during the presentation of generally disgust- and fear-inducing pictures. This points to an elevated sensitivity to repulsive and threatening stimuli in spider phobics and implicates the amygdala as a crucial neural substrate.

Neurofunctional mechanisms underlying cognitive behavior therapy (CBT) are still not clearly understood. This functional magnetic resonance imaging (fMRI) study focused on changes in brain activation as a result of one-session CBT in patients suffering from spider phobia. Twenty-six female spider phobics and 25 non-phobic subjects were presented with spider pictures, generally disgust-inducing, generally fear-inducing and affectively neutral scenes in an initial fMRI session. Afterwards, the patients were randomly assigned to either a therapy group (TG) or a waiting list group (WG). The scans were repeated one week after the treatment or after a one-week waiting period. Relative to the non-phobic participants, the patients displayed increased activation in the amygdala and the fusiform gyrus as well as decreased activation in the medial orbitofrontal cortex (OFC) during the first exposure. The therapy effect consisted of increased medial OFC activity in the TG relative to the WG. Further, therapy-related reductions in experienced somatic anxiety symptoms were positively correlated with activation decreases in the amygdala and the insula. We conclude that successful treatment of spider phobia is primarily accompanied by functional changes of the medial OFC. This brain region is crucial for the self-regulation of emotions and the relearning of stimulus-reinforcement associations.

Findings from several functional magnetic resonance imaging (fMRI) studies implicate the existence of a distinct neural disgust substrate, whereas others support the idea of distributed and integrative brain systems involved in emotional processing. In the present fMRI experiment 12 healthy females viewed pictures from four emotion categories. Two categories were disgust-relevant and depicted contamination or mutilation. The other scenes showed attacks (fear) or were affectively neutral. The two types of disgust elicitors received comparable ratings for disgust, fear and arousal. Both were associated with activation of the occipitotemporal cortex, the amygdala, and the orbitofrontal cortex; insula activity was nonsignificant in the two disgust conditions. Mutilation scenes induced greater inferior parietal activity than contamination scenes, which might mirror their greater capacity to capture attention. Our results are in disagreement with the idea of selective disgust processing at the insula. They point to a network of brain regions involved in the decoding of stimulus salience and the regulation of attention.

We examined the effects of symptom induction on neural activation in blood-injection-injury (BII) phobia. Nine phobic and 10 non-phobic subjects participated in an fMRI study in which they were presented with disorder-relevant, generally disgust-inducing, generally fear-evoking and neutral pictures. We observed diminished medial prefrontal cortex (MPFC) activity in patients compared to controls for phobia-relevant and disgust-inducing pictures. The MPFC has been shown to be critically involved in the automatic and effortful cognitive regulation of emotions. Therefore, the results might reflect reduced cognitive control of emotions in BII phobics during the experience of phobic symptoms as well as during states of disgust. The latter response component might be a result of the elevated disgust sensitivity of BII phobics.

Phobic responses are strong emotional reactions towards phobic objects, which can be described as a deficit in the automatic regulation of emotions. Difficulties in the voluntary cognitive control of these emotions suggest a further phobia-specific deficit in effortful emotion regulation mechanisms. The actual study is based on this emotion regulation conceptualization of specific phobias. The aim is to investigate the neural correlates of these two emotion regulation deficits in spider phobics. Sixteen spider phobic females participated in a functional magnetic resonance imaging (fMRI) study in which they were asked to voluntarily up- and down-regulate their emotions elicited by spider and generally aversive pictures with a reappraisal strategy. In line with the hypothesis concerning an automatic emotion regulation deficit, increased activity in the insula and reduced activity in the ventromedial prefrontal cortex was observed. Furthermore, phobia-specific effortful regulation within phobics was associated with altered activity in medial prefrontal cortex areas. Altogether, these results suggest that spider phobic subjects are indeed characterized by a deficit in the automatic as well as the effortful regulation of emotions elicited by phobic compared with aversive stimuli. These two forms of phobic emotion regulation deficits are associated with altered activity in different medial prefrontal cortex subregions.

Patients suffering from obsessive-compulsive disorder (OCD) are characterized by dysregulated neuronal processing of disorder-specific and also unspecific affective stimuli. In the present study, we investigated whether generic fear-inducing, disgust-inducing, and neutral stimuli can be decoded from brain patterns of single fMRI time samples of individual OCD patients and healthy controls. Furthermore, we tested whether differences in the underlying encoding provide information to classify subjects into groups (OCD patients or healthy controls). Two pattern classification analyses were conducted. In analysis 1, we used a classifier to decode the category of a currently viewed picture from extended fMRI patterns of single time samples (TR=3s) in individual subjects for several pairs of categories. In analysis 2, we used a searchlight approach to predict subjects' diagnostic status based on local brain patterns. In analysis 1, we obtained significant accuracies for the separation of fear-eliciting from neutral pictures in OCD patients and healthy controls. Separation of disgust-inducing from neutral pictures was significant in healthy controls. In analysis 2, we identified diagnostic information for the presence of OCD in the orbitofrontal cortex, and in the caudate nucleus. Accuracy obtained in these regions was 100% (p<10(-6)). To summarize our findings, by using multivariate pattern classification techniques we were able to identify neurobiological markers providing reliable diagnostic information about OCD. The classifier-based fMRI paradigms proposed here might be integrated in future diagnostic procedures and treatment concepts.

We investigated subjective and hemodynamic responses towards disgust-inducing, fear-inducing, and neutral pictures in a functional magnetic resonance imaging study. Within an interval of 1 week, 24 male subjects underwent the same block design twice in order to analyze possible response changes to the repeated picture presentation. The results showed that disgust-inducing and fear-inducing scenes provoked a similar activation pattern in comparison to neutral scenes. This included the thalamus, primary and secondary visual fields, the amygdala, the hippocampus, and various regions of the prefrontal cortex. During the retest, the affective ratings hardly changed. In contrast, most of the previously observed brain activations disappeared, with the exception of the temporo-occipital activation. An additional analysis, which compared the emotion-related activation patterns during the two presentations, showed that the responses to the fear-inducing pictures were more stable than the responses to the disgust-inducing ones.

The aim of this fMRI study was to explore brain structures that are involved in the processing of erotic and disgust-inducing pictures. The stimuli were chosen to trigger approach and withdrawal tendencies, respectively. By adding sadomasochistic (SM) scenes to the design and examining 12 subjects with and 12 subjects without sadomasochistic preferences, we introduced a picture category that induced erotic pleasure in one sample and disgust in the other sample. Since we also presented neutral pictures, all subjects viewed pictures of four different categories: neutral, disgust-inducing, erotic, and SM erotic pictures. The analysis indicated that several brain structures are commonly involved in the processing of disgust-inducing and erotic pictures (occipital cortex, hippocampus, thalamus, and the amygdala). The ventral striatum was specifically activated when subjects saw highly sexually arousing pictures. This indicates the involvement of the human reward system during the processing of visual erotica.