Recent studies indicate differential involvement of the centromedial amygdala (CM) and the bed nucleus of the stria terminalis (BNST) during processing (anticipation and confrontation) of threat stimuli. Here, temporal predictability was shown to be a relevant factor. In this study, we want to investigate the relevance of these effects, which were found in healthy subjects, for anxiety disorders. Therefore, we investigated the differential involvement of CM and BNST in the anticipation and confrontation of phobic stimuli under variation of temporal predictability in spider phobia. 21 patients with spider phobia and 21 healthy controls underwent a temporally predictable/unpredictable phobic and neutral anticipation and confrontation paradigm using functional magnetic resonance imaging (fMRI) and ROI analyses. During the anticipation phase, healthy controls showed higher CM and BNST activity during the predictable compared with the unpredictable condition compared with the anxiety patients. During a confrontation phase that followed the anticipation phase, CM was more activated than BNST during the phobic compared with the neutral confrontation. While this effect was independent of threat predictability in patients, healthy controls showed higher activation in the CM compared with the BNST only during the predictable spider confrontation compared with the predictable bird confrontation. The results contribute to a better understanding of the separate roles of the CM and BNST during phobic processes. The CM was found to be more relevant to phobic confrontation in patients with spider phobia compared with the BNST.

最近的研究表明，在处理（预期和对抗）威胁刺激过程中，中央杏仁核 (CM) 和终纹床核 (BNST) 的参与程度不同。在这里，时间可预测性被证明是一个相关因素。在这项研究中，我们想调查在健康受试者中发现的这些影响与焦虑症的相关性。因此，我们研究了 CM 和 BNST 在蜘蛛恐惧症的时间可预测性变化下对恐惧刺激的预期和对抗的不同参与。21 名蜘蛛恐惧症患者和 21 名健康对照者使用功能磁共振成像 (fMRI) 和 ROI 分析进行了时间可预测/不可预测的恐惧和中性预期和对抗范式。在预期阶段，与焦虑患者相比，健康对照组在可预测期间表现出更高的 CM 和 BNST 活性。在预期阶段之后的对抗阶段，与中立对抗相比，在恐惧期间 CM 比 BNST 更活跃。虽然这种效果与患者的威胁可预测性无关，但与可预测的鸟类对抗相比，仅在可预测的蜘蛛对抗期间，与 BNST 相比，健康对照组的 CM 显示出更高的激活。结果有助于更好地理解 CM 和 BNST 在恐惧过程中的不同作用。与 BNST 相比，发现 CM 与蜘蛛恐惧症患者的恐惧对抗更相关。