How Do Fear and Anxiety Arise in the Brain?

Dr. Matthias Sperl, a psychotherapist for cognitive behavioral therapy at the University of Siegen, is searching for new ways to understand and treat fear and anxiety. His efforts have earned him the Early Career Award from the German Society for Psychophysiology and its Application (DGPA).

Many people in Germany suffer from a mental health issues related to anxiety or trauma. For most patients, these issues cause massive limitations to their daily lives and can only be addressed with therapeutic help.

Dr. Matthias Sperl knows much about anxiety — as the subject of his research. As a psychological psychotherapist for cognitive behavioral therapy at the University of Siegen, he examines how fear can be influenced, the underlying processes in the brain, and which kind of therapies are most effective for anxiety disorders. Sperl’s work has earned him an Early Career Award from the German Society for Psychophysiology and its Application (DGPA).

His research seeks to close gaps of understanding in how anxiety arises. Previous studies demonstrated how the activity of neurons in the prefrontal cortex of the brain changed when faced with a serious threat, accompanied by an increase in theta oscillation activity. At the same time, it became known that the amygdala — a deep-lying, almond-shaped part of the brain — is activated during anxiety situations, triggering changes in the body that have been described similarly by many patients suffering from fear: “You begin to sweat, you feel flushed, your heart beats faster, you breathe more quickly and shallowly — until finally you have the feeling that you can't get any air.” Sperl sees a commonality here: “We presume that the prefrontal cortex has some control over the amygdala, meaning it can turn it up or down. Regions of the brain communicate with each other by synchronizing neural networks known as theta oscillations. There is a section of the brain that does the equivalent of hitting the gas pedal when we are afraid. Another adjacent part of the brain acts like a brake pedal, throttling that fear once the danger has passed. And it's precisely that area that we’re trying to reinforce through therapy.”

The key question: Why do people have such extraordinarily clear memories of situations when they were afraid? Sperl and his team of researchers suspect that a higher emotional activation in the brain, known among specialists as “arousal,” is responsible for this phenomenon. When this special type of arousal occurs, the body emits a neurotransmitter called noradrenaline, which controls the amygdala. This in turn stores emotional experiences in the memory. The stronger the arousal incident, the more vivid the fears when stored in memory. “Hyperarousal,” i.e., an incident of enormously strong activity, probably contributes to the arising of anxiety, Sperl says.

To prove the interaction between the prefrontal cortex and the amygdala, Sperl and his team worked with the paradigm of fear conditioning: test subjects were repeatedly confronted with unpleasant stimuli. As part of the experiment, test subjects were placed within an MRI scanner while wearing headgear containing metal plates, allowing researchers to monitor the bodily reaction alongside an EEG (electroencephalogram) and fMRI (functional magnetic resonance imaging). The innovative concept juxtaposed the MRI data with the EEG measurements, which record the speed of brain activity: “Temporal precision and rapid processes are extremely important when it comes to fear and anxiety,” Sperl underscores.

For the second stage of the experiment, the team examined the impact of an increased norepinephrine production, and especially how ‘arousal’ incidents influence previously learned anxiety. To do so, they gave a dose of a substance called yohimbine to one test group before it was engaged with the stimuli. Yohimbine is known to encourage production of the neurotransmitter norepinephrine. The results were very clear: Test subjects who receive yohimbine showed significantly stronger fear reactions. This indicates that they perceived the stimulus as a larger threat than did other persons who had not received the substance. Sperl and his colleagues suspect that the amygdala in the affected group was so strongly activated that a ‘hyperarousal’ occurred. Characteristic symptoms included a modified processing speed in the brain and in the heart rate.

New therapy options for patients suffering from anxiety and fear?

Therapists have long presumed that experiences of fear and anxiety can be expunged. Newer studies have shown: fears cannot be eliminated, but it is possible to create parallel “safe memory pathways.” “Both pathways are then in competition with each other,” Sperl explains. The goal of successful therapy is to help the fear-limiting pathway achieve dominance. That does not mean, however, that the fear can’t return.

How might the new research findings affect future therapies? Sperl for his part would like to see greater preventative work: “We have to think about what we can do to avoid hyperarousal, which often arises automatically during stress situations. If we presume that we store threatening content more effectively [due to hyperarousal] — how can we counteract this storage process in unwanted situations?” For Sperl, this points to the need for further research into new potential therapies and preventative methods.

Early Career Award:

Sperl’s work earned him an Early Career Award from the German Society for Psychophysiology and its Application (DGPA) at the annual meeting on “Psychology and the Brain” in Hamburg. The prize brought 1,500 euros and is awarded regularly to young researchers under 40 and who competed their doctorate less than 5 years ago. Dr. Matthias Sperl says of the distinction: “It was a tremendous honor for me to receive this prize. I remember very clearly during my own early years just how much I respected the prizewinners and their research programs. It is naturally also an honor for the entire team, which undertook this research with me.”

Contact:
Dr. Matthias Sperl
Department for Clinical Psychology and Psychotherapy (Fac. V)
Tel.: +49 271 740 - 5287
Email: matthias.sperl@uni-siegen.de
Web: https://psychologie.uni-siegen.de/sperl

Note for (potential) patients suffering from anxiety: 

Should you suffer from an anxiety disorder, or suspect that you have a psychological problem that you cannot resolve on your own, don't hesitate to speak with a mental health professional. The Psychotherapeutic University Clinic at the University of Siegen is available to anyone in need as a public point of assistance: https://u-si.de/ZO6bg 

Information for the press:

Dr. Matthias Sperl took part in a live studio chat on July 12 on the topic of anxiety disorders. It was broadcast on WDR Lokalzeit Südwestfalen. Link to broadcast: Lokalzeit Südwestfalen | 12.07.2024 - Lokalzeit Südwestfalen - Sendungen A-Z - Video - Mediathek - WDR (starting at 7:00, studio chat starting at 11:35).