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Fear and panic in humans with bilateral amygdala damage

Nature Neuroscience volume 16, pages 270–272 (2013)Cite this article

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Abstract

Decades of research have highlighted the amygdala's influential role in fear. We found that inhalation of 35% CO2 evoked not only fear, but also panic attacks, in three rare patients with bilateral amygdala damage. These results indicate that the amygdala is not required for fear and panic, and make an important distinction between fear triggered by external threats from the environment versus fear triggered internally by CO2.

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Figure 1: Panic attack rate and self-reported levels of fear and panic during the first CO2 inhalation.
Figure 2: CO2-evoked physiological changes.
Figure 3: Anticipatory physiological responses before inhalation.

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Acknowledgements

We thank A. Wunsch for technical support and M. Coryell and J. Potash for critically reading this manuscript. C.B. was supported by a Doris Duke Clinical Research Fellowship. D.T. was supported by the National Institute of Neurological Disorders and Stroke (P50 NS19632). J.A.W. was supported by the Department of Veterans Affairs (Merit Award), the National Institutes of Mental Health (5RO1MH085724) and a McKnight Neuroscience of Brain Disorders Award. R.H. was supported by a Starting Independent Researcher Grant (NEMO—Neuromodulation of Emotion) jointly provided by the Ministry of Innovation, Science, Research and Technology of the German State of North Rhine-Westphalia (MIWFT) and the University of Bonn. M.J.W. receives funding from the Howard Hughes Medical Institute.

Author information

Author notes

  1. Justin S Feinstein, Colin Buzza and Rene Hurlemann: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Neurology, University of Iowa, Iowa City, Iowa, USA

    Justin S Feinstein & Daniel Tranel

  2. Department of Psychology, University of Iowa, Iowa City, Iowa, USA

    Justin S Feinstein & Daniel Tranel

  3. Department of Psychiatry, University of Iowa, Iowa City, Iowa, USA

    Colin Buzza, Rene Hurlemann, Robin L Follmer, William H Coryell & John A Wemmie

  4. Department of Psychiatry, University of Bonn, Bonn, Germany

    Rene Hurlemann

  5. Department of Neurosurgery, University of Iowa, Iowa City, Iowa, USA

    Nader S Dahdaleh, Michael J Welsh & John A Wemmie

  6. Department of Internal Medicine, University of Iowa, Iowa City, Iowa, USA

    Michael J Welsh

  7. Department of Molecular Physiology and Biophysics, University of Iowa, Iowa City, Iowa, USA

    Michael J Welsh & John A Wemmie

  8. Interdisciplinary Graduate Program in Neuroscience, University of Iowa, Iowa City, Iowa, USA

    Michael J Welsh, Daniel Tranel & John A Wemmie

  9. Howard Hughes Medical Institute, Chevy Chase, Maryland, USA

    Michael J Welsh

  10. Department of Veterans Affairs Medical Center, Iowa City, Iowa, USA

    John A Wemmie

Authors
  1. Justin S Feinstein
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  5. Nader S Dahdaleh
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  6. William H Coryell
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  7. Michael J Welsh
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  8. Daniel Tranel
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Contributions

J.A.W., M.J.W., J.S.F., R.L.F., D.T., W.H.C. and N.S.D. conceived and planned the experiments. J.A.W., D.T., R.H. and W.H.C. provided financial support, equipment and supplies. J.A.W., C.B., J.S.F., R.L.F., R.H. and N.S.D. recruited participants and performed the experiments. J.A.W., C.B., M.J.W., J.S.F., R.H., D.T., R.L.F., W.H.C. and N.S.D. wrote and edited the manuscript and figures.

Corresponding authors

Correspondence to Daniel Tranel or John A Wemmie.

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The authors declare no competing financial interests.

Supplementary information

Supplementary Text and Figures

Supplementary Figures 1–3, Supplementary Table 1, Supplementary Panic Descriptions (PDF 2975 kb)

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Feinstein, J., Buzza, C., Hurlemann, R. et al. Fear and panic in humans with bilateral amygdala damage. Nat Neurosci 16, 270–272 (2013). https://doi.org/10.1038/nn.3323

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