Hyperactivation of brain networks conferring defensive mobilization is assumed to underlie inappropriate defensive-preparation in patients with Specific Phobia. However, studies targeting Dental Phobia (DP) yielded quite heterogeneous results and research concerning the effects of exposure treatments on phobic brain activation so far is missing. This functional Magnetic Resonance Imaging (fMRI) study aimed to investigate activation patterns in DP patients during exposure to phobia-related stimuli and the effects of an exposure-based fear treatment on phobia-related activation. Seventeen patients with DP and seventeen non-phobic, healthy controls participated in this fMRI experiment presenting dental-related and neutral auditory and visual stimuli. After completing a short exposure-based CBT program, patients were scanned a second time to illustrate treatment-related changes in brain activation patterns. Pre-treatment fMRI results demonstrate enhanced activation in DP-patients mainly in the precuneus and lateral parietal cortex. Moreover, a small activation focus was observed in the amygdala and anterior cingulate cortex (ACC) as parts of classically fear-related structures. Activation in all these clusters decreased significantly from pre- to post-treatment assessment and in the case of the ACC was correlated with dental fear reduction. Activation changes in the precuneus and lateral parietal cortex suggest a pronounced first-person perspective memory processing including a vivid recall of contextual information from an egocentric perspective triggered by exposure to phobia-related stimuli. Besides a treatment-sensitive hyperactivity of fear-sensitive structures, DP may also be characterized by a disturbed memory retrieval that can be reorganized by successful exposure treatment.

赋予防御性动员的大脑网络过度激活被认为是特定恐惧症患者不适当的防御准备的基础。然而，针对牙科恐惧症（DP）的研究产生了相当不同的结果，并且迄今为止还缺少关于暴露治疗对恐惧性大脑激活的影响的研究。这项功能性磁共振成像 (fMRI) 研究旨在调查 DP 患者在暴露于恐惧症相关刺激期间的激活模式，以及基于暴露的恐惧治疗对恐惧症相关激活的影响。17 名 DP 患者和 17 名非恐惧症健康对照者参与了这项功能磁共振成像实验，呈现与牙齿相关的中性听觉和视觉刺激。完成基于短期暴露的 CBT 计划后，患者接受了第二次扫描，以说明与治疗相关的大脑激活模式变化。治疗前的功能磁共振成像结果表明，DP 患者的激活增强，主要集中在楔前叶和外侧顶叶皮层。此外，在杏仁核和前扣带皮层（ACC）中观察到一个小的激活焦点，作为经典恐惧相关结构的一部分。从治疗前到治疗后评估，所有这些簇的激活均显着下降，并且就 ACC 而言，与牙科恐惧减少相关。楔前叶和外侧顶叶皮层的激活变化表明明显的第一人称视角记忆处理，包括因暴露于恐惧症相关刺激而触发的以自我为中心的视角生动地回忆上下文信息。除了恐惧敏感结构对治疗敏感的过度活跃之外，DP 的特征还可能是记忆检索受到干扰，而这种记忆检索可以通过成功的暴露治疗进行重组。