D-Cycloserine And Conditioning: Increasing The Effectiveness Of Exposure Therapy For Fear And Anxiety
Funder
National Health and Medical Research Council
Funding Amount
$400,750.00
Summary
The psychological, social, and financial costs of anxiety problems are among the highest burden-of-disease costs to the community. The most effective long-term psychological treatment for anxiety disorders is cognitive behaviour therapy (CBT), in particular exposure therapy. However only a small minority of individuals receive comprehensive treatment, and a portion of these individuals re-experience symptoms in the long-term. These difficulties are partially due to the cost of treatment and diff ....The psychological, social, and financial costs of anxiety problems are among the highest burden-of-disease costs to the community. The most effective long-term psychological treatment for anxiety disorders is cognitive behaviour therapy (CBT), in particular exposure therapy. However only a small minority of individuals receive comprehensive treatment, and a portion of these individuals re-experience symptoms in the long-term. These difficulties are partially due to the cost of treatment and difficulties with relapse. Recent research has shown that D-Cycloserine (DCS) facilitates extinction in animals and possibly in humans. DCS has the potential to offer a simple, brief, and cost-effective intervention that enhances treatment effects. In the United States the new NIMH director has set research into DCS and exposure to fear as a high priority that is likely to have a significant public health impact. This proposal provides an opportunity for Australian researchers to become involved in a rapidly expanding research field. The research team at UNSW have already established an international reputation in DCS applications, fear conditioning in humans, and clinical trials in humans. They are in a unique position internationally to investigate the means by which DCS exerts its effects and to conduct randomised clinical trials of DCS in recovery from fear in humans.The goal is to test DCS in facilitating exposure and extinction of fear. The research will directly lead to recommendations for clinical application and demonstrate whether the drug has the capability of significantly increasing the success of exposure therapy by reducing the time required for treatment, the rate of relapse, the financial cost of treatment, and the overall burden of anxiety to the community. The fear-conditioning studies will also inform our theoretical understanding of emotion processing and fear conditioning in humans, which in turn will allow clinical applications to be optimised.Read moreRead less
Neuroanatomical Dynamics Of Attention In Stroke Patients And Healthy Individuals: A Magnetic Stimulation Investigation
Funder
National Health and Medical Research Council
Funding Amount
$360,363.00
Summary
Mechanisms of selective attention are of central importance in guiding human behaviour. The brain uses attention to enhance the processing of information that is behaviourally relevant, and to suppress irrelevant information. The operation of attention within sensory modalities (vision, touch, hearing) has been studied for many decades; however, little is known about how attention combines information between different senses. An understanding of 'crossmodal' attention is important for many reas ....Mechanisms of selective attention are of central importance in guiding human behaviour. The brain uses attention to enhance the processing of information that is behaviourally relevant, and to suppress irrelevant information. The operation of attention within sensory modalities (vision, touch, hearing) has been studied for many decades; however, little is known about how attention combines information between different senses. An understanding of 'crossmodal' attention is important for many reasons. First, real events in the environment provide inputs simultaneously from different locations to multiple senses, and these inputs must be integrated to yield coherent perception. Second, the most basic aspects of human perception depend upon attention; the brain implements selective mechanisms in order to filter the immense quantities of information that constantly bombard our sensory receptors. Finally, many neurological disorders are characterised by impairments of attention; these syndromes are debilitating for the patients themselves, and also place a heavy burden on caregivers and the healthcare system. This project will examine mechanisms of attention in healthy individuals and in stroke patients with attentional deficits. In all experiments, we will employ a new technique in neuroscience called 'transcranial magnetic stimulation' (TMS). TMS enables the safe and reversible stimulation of brain activity in humans. In the current project, we will use TMS with two broad objectives: (i) to determine the key brain areas involved in crossmodal attention in healthy individuals, and (ii) to treat attentional deficits that occur within and between the senses in stroke patients ('magnetic stimulation rehabilitation'). This research will provide important insights into the brain mechanisms that govern selective attention in the healthy brain, and will help guide future methods for managing and treating neurological disorders in which deficits of attention are prominent.Read moreRead less
Crossmodal Interactions In Selective Attention: A Combined Human Lesion/transcranial Magnetic Stimulation Study
Funder
National Health and Medical Research Council
Funding Amount
$188,182.00
Summary
Aspects of attention are of central importance in guiding human behaviour. The brain uses these mechanisms to enhance the processing of sensory information that is currently relevant for behaviour, and to suppress irrelevant sensory information. Although there is a considerable body of knowledge, from both animal and human research, on how attention operates within individual sensory modalities (vision, touch, hearing, etc.), very little is known about how attention integrates information across ....Aspects of attention are of central importance in guiding human behaviour. The brain uses these mechanisms to enhance the processing of sensory information that is currently relevant for behaviour, and to suppress irrelevant sensory information. Although there is a considerable body of knowledge, from both animal and human research, on how attention operates within individual sensory modalities (vision, touch, hearing, etc.), very little is known about how attention integrates information across these different modalities. An understanding of these 'crossmodal' attentional mechanisms is important for several reasons. First, much brain activity in primary sensory areas is modulated by the attentive state of the individual, so discovering how crossmodal attention works will facilitate our understanding of the neural mechanisms of sensory processing generally. Second, the most basic aspects of human perception are fundamentally dependent upon attention; without attention we would perceive inputs from the different senses as fragmentary, rather than as bound together into coherent multimodal representations. Finally, many acquired and developmental neurological disorders are characterised by debilitating impairments of attention. This project will examine crossmodal spatial attention in stroke patients with damage to an exclusively visual brain area (occipital cortex), or to a multisensory brain area (parietal cortex). It will also measure the extent of crossmodal interactions in healthy participants, using cortical transcranial magnetic stimulation (TMS) to induce reversible, 'virtual' lesions that mimic those of the stroke patients. The specific goals of the research are to explain how inputs from the senses of vision and touch interact to give rise to coherent perception; and to provide an empirical foundation for the development of more effective rehabilitative techniques for stroke patients, by exploiting any preserved crossmodal attentional mechanisms.Read moreRead less