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      • KCI등재

        건강한 성인에서의 고전적 공포 조건화 및 소거에 연관된 뇌 영역에 대한 뇌영상 연구 고찰

        강일향,서채원,윤수정,김정윤,Kang, Ilhyang,Suh, Chaewon,Yoon, Sujung,Kim, Jungyoon 대한생물정신의학회 2021 생물정신의학 Vol.28 No.2

        Fear conditioning and extinction, which are adaptive processes to learn and avoid potential threats, have essential roles in the pathophysiology of anxiety disorders. Experimental fear conditioning and extinction have been used to identify the mechanism of fear and anxiety in humans. However, the brain-based mechanisms of fear conditioning and extinction are yet to be established. In the current review, we summarized the results of neuroimaging studies that examined the brain changes-functional activity and structures-regarding fear conditioning or extinction in healthy individuals. The functional activity of the amygdala, insula, anterior cingulate gyrus, ventromedial prefrontal cortex, and hippocampus changed dynamically with both fear conditioning and extinction. This review may provide an up-to-date summary that may broaden our understanding of pathophysiological mechanisms of anxiety disorder. In addition, the brain regions that are involved in the fear conditioning and extinction may be considered as potential treatment targets in the future studies.

      • KCI등재

        신경항법을 이용한 반복적 경두개자기자극의 적용 위치 선정 방법과 우울증 치료 효과 고찰

        김명주(Myeongju Kim),송유미(Yumi Song),서채원(Chaewon Suh),마지영(Jiyoung Ma),홍가혜(Gahae Hong),김정윤(Jungyoon Kim) 대한생물치료정신의학회 2020 생물치료정신의학 Vol.26 No.2

        Repetitive transcranial magnetic stimulation (rTMS) is widely recognized as an effective and noninvasive neuromodulation for treating depression, and has been applied in a wide range of clinical settings. However, previous studies often reported inconsistent antidepressant effects that may be due to differences in the rTMS protocols such as coil placement. The typical simulation site for rTMS depression protocol is the left dorsolateral prefrontal cortex (DLPFC). Targeting the exact site of the left DLPFC while considering individual brain structure has been challenging due to the non-invasive nature of rTMS. Several researchers have applied various targeting methods to overcome the abovementioned issue. Most of the previous studies have applied the “5-cm rule” or the “international 10-20 system,” which is easily applicable. Recently, researchers started to apply a neuronavigation system that targets the stimulation site based on neuroimaging of each individual. Pros and cons of targeting methods have been discussed in terms of validity and reliability of targeting stimulation sites, differences in treatment responses, as well as considerations of individual characteristics. Therefore, the current review focuses on the targeting methods of stimulation site and the treatment effects of depression in previous studies. For discussion, we divided neuronavigation methods into using fixed coordinates and using individualized targets. Furthermore, the limitations of each targeting method are discussed that may potentially contribute to the development of the optimal rTMS protocol for depression treatment.

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