Translational neuroscience of basolateral amygdala lesions: Studies of urbach-wiethe disease

Urbach‐Wiethe disease (UWD) is an extremely rare autosomal recessive disorder characterized by mutations in the extracellular matrix protein 1 gene on chromosome 1. Typical clinical manifestations include voice hoarseness in early infancy and neuropsychiatric, laryngeal, and dermatological pathologi...

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Published inJournal of neuroscience research Vol. 94; no. 6; pp. 504 - 512
Main Authors Koen, N., Fourie, J., Terburg, D., Stoop, R., Morgan, B., Stein, D.J., van Honk, J.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.06.2016
Wiley Subscription Services, Inc
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Online AccessGet full text
ISSN0360-4012
1097-4547
1097-4547
DOI10.1002/jnr.23731

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Summary:Urbach‐Wiethe disease (UWD) is an extremely rare autosomal recessive disorder characterized by mutations in the extracellular matrix protein 1 gene on chromosome 1. Typical clinical manifestations include voice hoarseness in early infancy and neuropsychiatric, laryngeal, and dermatological pathologies later in life. Neuroimaging studies have revealed a pattern of brain calcification often but not exclusively leading to selective bilateral amygdala damage. A large body of work on amygdala lesions in rodents exists, generally employing a subregion model focused on the basolateral amygdala (BLA) and the central–medial amygdala. However, human work usually considers the amygdala as a unified structure, not only complicating the translation of animal findings to humans but also providing a unique opportunity for further research. To compare data from rodent models with human cases and to complement existing data from Europe and North America, a series of investigations was undertaken on UWD subjects with selective BLA damage in the Namaqualand region, South Africa. This review presents key findings from this work, including fear processing, social‐economic behavior, and emotional conflict processing. Our findings are broadly consistent with and support rodent models of selective BLA lesions and show that the BLA is integral to processing sensory stimuli and exhibits inhibitory regulation of responses to unconditioned innate fear stimuli. Furthermore, our findings suggest that the human BLA mediates calculative–instrumental economic behaviors and may compromise working memory via competition for attentional resources between the BLA salience detection system and the dorsolateral prefrontal cortex working memory system. © 2016 Wiley Periodicals, Inc.
Bibliography:Swiss-South Africa (SNF-NRF) Joint Research Programme
Medical Research Council of South Africa
Netherlands Society of Scientific Research - No. VENI 451-13-004
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ArticleID:JNR23731
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SIGNIFICANCE: Animal studies of selective bilateral amygdala damage have provided important information on the functional role of amygdala neurocircuitry. However, there are few data on humans with bilateral amygdala lesions. This review summarizes novel information obtained from patients with Urbach‐Wiethe disease, a rare genetic disorder often characterized by bilateral BLA damage. Our work demonstrates that these patients have fear hypervigilance, generous economic investments, and paradoxically improved working memory. This work is consistent with laboratory findings on selective bilateral amygdala lesions and extends earlier human studies on North American and European populations with amygdala lesions.
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ISSN:0360-4012
1097-4547
1097-4547
DOI:10.1002/jnr.23731