NDLI: The anterior insula and anterior cingulate cortex are associated with avoidance of dental treatment based on prior experience of treatment in healthy adults

Content Provider	Springer Nature : BioMed Central
Author	Lin, Chia-Shu Wu, Shih-Yun Wu, Long-Ting
Abstract	Background Fear concerning stressful medical or dental procedures is one of the major factors that distance patients from health care. Fear and avoidance of dental treatments can be shaped by a patient’s prior experience with receiving dental procedures or by imagining the procedures. Methods We performed two functional magnetic resonance imaging (fMRI) experiments to investigate the role of the anterior insula (aINS) and dorsal anterior cingulate cortex (dACC), which are both critical to threat perception, in dental avoidance. Dental avoidance based on both prior treatment experience and imagination was assessed using a customized questionnaire. In an fMRI task-based study, we investigated brain activation in 17 healthy participants when they viewed images depicting dental procedures that evoked a moderate degree of fear. Region-of-interest analysis was performed to assess the association between dental avoidance and aINS as well as dACC activation. In a resting state fMRI study, we investigated 18 healthy participants for the association between the intrinsic functional connectivity of the aINS and dACC and dental avoidance. Results We found that (1) the participants showed a higher activation of the right aINS and bilateral dACC when they viewed images of dental procedures compared with the brain activation observed when they viewed scrambled images (p < 0.05 corrected for small volume and family-wise error). (2) The avoidance ratings based on prior experience of dental treatment were significantly positively correlated with the activation in the right aINS (r = 0.67, p = 0.003), right dACC (r = 0.65, p = 0.005) and left dACC (r = 0.63, p = 0.007). (3) The intrinsic functional connectivity between the aINS and the orbitofrontal cortex was positively correlated with the avoidance ratings based on experience (uncorrected p < 0.001). Conclusions The findings highlight prior experience of dental treatment as a predominant factor in shaping patients’ avoidance behavior. Individual differences in threat perception may play a key role in the development of dental avoidance.
Related Links	https://bmcneurosci.biomedcentral.com/counter/pdf/10.1186/s12868-015-0224-9.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14712202
DOI	10.1186/s12868-015-0224-9
Journal	BMC Neuroscience
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2015-12-10
Access Restriction	Open
Subject Keyword	Neurosciences Neurobiology Animal Models fMRI Anterior insula Anterior cingulate cortex Dental fear Dental avoidance
Content Type	Text
Resource Type	Article
Subject	Neuroscience Cellular and Molecular Neuroscience
Journal Impact Factor	2.4/2023
5-Year Journal Impact Factor	2.9/2023

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