Fear and panic in humans with bilateral amygdala damage
Open accessAbstract
Decades of research have highlighted the amygdala's influential role in fear. We found that inhalation of 35% CO(2) evoked not only fear, but also panic attacks, in three rare patients with bilateral amygdala damage. These results indicate that the amygdala is not required for fear and panic, and make an important distinction between fear triggered by external threats from the environment versus fear triggered internally by CO(2).
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Different emotional and cognitive states alter the depth and frequency of breathing, which impacts emotional state in part by regulation of carbon dioxide levels.
“It is also clear that different emotional and cognitive states alter the depth and frequency of breathing,8,9,10,11,12 which likewise impacts emotional state, in part by regulation of carbon dioxide levels.13,14,15,16,17”
From Brief structured respiration practices enhance mood and reduce physiological arousal (2023) · cites this paper as [16]
The paper’s main text (indexed under Abstract; page unavailable) reports that inhaled CO2 induced fear and panic, supporting the part of the cited clause that links CO2 to emotional state. It does not show that changes in breathing depth or frequency regulate CO2 levels and thereby change emotion; the study administered CO2 and measured breathing as a response. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDamage to the amygdala interferes with bodily responses to threats but does not interfere with conscious experience of emotions such as fear.
“Fourth, although damage to the amygdala interferes with bodily responses to threats, it does not interfere with conscious experience of emotions such as fear (43,44).”
From A higher-order theory of emotional consciousness (2017) · cites this paper as [43]
The paper (section labeled Abstract; page not available) reports deficient anticipatory heart-rate and skin-conductance responses in patients with amygdala lesions, while those patients consciously experienced fear and panic during CO2 inhalation. The claim is too broad: the paper also reports a marked absence of fear in response to external threats and heightened physiological responses after CO2 inhalation. (LLM, conf=0.90)
Experimental — accuracy not yet measured
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- Authors
- Feinstein, J. S., Buzza, C., Hurlemann, R., Follmer, R. L., Dahdaleh, N. S., Coryell, W. H., Welsh, M. J., Tranel, D., & Wemmie, J. A.
- Affiliations
- University of Iowa (US)
- Corresponding author
- Tranel, Daniel
- Wemmie, John A
- ORCID
- Venue
- Nature Neuroscience
- Published
- 2013-02-03
- Volume
- 16
- Issue
- 3
- Pages
- 270-272
- ISSN
- 1097-6256 (ISSN-L)
- 1546-1726
- PMC
- PMC3739474
- OpenAlex
- W2006030610
- Cited by
- 350
- References
- 24
- Citations by year
- 2026: 13 · 2025: 11 · 2024: 50 · 2023: 28 · 2022: 17 · 2021: 15 · 2020: 38 · 2019: 28 · 2018: 15 · 2017: 23 · 2016: 36 · 2015: 27 · 2014: 34 · 2013: 14
- FWCI
- 20.21
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Neuroscience (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Howard Hughes Medical Institute
- National Institutes of Health (5p50ns019632-28)
- National Institute of Mental Health (R01MH085724)
- National Institute of Neurological Disorders and Stroke (P01NS019632, P50-NS019632, P50NS19632)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Memory and Neural Mechanisms
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- amygdala, fear, panic attacks, carbon dioxide inhalation, insider threats, external threats, fear conditioning
- MeSH terms
- Adult, Amygdala, Carbon Dioxide, Facial Expression, Fear, Female, Humans, Lipoid Proteinosis of Urbach and Wiethe, Middle Aged, Panic, Panic Disorder
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