Fear in the neuropsychiatric aspects of epilepsy: What role for the amygdala?

Abstract

Fear is essential for survival; however, its dysregulation may lead to various neuropsychiatric disorders. Understanding the neural networks involved in the expression of fear is useful for elaborating therapeutic interventions (pharmacological or psychoeducation). We aimed to summarize suspected roles of amygdala, but also of other structures such as insula, frontal and temporal associative cortices, and brainstem. Three pathways can be distinguished leading to the expression of fear: indirect, direct and interoceptive, comprising the amygdala as a “hub of fear”. Moreover, temporal epilepsies that imply fear as a “spontaneous” symptom may constitute an interesting model for understanding physiological mechanisms of fear.