Feinstein · Nature neuroscience 2013 · case series · n=3

Fear and panic in humans with bilateral amygdala damage.

Cited 358 times in the scientific literature.

Level 4 - case-series / case-control

Case series of patients with rare bilateral brain lesions tested with an experimental challenge

PubMed 23377128 · doi:10.1038/nn.3323 · record verified 2026-08-26

What was done

Researchers administered an inhalation challenge of 35% CO2 to three patients with bilateral amygdala damage to determine whether the amygdala is required for the induction of fear and panic.

What was found

The abstract reports no quantitative values or statistical tests. It reports that 35% CO2 inhalation elicited both fear and panic attacks in all three patients with bilateral amygdala damage.

Why it matters

These findings indicate that an intact amygdala is not necessary for experiencing fear and panic, establishing a functional distinction between internally generated fear responses (e.g., to hypercapnia) and fear triggered by external environmental threats.

Limits

The study is limited by an extremely small sample size (n = 3) and a lack of reported quantitative endpoints or comparator details in the abstract.

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