How cognitive and reactive fear circuits optimize escape decisions in humans

Significance Humans, like other animals, have evolved a set of neural circuits whose primary function is survival. In the case of predation, these circuits include “reactive fear” circuits involved in fast escape decisions and “cognitive fear” circuits that are involved in more complex processing associated with slow strategic escape. Using neuroimaging combined with computational modeling, we support this differentiation of fear circuits by showing that fast escape decisions are elicited by the periaqueductal gray and midcingulate cortex, regions involved in reactive flight. Conversely, slower escape decisions rely on the hippocampus, posterior cingulate cortex, and prefrontal cortex, a circuit implicated in behavioral flexibility. These results support a separation of fear into reactive and cognitive circuits.