Reviewer #2 (Public review):
Summary:
The authors quantify human fMRI BOLD responses in pulvinar and mediodorsal thalamic nuclei during a fear conditioning and extinction task across two days, in a large sample size (hundreds of participants). They show that the BOLD responses in these areas differentiate the conditioned (CS+) and safety (CS-) stimulus. Additionally this changes with repeated trials which could be a neural correlate of fear learning. They show that the anterior pulvinar is most correlated with the MD, and that this is not due to anatomical proximity. They perform graph analysis on the pulvinar sub nuclei which suggests that the medial pulvinar is a hub between the sensory (lateral/inferior) and associative (anterior) pulvinar. They show different patterns of thalamic activity across conditioning, extinction, recall, and renewal.
Strengths:
The data has a large sample size (n=293 in some measures, n=412 in others). This is a validated human fear conditioning/extinction task that Dr Milad's group has been working with for several years. Few labs have investigated the thalamus activity during fear conditioning and extinction, particularly with a large sample size. There is an independent replication of the pulvinar network structure (Fig. 3), which suggests that the processing in the more sensory-related inferior and lateral pulvinar is relayed to the anterior pulvinar (and possibly thereby to more action-related prefrontal areas) via an intermediate step in the medial pulvinar - potentially a novel discovery but that needs more validation.
Weaknesses:
(1) The authors cannot make causal claims about their results based on correlational neuroimaging evidence. Causal claims should be pared back. E.g. Sentence 1 in results "The anterior pulvinar and MD contribute to early associative threat learning, as evidenced by increased functional activation in response to CS+ compared to CS- at the block level (Fig. 1b-c)." needs to be reworded to something like 'the anterior pulvinar and MD have increased functional activation... This suggests that these areas may contribute to early associate threat learning"
(2) Fig .1 The fact that the difference in BOLD activity between CS+ and CS- goes away on the third trial is not addressed. This is a very large effect in the data.
(3) Fig. 3 Could the observed network structure be due to anatomical proximity? Perhaps the authors should do an analogous analysis to what they did in Fig. 2 for this intra-pulvinar analysis. This analysis doesn't take into account the indirect connections through corticothalamic and thalamocortical connections with visual cortex and the pulvinar. There is an implicit assumption that there are interconnections between the pulvinar sub nuclei, but there are few strong excitatory projections between these sub nuclei to my knowledge. If visual areas are included in the graph, it would make things more complex, but would probably dramatically change the story. In this way, the message is somewhat constructed or arbitrary.
(4) In the results section describing Fig. 4-7, there are no statistics supporting the claims made.<br /> There needs to be a set of graphs comparing the results across the study sessions and days, with statistical comparisons between the different experiments to confirm differences.
(5) FIg. 7 does not include the major corticothalamic and thalamocortical projections from early, mid-level, and higher visual cortex to the different pulvinar nuclei. I doubt that there are strong direct projections between the pulvinar nuclei, rather the functional connections are probably mediated through interconnections with cortical visual areas.
(6) Stylistic: There are a lot of hypotheses and interpretations presented in this primary literature paper which may be better suited for a review or perspective piece.
(7) In the discussion there is an assumption that the fMRI BOLD responses to CS+ and CS- need to be different to indicate that an area is processing these distinctly, but the BOLD signal can only detect large scale changes in overall activity. It's easy to imagine that an area could be involved in processing these two stimuli distinctly without showing an overall difference in the gross amount of activity.
(8) There is strong evidence that the BOLD responses to the threat-related and safety-related stimuli are different, modest evidence for their claims of learning/plasticity in these pathways, and circumstantial evidence supporting their hypothesized graph network models. Overall most of the claims made in the discussion are better considered possible interpretations rather than proven findings - this is not a criticism, as these experiments and subject matter are extremely complex.
(9) This study continues to validate the power and utility of this in human fear conditioning/extinction paradigm, and extends this paradigm to investigating fear learning beyond the traditional limbic system pathways. It's possible that their models for the pulvinar nuclei interconnections could guide future neuromodulation or DBS studies that could provide more causal evidence for their hypotheses.
Comments on revisions:
The reviewers addressed my major concerns appropriately in the modified manuscript. As long as the MRI analysis concerns of Reviewer 3 are satisfied (MRI analysis is not my expertise), I am satisfied with the modified manuscript.