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Graeff FG, Joca S, Zangrossi H. Bradykinin actions in the central nervous system: historical overview and psychiatric implications. Acta Neuropsychiatr 2024; 36:129-138. [PMID: 38178717 DOI: 10.1017/neu.2023.57] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
Bradykinin (BK), a well-studied mediator of physiological and pathological processes in the peripheral system, has garnered less attention regarding its function in the central nervous system, particularly in behavioural regulation. This review delves into the historical progression of research focused on the behavioural effects of BK and other drugs that act via similar mechanisms to provide new insights into the pathophysiology and pharmacotherapy of psychiatric disorders. Evidence from experiments with animal models indicates that BK modulates defensive reactions associated with panic symptoms and the response to acute stressors. The mechanisms are not entirely understood but point to complex interactions with other neurotransmitter systems, such as opioids, and intracellular signalling cascades. By addressing the existing research gaps in this field, we present new proposals for future research endeavours to foster a new era of investigation regarding BK's role in emotional regulation. Implications for psychiatry, chiefly for panic and depressive disorders are also discussed.
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Affiliation(s)
- Frederico Guilherme Graeff
- Behavioural Neurosciences Institute (INeC), Ribeirão Preto, SP, Brazil
- Department of Psychology, FFCLRP, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Sâmia Joca
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Helio Zangrossi
- Department of Pharmacology, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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2
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Guan X, Cao P. Brain Mechanisms Underlying Panic Attack and Panic Disorder. Neurosci Bull 2024; 40:795-814. [PMID: 37477800 PMCID: PMC11178723 DOI: 10.1007/s12264-023-01088-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/23/2023] [Indexed: 07/22/2023] Open
Abstract
Panic disorder is a psychiatric disorder characterized by recurrent panic attacks, with a prevalence of ~ 4% in the general population, causing heavy personal and socioeconomic burdens. The similarities of animal defense responses to clinical panic attack symptoms in humans make it possible to translate neuroanatomical pathways identified in animal studies to panic disorder in humans. Therefore, in this review we first present a basic overview of panic disorder in humans including the main subtypes, models commonly used to trigger panic attacks, related hypotheses, the neurotransmitter systems that may be involved, and the current clinical treatments to give the reader a comprehensive understanding of panic disorder. The animal section introduces the models that trigger panic-like behavior in animals and the brain regions that may be involved, providing insights for future elucidation of the neural circuit mechanisms behind panic attacks.
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Affiliation(s)
- Xuyan Guan
- Tsinghua Institute of Multidisciplinary Biomedical Research, Tsinghua University, Beijing, 102206, China.
- National Institute of Biological Sciences (NIBS), Beijing, 102206, China.
| | - Peng Cao
- Tsinghua Institute of Multidisciplinary Biomedical Research, Tsinghua University, Beijing, 102206, China
- National Institute of Biological Sciences (NIBS), Beijing, 102206, China
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3
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Kaiya H. Anxious-depressive attack and rejection sensitivity-Toward a new approach to treatment-resistant depression. Neuropsychopharmacol Rep 2024; 44:17-28. [PMID: 38059339 PMCID: PMC10932773 DOI: 10.1002/npr2.12399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 10/03/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023] Open
Abstract
This paper aimed to find clues to treatment-resistant depression (TRD) solutions. Depression comorbid with anxiety is often treatment-resistant where anxious-depressive attack (ADA) often lurks. ADA is a recently proposed clinical idea for just a psychological version of a panic attack. It mostly begins with an abrupt surge of intense anxiety followed by uninterrupted intrusive thoughts; lasting ruminations about regret or worry produced by violent anxiety, agitation, and loneliness. Acting-out behaviors such as deliberate self-injury and over-dose may also be observed during the attack. As the basic psychopathology of ADA, rejection sensitivity (RS) was revealed by a structural equation model. It is said that the presence of RS in depressive disorders implies a poor prognosis. The following biological markers for RS were reviewed in the literature: first, the involvement of the μ-opioid receptor function in RS and, secondly, hypersensitivity of the dopamine D4 receptor (DRD4) in the medial prefrontal cortex. The latter has been suggested in fear-conditioned animal experiments. Manipulation of the μ-opioid receptor function together with the DRD4 function may culminate in a treatment for RS, which could contribute to the development of a treatment for TRD via the improvement of ADA.
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Affiliation(s)
- Hisanobu Kaiya
- Panic Disorder Research CenterWarakukai Medical CorporationTokyoJapan
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4
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Pini S, Milrod B, Baldwin DS, Schiele MA, Massimetti G, Costa B, Martini C, Bandelow B, Domschke K, Abelli M. The relationship of separation anxiety with the age of onset of panic disorder. Early Interv Psychiatry 2023; 17:1172-1179. [PMID: 37051643 DOI: 10.1111/eip.13419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 01/16/2023] [Accepted: 03/28/2023] [Indexed: 04/14/2023]
Abstract
AIM This study aimed to investigate whether separation anxiety (SA) constitutes a dimension related to age at onset of panic disorder (PD), in homogeneous subgroups of outpatients with PD, based on their age of onset and symptom severity. METHODS A sample of 232 outpatients with PD was assessed with the Panic Disorder Severity Scale (PDSS) and the Sheehan Disability Scale (SDS) for functional impairments. Separation anxiety was evaluated using structured interviews and questionnaires. We applied a K-Means Cluster Analysis based on the standardized "PD age of onset" and "the PDSS total score" to identify distinct but homogeneous groups. RESULTS We identified three groups of patients: group 1 ("PD early onset/severe", N = 97, 42%, onset 23.2 ± 6.7 years), group 2 ("PD early onset/not severe", N = 76, 33%, onset 23.4 ± 6.0 years) and group 3 ("PD adult onset/not severe", N = 59, 25%, onset 42.8 ± 7.0 years). Patients with early onset/severe PD had significantly higher scores on all SA measures than PD late-onset/not severe. Regression analyses showed that SA scores, but not PDSS scores, were predictive of impairment in SDS work/school, social life, and family functioning domains. CONCLUSIONS Our data indicate a significant relationship between SA and PD with an earlier age of onset and an impact on individual functioning. This may have important implications for implementing preventive interventions targeting early risk factors for the subsequent onset of PD.
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Affiliation(s)
- Stefano Pini
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Barbara Milrod
- Albert Einstein College of Medicine, PRIME, (Psychiatric Research Institute of Montefiore Einstein), New York, New York, USA
| | - David S Baldwin
- Clinical and Experimental Sciences, Faculty of Medicine, Academic Centre, College Keep, University of Southampton, Southampton, UK
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Gabriele Massimetti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Barbara Costa
- Department of Pharmacy, University of Pisa, Pisa, Italy
| | | | - Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University Medical Center Gottingen, Göttingen, Germany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Marianna Abelli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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5
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Bode A. Romantic love evolved by co-opting mother-infant bonding. Front Psychol 2023; 14:1176067. [PMID: 37915523 PMCID: PMC10616966 DOI: 10.3389/fpsyg.2023.1176067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 09/18/2023] [Indexed: 11/03/2023] Open
Abstract
For 25 years, the predominant evolutionary theory of romantic love has been Fisher's theory of independent emotion systems. That theory suggests that sex drive, romantic attraction (romantic love), and attachment are associated with distinct neurobiological and endocrinological systems which evolved independently of each other. Psychological and neurobiological evidence, however, suggest that a competing theory requires attention. A theory of co-opting mother-infant bonding sometime in the recent evolutionary history of humans may partially account for the evolution of romantic love. I present a case for this theory and a new approach to the science of romantic love drawing on human psychological, neurobiological, and (neuro)endocrinological studies as well as animal studies. The hope is that this theoretical review, along with other publications, will generate debate in the literature about the merits of the theory of co-opting mother-infant bonding and a new evolutionary approach to the science of romantic love.
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Kyriakoulis P, Kyrios M. Biological and cognitive theories explaining panic disorder: A narrative review. Front Psychiatry 2023; 14:957515. [PMID: 36793941 PMCID: PMC9924294 DOI: 10.3389/fpsyt.2023.957515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/04/2023] [Indexed: 02/01/2023] Open
Abstract
The current narrative review summarizes and examines several theories of panic disorder (PD) including biological theories, encompassing neurochemical factors, metabolic and genetic theories, respiratory and hyperventilation theories and cognitive theory. Biological theories have informed the development of psychopharmacological treatments; however, they may be limited in their utility given the efficacy of psychological treatments. In particular, behavioral and, more recently, cognitive models have garnered support due to the efficacy of cognitive-behavior therapy (CBT) in treating PD. The role of combination treatments has been found to be superior in the treatment of PD in particular cases, lending support for the need for an integrated approach and model for PD given that the etiology of PD is complex and multifactorial.
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Affiliation(s)
- Peter Kyriakoulis
- Faculty of Arts, Health and Design, Swinburne University, Hawthorn, VIC, Australia
| | - Michael Kyrios
- College of Education, Psychology and Social Work, Órama Institute for Mental Health and Wellbeing, Flinders University, Bedford Park, SA, Australia
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7
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Rosa DS, Frias AT, Vilela-Costa HH, Junior AS, Sant’Ana AB, Fusse EJ, Suchecki D, Campos AC, Lovick TA, Zangrossi H. Neonatal maternal deprivation facilitates the expression of a panic-like escape behavior in adult rats. Behav Brain Res 2022; 434:114031. [DOI: 10.1016/j.bbr.2022.114031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/21/2022] [Accepted: 07/27/2022] [Indexed: 11/02/2022]
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Ahmed GK, Khedr EM, Hamad DA, Meshref TS, Hashem MM, Aly MM. Long term impact of Covid-19 infection on sleep and mental health: A cross-sectional study. Psychiatry Res 2021; 305:114243. [PMID: 34673325 PMCID: PMC8507572 DOI: 10.1016/j.psychres.2021.114243] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 10/03/2021] [Accepted: 10/10/2021] [Indexed: 01/15/2023]
Abstract
The long-term impact of the COVID-19 infection on mental health in people and its relation to the severity is unclear. We aimed to study the long-term effect of post-COVID-19 disease on sleep and mental health and to detect possible relationship between severity of COVID-19 at onset and sleep and mental illness. We enrolled 182 participants 6 months post COVID-19 infection and grouped into non-severe(101),severe(60) and critical(20) according to according to WHO guidance. All participants were assessed using Pittsburgh Sleep Quality Index ", Post traumatic stress disorder (PTSD) Checklist for DSM-5, and Symptom Checklist90 test. Only 8.8% had no psychiatric symptoms while 91.2% had psychiatric symptoms as follow (poor sleep (64.8%), PTSD (28.6%), somatization (41.8%), obsessive-compulsive (OCD) (19.8%), depression (11.5%), anxiety (28%), phobic-anxiety (24.2%), psychoticism (17.6%)). Diabetes, oxygen support or mechanically ventilated were a risk for sleep impairment, while high Neutrophil/lymphocyte ratio(NLR) was the only risk factor for PTSD. Other psychiatric illnesses had several risk factors: being female, diabetes, oxygen support or mechanically ventilated. Abnormal sleep, somatization and anxiety are the most common mental illnesses in Post-Covid19. The critical group is common associated with PTSD, anxiety, and psychosis. Being female, diabetic, having oxygen support or mechanically ventilated, and high NLR level are more vulnerable for mental illness in post COVID19.
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Affiliation(s)
- Gellan K. Ahmed
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt,Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London SE5 8AF, United Kingdom,Corresponding author at: Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Eman M. Khedr
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Dina A. Hamad
- Critical Care unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Taghreed S. Meshref
- Critical Care unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mustafa M. Hashem
- Department of Neurology and Psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Mai M. Aly
- Clinical Hematology Unit, Department of Internal Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt
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Krause E, Benke C, Hamm AO, Pané-Farré CA. Hold your breath: Voluntary breath-holding time predicts defensive activation to approaching internal threat. Biol Psychol 2021; 166:108196. [PMID: 34601017 DOI: 10.1016/j.biopsycho.2021.108196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 11/27/2022]
Abstract
Bodily disturbances, like dyspnea, elicit responses to regain homeostasis and ensure survival. However, this life-saving function can become hyperreactive, which may lead to the emergence of psychopathology. This study investigated whether maximal voluntary breath-holding time (mvBHT), a biobehavioral marker that characterizes sensitivity to respiratory stimulation, predicts defensive mobilization to cues signaling the proximity of a mild electric shock vs. a respiratory threat (shortness of breath elicited by forced breath-holding) and the opportunity to avoid threat delivery in 60 healthy participants. While the startle reflex, a measure of defensive mobilization, generally increased with the proximity of an inevitable threat, shorter breath-holding time was specifically associated with greater startle potentiation when anticipating a respiratory threat but not an electric shock. In contrast, when both threats were avoidable, the startle reflex was comparably inhibited, irrespective of mvBHT. This study suggests that mvBHT specifically predicts hypersensitive responding to an anticipated inevitable respiratory threat.
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Affiliation(s)
- Elischa Krause
- Department of Physiological and Clinical Psychology/ Psychotherapy, University of Greifswald, Franz-Mehring-Str. 47, 17487 Greifswald, Germany; Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Ferdinand-Sauerbruch-Str., 17475 Greifswald, Germany
| | - Christoph Benke
- Department of Clinical Psychology and Psychotherapy, University of Marburg, Gutenbergstr. 18, 35037 Marburg, Germany
| | - Alfons O Hamm
- Department of Physiological and Clinical Psychology/ Psychotherapy, University of Greifswald, Franz-Mehring-Str. 47, 17487 Greifswald, Germany
| | - Christiane A Pané-Farré
- Department of Physiological and Clinical Psychology/ Psychotherapy, University of Greifswald, Franz-Mehring-Str. 47, 17487 Greifswald, Germany; Department of Clinical Psychology and Psychotherapy, University of Marburg, Gutenbergstr. 18, 35037 Marburg, Germany.
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10
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Šimić G, Tkalčić M, Vukić V, Mulc D, Španić E, Šagud M, Olucha-Bordonau FE, Vukšić M, R. Hof P. Understanding Emotions: Origins and Roles of the Amygdala. Biomolecules 2021; 11:biom11060823. [PMID: 34072960 PMCID: PMC8228195 DOI: 10.3390/biom11060823] [Citation(s) in RCA: 80] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/11/2022] Open
Abstract
Emotions arise from activations of specialized neuronal populations in several parts of the cerebral cortex, notably the anterior cingulate, insula, ventromedial prefrontal, and subcortical structures, such as the amygdala, ventral striatum, putamen, caudate nucleus, and ventral tegmental area. Feelings are conscious, emotional experiences of these activations that contribute to neuronal networks mediating thoughts, language, and behavior, thus enhancing the ability to predict, learn, and reappraise stimuli and situations in the environment based on previous experiences. Contemporary theories of emotion converge around the key role of the amygdala as the central subcortical emotional brain structure that constantly evaluates and integrates a variety of sensory information from the surroundings and assigns them appropriate values of emotional dimensions, such as valence, intensity, and approachability. The amygdala participates in the regulation of autonomic and endocrine functions, decision-making and adaptations of instinctive and motivational behaviors to changes in the environment through implicit associative learning, changes in short- and long-term synaptic plasticity, and activation of the fight-or-flight response via efferent projections from its central nucleus to cortical and subcortical structures.
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Affiliation(s)
- Goran Šimić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb Medical School, 10000 Zagreb, Croatia; (V.V.); (E.Š.); (M.V.)
- Correspondence:
| | - Mladenka Tkalčić
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Rijeka, 51000 Rijeka, Croatia;
| | - Vana Vukić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb Medical School, 10000 Zagreb, Croatia; (V.V.); (E.Š.); (M.V.)
| | - Damir Mulc
- University Psychiatric Hospital Vrapče, 10090 Zagreb, Croatia;
| | - Ena Španić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb Medical School, 10000 Zagreb, Croatia; (V.V.); (E.Š.); (M.V.)
| | - Marina Šagud
- Department of Psychiatry, Clinical Hospital Center Zagreb and University of Zagreb School of Medicine, 10000 Zagreb, Croatia;
| | | | - Mario Vukšić
- Department of Neuroscience, Croatian Institute for Brain Research, University of Zagreb Medical School, 10000 Zagreb, Croatia; (V.V.); (E.Š.); (M.V.)
| | - Patrick R. Hof
- Nash Family Department of Neuroscience and Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY 07305, USA;
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11
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Vagal control of the heart decreases during increasing imminence of interoceptive threat in patients with panic disorder and agoraphobia. Sci Rep 2021; 11:7960. [PMID: 33846417 PMCID: PMC8041829 DOI: 10.1038/s41598-021-86867-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/19/2021] [Indexed: 01/09/2023] Open
Abstract
Theoretically, panic disorder and agoraphobia pathology can be conceptualized as a cascade of dynamically changing defensive responses to threat cues from inside the body. Guided by this trans-diagnostic model we tested the interaction between defensive activation and vagal control as a marker of prefrontal inhibition of subcortical defensive activation. We investigated ultra-short-term changes of vagally controlled high frequency heart rate variability (HRV) during a standardized threat challenge (entrapment) in n = 232 patients with panic disorder and agoraphobia, and its interaction with various indices of defensive activation. We found a strong inverse relationship between HRV and heart rate during threat, which was stronger at the beginning of exposure. Patients with a strong increase in heart rate showed a deactivation of prefrontal vagal control while patients showing less heart rate acceleration showed an increase in vagal control. Moreover, vagal control collapsed in case of imminent threat, i.e., when body symptoms increase and seem to get out of control. In these cases of defensive action patients either fled from the situation or experienced a panic attack. Active avoidance, panic attacks, and increased sympathetic arousal are associated with an inability to maintain vagal control over the heart suggesting that teaching such regulation strategies during exposure treatment might be helpful to keep prefrontal control, particularly during the transition zone from post-encounter to circa strike defense. Trial Registration Number: ISRCTN80046034.
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12
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Kapaldo N, McMurphy R, Hodgson D, Roush J, Berke K, Klocke E. Laryngeal function in normal dogs administered isoflurane following partial clearance of alfaxalone or propofol. Vet Anaesth Analg 2021; 48:493-500. [PMID: 33941487 DOI: 10.1016/j.vaa.2021.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/18/2021] [Accepted: 03/24/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To assess laryngeal function in normal dogs administered isoflurane following partial clearance of alfaxalone or propofol. STUDY DESIGN Randomized experimental crossover study. ANIMALS A group of 12 purpose-bred, male Beagle dogs. METHODS Dogs were randomly assigned to one of two treatments: alfaxalone-isoflurane (ALF-ISO) or propofol-isoflurane (PRO-ISO) and anesthetized for three video laryngoscopy examinations. The alternate treatment occurred after ≥ 14 days interval. Examinations were performed after induction of anesthesia (LS-A), after 20 minutes of breathing isoflurane via a facemask (LS-B) and after a further 20 minutes of isoflurane (LS-C). Parameters of objective laryngeal function included inspiratory rima glottidis surface area (RGSA-I), expiratory rima glottidis surface area (RGSA-E) and % RGSA increase, calculated from three consecutive respiratory cycles in the final 15 seconds of each video laryngoscopy examination. The % RGSA increase was calculated using [(RGSA-I - RGSA-E)/RGSA-E] × 100. Subjective laryngeal function was evaluated independently by two experienced surgeons blinded to treatment. RESULTS The % RGSA increase within each treatment was greater for LS-B and LS-C than for LS-A (ALF-ISO: p = 0.03, PRO-ISO: p = < 0.001). There was no difference within each treatment from LS-B compared with LS-C. RGSA-I increased within each treatment from LS-A to both LS-B and LS-C (ALF-ISO: p = 0.002) and to LS-C (PRO-ISO: p = 0.006). Subjective laryngeal function scores improved from LS-A to LS-C. CONCLUSIONS AND CLINICAL RELEVANCE Laryngeal function improved from postinduction examination following either 20 or 40 minutes of anesthesia with isoflurane via facemask. This study demonstrates that isoflurane may have a lesser effect on arytenoid abduction activity compared with more commonly used intravenous induction anesthetics (alfaxalone and propofol).
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Affiliation(s)
- Nathaniel Kapaldo
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA.
| | - Rose McMurphy
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - David Hodgson
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - James Roush
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Kara Berke
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
| | - Emily Klocke
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, KS, USA
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13
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Naseem S, Mohsin M, Hui W, Liyan G, Penglai K. The Investor Psychology and Stock Market Behavior During the Initial Era of COVID-19: A Study of China, Japan, and the United States. Front Psychol 2021; 12:626934. [PMID: 33643158 PMCID: PMC7902781 DOI: 10.3389/fpsyg.2021.626934] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 01/04/2021] [Indexed: 12/19/2022] Open
Abstract
A highly transmittable and pathogenic viral infection, COVID-19, has dramatically changed the world with a tragically large number of human lives being lost. The epidemic has created psychological resilience and unbearable psychological pressure among patients and health professionals. The objective of this study is to analyze investor psychology and stock market behavior during COVID-19. The psychological behavior of investors, whether positive or negative, toward the stock market can change the picture of the economy. This research explores Shanghai, Nikkei 225, and Dow Jones stock markets from January 20, 2020, to April 27, 2020, by employing principal component analysis. The results showed that investor psychology was negatively related to three selected stock markets under psychological resilience and pandemic pressure. The negative emotions and pessimism urge investors to cease financial investment in the stock market, and consequently, the stock market returns decreased. In a deadly pandemic, the masses were more concerned about their lives and livelihood and less about wealth and leisure. This research contributes to the literature gap of investors’ psychological behavior during a pandemic outbreak. The study suggests that policy-makers should design a plan to fight against COVID-19. The government should manage the health sector’s budget to overcome future crises.
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Affiliation(s)
- Sobia Naseem
- School of Economics and Management, Shijiazhuang Tiedao University, Shijiazhuang, China
| | - Muhammad Mohsin
- School of Business, Hunan University of Humanities, Science and Technology, Loudi, China
| | - Wang Hui
- School of Economics and Management, Shijiazhuang Tiedao University, Shijiazhuang, China
| | - Geng Liyan
- School of Economics and Management, Shijiazhuang Tiedao University, Shijiazhuang, China
| | - Kun Penglai
- School of Economics and Management, Shijiazhuang Tiedao University, Shijiazhuang, China
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14
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Francesetti G, Alcaro A, Settanni M. Panic disorder: attack of fear or acute attack of solitude? Convergences between affective neuroscience and phenomenological-Gestalt perspective. ACTA ACUST UNITED AC 2020; 23:421. [PMID: 32913822 PMCID: PMC7451360 DOI: 10.4081/ripppo.2020.421] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 02/19/2020] [Indexed: 11/23/2022]
Abstract
There is consensus among scientists in considering Panic Attack (PA) as an exaggerated fear response triggered by intense activation of the amygdala and related Fear brain network. Current guidelines for treatment (e.g. National Institute for Clinical Excellence, NICE, 2011), that are based on this view, do not achieve satisfactory results: one-third of all treated patients report persistent PAs and other Panic Disorder (PD) symptoms, and several meta-analyses report the high likelihood of relapse. Here we review findings from Affective Neuroscience and clinical insights from a phenomenological-Gestalt perspective, putting into question the link between PD and activation of the Fear brain network. We propose an alternative hypothesis about PD etiology: PD is mainly connected to the Panic system, that is activated in situations of separation from affective support and overexposure to the environment. In our view, PA can be understood as an acute attack of solitude which is not adequately recognized by the patient due to the intervention of a dissociative component that makes it impossible to integrate all neuro-physiological responses activated by the Panic/Separation brain system within a coherent emotional feeling. This perspective can explain many evidences that otherwise remain isolated elements without a comprehensive frame: i.e., the association with agoraphobia, the onset of PD during adolescence and young adult life, the need to be accompanied, the connection with air hunger and other respiratory anomalies, the efficacy of antidepressants and the lack of activation of the Hypothalamic-Pituitary-Adrenal (HPA) axe. We discuss future steps to test this hypothesis and the consequences for psychotherapeutic treatment.
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Affiliation(s)
- Gianni Francesetti
- International Institute for Gestalt Therapy and Psychopathology - IPsiG.,Department of Psychology, University of Turin
| | - Antonio Alcaro
- Santa Lucia Foundation, European Centre for Brain Research, Italy
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15
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Godoi MM, Junior HZ, da Cunha JM, Zanoveli JM. Mu-opioid and CB1 cannabinoid receptors of the dorsal periaqueductal gray interplay in the regulation of fear response, but not antinociception. Pharmacol Biochem Behav 2020; 194:172938. [PMID: 32376258 DOI: 10.1016/j.pbb.2020.172938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/21/2022]
Abstract
Evidence indicates that periaqueductal gray matter (PAG) plays an important role in defensive responses and pain control. The activation of cannabinoid type-1 (CB1) or mu-opioid (MOR) receptors in the dorsal region of this structure (dPAG) inhibits fear and facilitates antinociception induced by different aversive stimuli. However, it is still unknown whether these two receptors work cooperatively in order to achieve these inhibitory actions. This study investigated the involvement and a likely interplay between CB1 and MOR receptors localized into the dPAG on the regulation of fear-like defensive responses and antinociception (evaluated in tail-flick test) evoked by dPAG chemical stimulation with N-methyl-d-aspartate (NMDA). Before the administration of NMDA, animals were first intra-dPAG injected with the CB1 agonist ACEA (0.5 pmol), or with the MOR agonist DAMGO (0.5 pmol) in combination with the respective antagonists AM251 (CB1 antagonist, 100 pmol) or CTOP (MOR antagonist, 1 nmol). To investigate the interplay between these receptors, microinjection of CTOP was combined with ACEA, or microinjection of AM251 was combined with DAMGO. Our results showed that both the intra-PAG treatments with ACEA or DAMGO inhibited NMDA-induced freezing expression, whereas only the treatment with DAMGO increased antinociception induced with NMDA, which are completely blocked by its respective antagonists. Interestingly, the inhibitory effects of ACEA or DAMGO on freezing was blocked by CTOP and AM251, respectively, indicating a functional interaction between these two receptors in the mediation of defensive behaviors. However, this cooperative interaction was not observed during the NMDA-induced antinociception. Our findings indicate that there is a cooperative action between the MOR and CB1 receptors within the dPAG and it is involved in the mediation of NMDA-induced defensive responses. Additionally, the MORs into the dPAG are involved in the modulation of the antinociceptive effects that follow a fear-like defense-reaction induced by dPAG chemical stimulation with NMDA.
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Affiliation(s)
- Manuella Machado Godoi
- Department of Pharmacology, Biological Sciences Building, Federal University of Paraná, Rua Coronel H. dos Santos S/N, P.O. Box 19031, Curitiba, Paraná 81540-990, Brazil
| | - Hélio Zangrossi Junior
- Department of Pharmacology, School of Medicine, University of São Paulo, Av. Bandeirantes 3900, Ribeirão Preto, São Paulo 14049-900, Brazil
| | - Joice Maria da Cunha
- Department of Pharmacology, Biological Sciences Building, Federal University of Paraná, Rua Coronel H. dos Santos S/N, P.O. Box 19031, Curitiba, Paraná 81540-990, Brazil; Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirão Preto, SP 14040-900, Brazil
| | - Janaina Menezes Zanoveli
- Department of Pharmacology, Biological Sciences Building, Federal University of Paraná, Rua Coronel H. dos Santos S/N, P.O. Box 19031, Curitiba, Paraná 81540-990, Brazil; Institute of Neurosciences and Behavior and Laboratory of Neuropsychopharmacology of Faculty of Philosophy, Sciences and Letters of University of São Paulo, Ribeirão Preto, SP 14040-900, Brazil.
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16
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Castro RR, Sales ARK, Nóbrega AC. Lifestyle interventions reduce exercise ventilatory variability in healthy individuals: a randomized intervention study. Future Cardiol 2020; 16:439-446. [PMID: 32323560 DOI: 10.2217/fca-2019-0070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: Variation of exercise ventilation confers poor prognosis in heart failure. Sedentary men have higher exercise ventilatory variability than athletes. However, the impact of lifestyle intervention on exercise ventilatory variability in sedentary people is unknown and this is the aim of this study. Materials & methods: Prospective controlled single-blinded interventional study that randomly assigned healthy sedentary individuals to diet and exercise (intervention group, n = 12) or no intervention (control group, n = 12) for 12 weeks. Exercise ventilatory variability was accessed before and after intervention. Results: Despite similar values at baseline, there was a 15% reduction in respiratory rate variability (root mean square of the successive differences/n) in intervention group. Conclusion: Diet and exercise training reduced exercise ventilatory variability.
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Affiliation(s)
- Renata Rt Castro
- Medicine School, Iguaçu University, Nova Iguaçu, Brazil.,Hospital Naval Marcílio Dias, Marinha do Brasil, Rio de Janeiro, Brazil
| | - Allan Robson Kluser Sales
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil.,D'Or Institute for Research and Education, São Paulo, Brazil
| | - Antonio Cl Nóbrega
- Department of Physiology and Pharmacology, Fluminense Federal University, Niterói, Brazil
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17
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Schiele MA, Bandelow B, Baldwin DS, Pini S, Domschke K. A neurobiological framework of separation anxiety and related phenotypes. Eur Neuropsychopharmacol 2020; 33:45-57. [PMID: 32046934 DOI: 10.1016/j.euroneuro.2020.01.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 10/25/2019] [Accepted: 01/22/2020] [Indexed: 01/09/2023]
Abstract
In the DSM-5, separation anxiety disorder (SAD) is newly classified in the chapter on anxiety, renewing research efforts into its etiology. In this narrative review, we summarize the current literature on the genetic, endocrine, physiological, neural and neuropsychological underpinnings of SAD per se, SAD in the context of panic disorder, separation anxiety symptoms, and related intermediate phenotypes. SAD aggregates in families and has a heritability of ~43%. Variants in the oxytocin receptor, serotonin transporter, opioid receptor µ1, dopamine D4 receptor and translocator protein genes have all been associated with SAD. Dysregulation of the hypothalamus-pituitary-adrenal axis, dysfunctional cortico-limbic interaction and biased cognitive processing seem to constitute further neurobiological markers of separation anxiety. Hypersensitivity to carbon dioxide appears to be an endophenotype shared by SAD, panic disorder and anxiety sensitivity. The identification of biological risk markers and its multi-level integration hold great promise regarding the prediction of SAD risk, maintenance and course, and in the future may allow for the selection of indicated preventive and innovative, personalized therapeutic interventions.
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Affiliation(s)
- Miriam A Schiele
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Borwin Bandelow
- Department of Psychiatry and Psychotherapy, University Medical Centre Göttingen, Germany
| | - David S Baldwin
- Clinical and Experimental Sciences, University of Southampton, Faculty of Medicine, Southampton, United Kingdom; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Stefano Pini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Center for Basics in NeuroModulation, Faculty of Medicine, University of Freiburg, Germany.
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18
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Nardi AE, Freire RC, Kahn JP. The Master of Psychopharmacology: an inspiration for future generations - Donald F. Klein (1928-2019). REVISTA BRASILEIRA DE PSIQUIATRIA 2019; 41:465-466. [PMID: 31826089 PMCID: PMC6899354 DOI: 10.1590/1516-4446-2019-4112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Antonio E Nardi
- Laboratório de Pânico e Respiração, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Rafael C Freire
- Laboratório de Pânico e Respiração, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil.,Department of Psychiatry, Queen's University, Kingston, Canada
| | - Jeffrey P Kahn
- Department of Psychiatry, Weill Cornell Medical College, New York, USA
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19
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Crowley JD, Thomas KA, Donahoe SL, Child G, Hickey MC, Mooney ET. Hypoventilation, cardiac dysrhythmia, and cardiac arrest following acute
Brunfelsia
species (Yesterday, today, tomorrow) intoxication in a dog. Aust Vet J 2019; 97:202-207. [DOI: 10.1111/avj.12815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 03/05/2019] [Accepted: 03/20/2019] [Indexed: 12/01/2022]
Affiliation(s)
- JD Crowley
- University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of ScienceUniversity of Sydney, Evelyn Williams Building B10 New South Wales, 2006 Australia
| | - KA Thomas
- University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of ScienceUniversity of Sydney, Evelyn Williams Building B10 New South Wales, 2006 Australia
| | - SL Donahoe
- Veterinary Pathology Diagnostic Services, Sydney School of Veterinary Science, Faculty of ScienceUniversity of Sydney NSW Australia
| | - G Child
- University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of ScienceUniversity of Sydney, Evelyn Williams Building B10 New South Wales, 2006 Australia
| | - MC Hickey
- University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of ScienceUniversity of Sydney, Evelyn Williams Building B10 New South Wales, 2006 Australia
| | - ET Mooney
- University Veterinary Teaching Hospital Sydney, Sydney School of Veterinary Science, Faculty of ScienceUniversity of Sydney, Evelyn Williams Building B10 New South Wales, 2006 Australia
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20
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Predictors of behavioral avoidance during respiratory symptom provocation. Behav Res Ther 2019; 112:63-67. [DOI: 10.1016/j.brat.2018.11.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 10/04/2018] [Accepted: 11/22/2018] [Indexed: 11/23/2022]
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21
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Dynamics of Defensive Response Mobilization to Approaching External Versus Interoceptive Threat. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:525-538. [DOI: 10.1016/j.bpsc.2017.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 11/18/2022]
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22
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Sestile CC, Maraschin JC, Rangel MP, Santana RG, Zangrossi H, Graeff FG, Audi EA. B2-kinin receptors in the dorsal periaqueductal gray are implicated in the panicolytic-like effect of opiorphin. Prog Neuropsychopharmacol Biol Psychiatry 2017; 79:493-498. [PMID: 28797641 DOI: 10.1016/j.pnpbp.2017.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/03/2017] [Accepted: 08/05/2017] [Indexed: 01/13/2023]
Abstract
Reported results have shown that the pentapeptide opiorphin inhibits oligopeptidases that degrade brain neuropeptides, and has analgesic and antidepressant effects in experimental animals, without either tolerance or dependency after chronic administration. In a previous study we showed that opiorphin has a panicolytic-like effect in the dorsal periaqueductal gray (dPAG) electrical stimulation test (EST), mediated by the μ-opioid receptor (MOR). This study further analyzes the mechanism of opiorphin panicolytic action, using the EST and drug injection inside the dPAG. The obtained results showed that blockade of the 5-HT1A receptors with WAY-100635 did not change the escape-impairing effect of opiorphin, and combined injection of sub-effective doses of opiorphin and the 5-HT1A-agonist 8-OH-DPAT did not have a significant anti-escape effect. In contrast, the anti-escape effect of opiorphin was antagonized by pretreatment with the kinin B2 receptor blocker HOE-140, and association of sub-effective doses of opiorphin and bradykinin caused a significant anti-escape effect. The anti-escape effect of bradykinin was not affected by previous administration of WAY-100635. Therefore, the anti-escape effect of opiorphin in the dPAG seems to be mediated by endogenous bradykinin, acting on kinin B2 receptors, which previous results have shown to interact synergistically with MOR in the dPAG to restrain escape in two animal models of panic. Chemical compounds: Opiorphin (PubChem CID: 25195667); WAY100635 maleate salt (PubChem CID: 11957721); 8-OH-DPAT hydrobromide (PubChem CID: 6917794); Bradykinin (PubChem CID: 439201); HOE-140 (Icatibant) (PubChem CID: 6918173).
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Affiliation(s)
- Caio César Sestile
- Department of Pharmacology and Therapeutics, State University of Maringá (UEM), Maringá, PR, Brazil.
| | | | - Marcel Pereira Rangel
- Department of Pharmacology and Therapeutics, State University of Maringá (UEM), Maringá, PR, Brazil
| | | | - Hélio Zangrossi
- Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto, SP, Brazil; Institute of Neurosciences and Behavior (INeC), Ribeirão Preto, Brazil
| | | | - Elisabeth Aparecida Audi
- Department of Pharmacology and Therapeutics, State University of Maringá (UEM), Maringá, PR, Brazil.
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23
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Leibold NK, van den Hove DLA, Viechtbauer W, Kenis G, Goossens L, Lange I, Knuts I, Smeets HJ, Myin-Germeys I, Steinbusch HW, Schruers KR. Amiloride-sensitive cation channel 2 genotype affects the response to a carbon dioxide panic challenge. J Psychopharmacol 2017; 31:1294-1301. [PMID: 28121219 DOI: 10.1177/0269881116686880] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Until recently, genetic research into panic disorder (PD) has had only limited success. Inspired by rodent research, demonstrating that the acid-sensing ion channel 1a (ASIC1a) is critically involved in the behavioral fear response to carbon dioxide (CO2) exposure, variants in the human homologue gene amiloride-sensitive cation channel 2 (ACCN2) were shown to be associated with PD. However, the relationship between changes in brain pH and ACCN2, as done in rodents by CO2 exposure, has not been investigated yet in humans. Here, we examined this link between the ACCN2 gene and the response to CO2 exposure in two studies: in healthy volunteers as well as PD patients and using both behavioral and physiological outcome measures. More specifically, 107 healthy volunteers and 183 PD patients underwent a 35% CO2 inhalation. Negative affect was assessed using visual analogue scales and the panic symptom list (PSL), and, in healthy volunteers, cardiovascular measurements. The single nucleotide polymorphism rs10875995 was significantly associated with a higher emotional response in PD patients and with an increase in systolic as well as diastolic blood pressure in healthy subjects. In all measurements, subjects homozygous for the T-allele showed a heightened reactivity to CO2. Furthermore, a trend towards an rs685012 genotype effect on the emotional response was found in PD patients. We provide the first evidence that genetic variants in the ACCN2 are associated with differential sensitivity to CO2 in PD patients as well as healthy volunteers, further supporting ACCN2 as a promising candidate for future research to improve current treatment options.
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Affiliation(s)
- Nicole K Leibold
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Daniel LA van den Hove
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.,2 Department of Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Wolfgang Viechtbauer
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Gunter Kenis
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Liesbet Goossens
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Iris Lange
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Inge Knuts
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Hubert J Smeets
- 3 Genome Center Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Inez Myin-Germeys
- 3 Genome Center Maastricht, Maastricht University, Maastricht, the Netherlands
| | - Harry Wm Steinbusch
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Koen Rj Schruers
- 1 Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
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Masdrakis VG, Papageorgiou C, Markianos M. Associations of plasma leptin to clinical manifestations in reproductive aged female patients with panic disorder. Psychiatry Res 2017; 255:161-166. [PMID: 28551488 DOI: 10.1016/j.psychres.2017.05.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Revised: 03/16/2017] [Accepted: 05/14/2017] [Indexed: 12/14/2022]
Abstract
Preclinical studies suggest the implication of the adipocyte hormone leptin in anxiety and fear processes. We explored for potential differences regarding plasma leptin, cortisol and the ratio leptin/Body Mass Index (BMI) between 27 medication-free female patients with Panic Disorder (PD) and 42 age-matched female controls, and for potential associations between plasma leptin and psychometric evaluations including number of panic attacks during last week, Clinical Global Impression-Severity of Illness (CGI-S) and Symptoms Checklist-90-Revised (SCL-90-R). Cortisol levels showed no differences between patients and controls, or correlations to leptin or to any clinical features. Both groups demonstrated a strong positive correlation between leptin and BMI and similar leptin and leptin/BMI, despite patients' lower BMI. However, patients -but not controls- demonstrated significant negative correlations of leptin to the 'somatization', 'anxiety', and 'phobic anxiety' SCL-90-R subscales. Moreover, there was a significant negative correlation of leptin and of leptin/BMI ratio to the number of panic attacks during last week, while higher CGI-S was associated with lower leptin/BMI ratio. Our results, limited to PD female patients, suggest that lower leptin serum levels are significantly associated with greater severity of psychopathological manifestations, including number of panic attacks, symptoms of somatization, anxiety and phobic anxiety and overall clinical presentation.
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Affiliation(s)
- Vasilios G Masdrakis
- National and Kapodistrian University of Athens, School of Medicine, First Department of Psychiatry, Eginition Hospital, 74 Vas. Sofias Avenue, 11528 Athens, Greece.
| | - Charalambos Papageorgiou
- National and Kapodistrian University of Athens, School of Medicine, First Department of Psychiatry, Eginition Hospital, 74 Vas. Sofias Avenue, 11528 Athens, Greece
| | - Manolis Markianos
- National and Kapodistrian University of Athens, School of Medicine, First Department of Psychiatry, Eginition Hospital, 74 Vas. Sofias Avenue, 11528 Athens, Greece
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25
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Fiaes GCDS, Roncon CM, Sestile CC, Maraschin JC, Souza RLS, Porcu M, Audi EA. Panicolytic-like effect of tramadol is mediated by opioid receptors in the dorsal periaqueductal grey. Behav Brain Res 2017; 326:52-58. [DOI: 10.1016/j.bbr.2017.02.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Revised: 02/20/2017] [Accepted: 02/22/2017] [Indexed: 11/15/2022]
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26
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Graeff FG. Translational approach to the pathophysiology of panic disorder: Focus on serotonin and endogenous opioids. Neurosci Biobehav Rev 2017; 76:48-55. [DOI: 10.1016/j.neubiorev.2016.10.013] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/30/2016] [Accepted: 10/13/2016] [Indexed: 12/18/2022]
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27
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Müller CJT, Quintino-dos-Santos JW, Schimitel FG, Tufik S, Beijamini V, Canteras NS, Schenberg LC. On the verge of a respiratory-type panic attack: Selective activations of rostrolateral and caudoventrolateral periaqueductal gray matter following short-lasting escape to a low dose of potassium cyanide. Neuroscience 2017; 348:228-240. [DOI: 10.1016/j.neuroscience.2017.02.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 12/05/2016] [Accepted: 02/12/2017] [Indexed: 10/20/2022]
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28
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Silva BA, Gross CT, Gräff J. The neural circuits of innate fear: detection, integration, action, and memorization. ACTA ACUST UNITED AC 2016; 23:544-55. [PMID: 27634145 PMCID: PMC5026211 DOI: 10.1101/lm.042812.116] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 07/19/2016] [Indexed: 12/26/2022]
Abstract
How fear is represented in the brain has generated a lot of research attention, not only because fear increases the chances for survival when appropriately expressed but also because it can lead to anxiety and stress-related disorders when inadequately processed. In this review, we summarize recent progress in the understanding of the neural circuits processing innate fear in rodents. We propose that these circuits are contained within three main functional units in the brain: a detection unit, responsible for gathering sensory information signaling the presence of a threat; an integration unit, responsible for incorporating the various sensory information and recruiting downstream effectors; and an output unit, in charge of initiating appropriate bodily and behavioral responses to the threatful stimulus. In parallel, the experience of innate fear also instructs a learning process leading to the memorization of the fearful event. Interestingly, while the detection, integration, and output units processing acute fear responses to different threats tend to be harbored in distinct brain circuits, memory encoding of these threats seems to rely on a shared learning system.
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Affiliation(s)
- Bianca A Silva
- Laboratory of Neuroepigenetics, Brain Mind Institute, Faculty of Life Sciences, Ecole Polytechnique Fédérale Lausanne, CH-1015 Lausanne, Switzerland
| | - Cornelius T Gross
- Mouse Biology Unit, European Molecular Biology Laboratory (EMBL), 00015 Monterotondo, Italy
| | - Johannes Gräff
- Laboratory of Neuroepigenetics, Brain Mind Institute, Faculty of Life Sciences, Ecole Polytechnique Fédérale Lausanne, CH-1015 Lausanne, Switzerland
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29
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Bandelow B, Baldwin D, Abelli M, Altamura C, Dell'Osso B, Domschke K, Fineberg NA, Grünblatt E, Jarema M, Maron E, Nutt D, Pini S, Vaghi MM, Wichniak A, Zai G, Riederer P. Biological markers for anxiety disorders, OCD and PTSD - a consensus statement. Part I: Neuroimaging and genetics. World J Biol Psychiatry 2016; 17:321-65. [PMID: 27403679 DOI: 10.1080/15622975.2016.1181783] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Biomarkers are defined as anatomical, biochemical or physiological traits that are specific to certain disorders or syndromes. The objective of this paper is to summarise the current knowledge of biomarkers for anxiety disorders, obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD). METHODS Findings in biomarker research were reviewed by a task force of international experts in the field, consisting of members of the World Federation of Societies for Biological Psychiatry Task Force on Biological Markers and of the European College of Neuropsychopharmacology Anxiety Disorders Research Network. RESULTS The present article (Part I) summarises findings on potential biomarkers in neuroimaging studies, including structural brain morphology, functional magnetic resonance imaging and techniques for measuring metabolic changes, including positron emission tomography and others. Furthermore, this review reports on the clinical and molecular genetic findings of family, twin, linkage, association and genome-wide association studies. Part II of the review focuses on neurochemistry, neurophysiology and neurocognition. CONCLUSIONS Although at present, none of the putative biomarkers is sufficient and specific as a diagnostic tool, an abundance of high-quality research has accumulated that will improve our understanding of the neurobiological causes of anxiety disorders, OCD and PTSD.
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Affiliation(s)
- Borwin Bandelow
- a Department of Psychiatry and Psychotherapy , University of Göttingen , Germany
| | - David Baldwin
- b Faculty of Medicine , University of Southampton , Southampton , UK
| | - Marianna Abelli
- c Department of Clinical and Experimental Medicine , Section of Psychiatry, University of Pisa , Italy
| | - Carlo Altamura
- d Department of Psychiatry , University of Milan; Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Bernardo Dell'Osso
- d Department of Psychiatry , University of Milan; Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico , Milan , Italy
| | - Katharina Domschke
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany
| | - Naomi A Fineberg
- f Hertfordshire Partnership University NHS Foundation Trust and University of Hertfordshire , Rosanne House, Parkway , Welwyn Garden City , UK
| | - Edna Grünblatt
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany ;,g Neuroscience Center Zurich , University of Zurich and the ETH Zurich , Zürich , Switzerland ;,h Department of Child and Adolescent Psychiatry and Psychotherapy , Psychiatric Hospital, University of Zurich , Zürich , Switzerland ;,i Zurich Center for Integrative Human Physiology , University of Zurich , Switzerland
| | - Marek Jarema
- j Third Department of Psychiatry , Institute of Psychiatry and Neurology , Warszawa , Poland
| | - Eduard Maron
- k North Estonia Medical Centre, Department of Psychiatry , Tallinn , Estonia ;,l Department of Psychiatry , University of Tartu , Estonia ;,m Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences , Imperial College London , UK
| | - David Nutt
- m Faculty of Medicine, Department of Medicine, Centre for Neuropsychopharmacology, Division of Brain Sciences , Imperial College London , UK
| | - Stefano Pini
- c Department of Clinical and Experimental Medicine , Section of Psychiatry, University of Pisa , Italy
| | - Matilde M Vaghi
- n Department of Psychology and Behavioural and Clinical Neuroscience Institute , University of Cambridge , UK
| | - Adam Wichniak
- j Third Department of Psychiatry , Institute of Psychiatry and Neurology , Warszawa , Poland
| | - Gwyneth Zai
- n Department of Psychology and Behavioural and Clinical Neuroscience Institute , University of Cambridge , UK ;,o Neurogenetics Section, Centre for Addiction & Mental Health , Toronto , Canada ;,p Frederick W. Thompson Anxiety Disorders Centre, Department of Psychiatry, Sunnybrook Health Sciences Centre , Toronto , Canada ;,q Institute of Medical Science and Department of Psychiatry, University of Toronto , Toronto , Canada
| | - Peter Riederer
- e Department of Psychiatry, Psychosomatics and Psychotherapy , University of Wuerzburg , Germany ;,g Neuroscience Center Zurich , University of Zurich and the ETH Zurich , Zürich , Switzerland ;,h Department of Child and Adolescent Psychiatry and Psychotherapy , Psychiatric Hospital, University of Zurich , Zürich , Switzerland
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Bokov P, Fiamma MN, Chevalier-Bidaud B, Chenivesse C, Straus C, Similowski T, Delclaux C. Increased ventilatory variability and complexity in patients with hyperventilation disorder. J Appl Physiol (1985) 2016; 120:1165-72. [DOI: 10.1152/japplphysiol.00859.2015] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/10/2016] [Indexed: 12/18/2022] Open
Abstract
It has been hypothesized that hyperventilation disorders could be characterized by an abnormal ventilatory control leading to enhanced variability of resting ventilation. The variability of tidal volume (VT) often depicts a nonnormal distribution that can be described by the negative slope characterizing augmented breaths formed by the relationship between the probability density distribution of VT and VT on a log-log scale. The objectives of this study were to describe the variability of resting ventilation [coefficient of variation (CV) of VT and slope], the stability in respiratory control (loop, controller and plant gains characterizing ventilatory-chemoresponsiveness interactions) and the chaotic-like dynamics (embedding dimension, Kappa values characterizing complexity) of resting ventilation in patients with a well-defined dysfunctional breathing pattern characterized by air hunger and constantly decreased PaCO2 during a cardiopulmonary exercise test. Compared with 14 healthy subjects with similar anthropometrics, 23 patients with hyperventilation were characterized by increased variability of resting tidal ventilation (CV of VT median [interquartile]: 26% [19-35] vs. 36% [28–48], P = 0.020; slope: −6.63 [−7.65; −5.36] vs. −3.88 [−5.91; −2.66], P = 0.004) that was not related to increased chemical drive (loop gain: 0.051 [0.039–0.221] vs. 0.044 [0.012–0.087], P = 0.149) but that was related to an increased ventilatory complexity (Kappa values, P < 0.05). Plant gain was decreased in patients and correlated with complexity (with Kappa 5 − degree 5: Rho = −0.48, P = 0.006). In conclusion, well-defined patients suffering from hyperventilation disorder are characterized by increased variability of their resting ventilation due to increased ventilatory complexity with stable ventilatory-chemoresponsiveness interactions.
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Affiliation(s)
- Plamen Bokov
- AP-HP, Hôpital Européen Georges Pompidou, Service de Physiologie, Clinique de la Dyspnée, Paris, and Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Marie-Noëlle Fiamma
- Sorbonne Universités, UPMC Université Paris 06, UMR_S 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
| | - Brigitte Chevalier-Bidaud
- AP-HP, Hôpital Européen Georges Pompidou, Unité d'Épidémiologie et de Recherche Clinique, Paris, France
| | - Cécile Chenivesse
- Sorbonne Universités, UPMC Université Paris 06, UMR_S 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale, Paris, France
| | - Christian Straus
- Sorbonne Universités, UPMC Université Paris 06, UMR_S 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service d'Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée, Paris, France
| | - Thomas Similowski
- Sorbonne Universités, UPMC Université Paris 06, UMR_S 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale, Paris, France
| | - Christophe Delclaux
- AP-HP, Hôpital Européen Georges Pompidou, Service de Physiologie, Clinique de la Dyspnée, Paris, and Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
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Hamm AO, Richter J, Pané-Farré C, Westphal D, Wittchen HU, Vossbeck-Elsebusch AN, Gerlach AL, Gloster AT, Ströhle A, Lang T, Kircher T, Gerdes ABM, Alpers GW, Reif A, Deckert J. Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative. Psychophysiology 2016; 53:312-22. [DOI: 10.1111/psyp.12553] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 06/25/2015] [Accepted: 08/01/2015] [Indexed: 12/30/2022]
Affiliation(s)
- Alfons O. Hamm
- Department of Biological and Clinical Psychology; University of Greifswald; Greifswald Germany
| | - Jan Richter
- Department of Biological and Clinical Psychology; University of Greifswald; Greifswald Germany
| | - Christiane Pané-Farré
- Department of Biological and Clinical Psychology; University of Greifswald; Greifswald Germany
| | - Dorte Westphal
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden; Dresden Germany
| | - Hans-Ulrich Wittchen
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden; Dresden Germany
| | | | - Alexander L. Gerlach
- Department of Clinical Psychology and Psychotherapy; University of Cologne; Cologne Germany
| | | | - Andreas Ströhle
- Department of Psychiatry and Psychotherapy; Charité-Universitätsmedizin; Berlin Germany
| | - Thomas Lang
- Christoph-Dornier Foundation for Clinical Psychology; Bremen Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy; Philipps-University Marburg; Marburg Germany
| | - Antje B. M. Gerdes
- Department Psychology; School of Social Sciences, University of Mannheim; Mannheim Germany
| | - Georg W. Alpers
- Department Psychology; School of Social Sciences, University of Mannheim; Mannheim Germany
| | - Andreas Reif
- Department of Psychiatry; Psychosomatics, and Psychotherapy, University of Frankfurt; Frankfurt Germany
| | - Jürgen Deckert
- Department of Psychiatry; Psychosomatics, and Psychotherapy, University of Würzburg; Würzburg Germany
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Maraschin JC, Rangel MP, Bonfim AJ, Kitayama M, Graeff FG, Zangrossi H, Audi EA. Opiorphin causes a panicolytic-like effect in rat panic models mediated by μ-opioid receptors in the dorsal periaqueductal gray. Neuropharmacology 2016; 101:264-70. [DOI: 10.1016/j.neuropharm.2015.09.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 08/24/2015] [Accepted: 09/05/2015] [Indexed: 11/30/2022]
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Translational approach to studying panic disorder in rats: hits and misses. Neurosci Biobehav Rev 2015; 46 Pt 3:472-96. [PMID: 25316571 DOI: 10.1016/j.neubiorev.2014.10.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 09/26/2014] [Accepted: 10/01/2014] [Indexed: 12/30/2022]
Abstract
Panic disorder (PD) patients are specifically sensitive to 5–7% carbon dioxide. Another startling feature of clinical panic is the counterintuitive lack of increments in ‘stress hormones’. PD is also more frequent in women and highly comorbid with childhood separation anxiety (CSA). On the other hand, increasing evidence suggests that panic is mediated at dorsal periaqueductal grey matter (DPAG). In line with prior studies showing that DPAG-evoked panic-like behaviours are attenuated by clinically-effective treatments with panicolytics, we show here that (i) the DPAG harbors a hypoxia-sensitive alarm system, which is activated by hypoxia and potentiated by hypercapnia, (ii) the DPAG suffocation alarm system is inhibited by clinically-effective treatments with panicolytics, (iii) DPAG stimulations do not increase stress hormones in the absence of physical exertion, (iv) DPAG-evoked panic-like behaviours are facilitated in neonatally-isolated adult rats, a model of CSA, and (v) DPAG-evoked responses are enhanced in the late diestrus of female rats. Data are consistent with the DPAG mediation of both respiratory and non-respiratory types of panic attacks.
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Lifestyle Behaviours Add to the Armoury of Treatment Options for Panic Disorder: An Evidence-Based Reasoning. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 12:7017-43. [PMID: 26095868 PMCID: PMC4483746 DOI: 10.3390/ijerph120607017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/11/2015] [Accepted: 06/12/2015] [Indexed: 11/16/2022]
Abstract
This article presents an evidence-based reasoning, focusing on evidence of an Occupational Therapy input to lifestyle behaviour influences on panic disorder that also provides potentially broader application across other mental health problems (MHP). The article begins from the premise that we are all different. It then follows through a sequence of questions, examining incrementally how MHPs are experienced and classified. It analyses the impact of individual sensitivity at different levels of analysis, from genetic and epigenetic individuality, through neurotransmitter and body system sensitivity. Examples are given demonstrating the evidence base behind the logical sequence of investigation. The paper considers the evidence of how everyday routine lifestyle behaviour impacts on occupational function at all levels, and how these behaviours link to individual sensitivity to influence the level of exposure required to elicit symptomatic responses. Occupational Therapists can help patients by adequately assessing individual sensitivity, and through promoting understanding and a sense of control over their own symptoms. It concludes that present clinical guidelines should be expanded to incorporate knowledge of individual sensitivities to environmental exposures and lifestyle behaviours at an early stage.
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The brain acid–base homeostasis and serotonin: A perspective on the use of carbon dioxide as human and rodent experimental model of panic. Prog Neurobiol 2015; 129:58-78. [DOI: 10.1016/j.pneurobio.2015.04.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Revised: 04/16/2015] [Accepted: 04/20/2015] [Indexed: 12/14/2022]
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de Souza Armini R, Bernabé CS, Rosa CA, Siller CA, Schimitel FG, Tufik S, Klein DF, Schenberg LC. In a rat model of panic, corticotropin responses to dorsal periaqueductal gray stimulation depend on physical exertion. Psychoneuroendocrinology 2015; 53:136-47. [PMID: 25618592 DOI: 10.1016/j.psyneuen.2014.12.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Revised: 12/29/2014] [Accepted: 12/29/2014] [Indexed: 01/06/2023]
Abstract
Panic disorder patients are exquisitely and specifically sensitive to hypercapnia. The demonstration that carbon dioxide provokes panic in fear-unresponsive amygdala-calcified Urbach-Wiethe patients emphasizes that panic is not fear nor does it require the activation of the amygdala. This is consonant with increasing evidence suggesting that panic is mediated caudally at midbrain's dorsal periaqueductal gray matter (DPAG). Another startling feature of the apparently spontaneous clinical panic is the counterintuitive lack of increments in corticotropin, cortisol and prolactin, generally considered 'stress hormones'. Here we show that the stress hormones are not changed during DPAG-evoked panic when escape is prevented by stimulating the rat in a small compartment. Neither did the corticotropin increase when physical exertion was statistically adjusted to the same degree as non-stimulated controls, as measured by lactate plasma levels. Conversely, neuroendocrine responses to foot-shocks were independent from muscular effort. Data are consonant with DPAG mediation of panic attacks.
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Affiliation(s)
- Rubia de Souza Armini
- Deparment of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | | | - Caroline Azevedo Rosa
- Deparment of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Carlos Antônio Siller
- Deparment of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | | | - Sérgio Tufik
- Department of Psychobiology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Donald Franklin Klein
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Department of Child and Adolescent Psychiatry, New York University Langone Medical Center, USA; The Nathan S. Kline Institute for Psychiatric Research, USA; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Luiz Carlos Schenberg
- Deparment of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil.
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Inoue A, Akiyoshi J, Muronaga M, Masuda K, Aizawa S, Hirakawa H, Ishitobi Y, Higuma H, Maruyama Y, Ninomiya T, Tanaka Y, Hanada H, Kawano Y. Association of TMEM132D, COMT, and GABRA6 genotypes with cingulate, frontal cortex and hippocampal emotional processing in panic and major depressive disorder. Int J Psychiatry Clin Pract 2015; 19:192-200. [PMID: 25974322 DOI: 10.3109/13651501.2015.1043133] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the association of transmembrane protein 132D (TMEM132D), catechol-O-methyltransferase (COMT), and gamma-aminobutyric acid (GABA) receptor alpha 6 subunit (GABRA6) genotypes with cingulate, frontal cortex and hippocampal emotional processing in panic disorder (PD) and major depressive disorder (MDD). METHOD The single nucleotide polymorphisms (SNPs) in TMEM132D, COMT, and GABRA6 were examined in patients with MDD, PD, and healthy controls. Functional magnetic resonance imaging (fMRI) was performed in patients with MDD, PD, and healthy controls. RESULTS rs4680 in COMT and rs3219151 in GABRA6 showed positive associations with PD and MDD. A dynamic fearful face was shown to the participants during fMRI scanning. In PD patients, responses in the bilateral anterior cingulate were stronger in carriers of the AA genotype of SNP rs11060369 in TMEM132D compared with carriers of the AC + CC genotype, and stronger in CT + TT genotype carriers of SNP rs3219151 in GABRA6 compared with carriers of the CC genotype. The response in the medial orbital frontal cortex was stronger in carriers of the CT + TT genotypes of SNP rs3219151 in PD. In MDD patients, the response in the right parahippocampus of carriers of the GG genotype of rs4680 in COMT was stronger than that of carriers of the AA + AG genotype. CONCLUSION These results suggest that TMEM132D, GABRA6, and COMT variants may increase vulnerability to panic.
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Affiliation(s)
- Ayako Inoue
- a Department of Neuropsychiatry , Oita University Faculty of Medicine , Hasama-Machi, Yufu-Shi, Oita , Japan
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Schimitel FG, Müller CJT, Tufik S, Schenberg LC. Evidence of a suffocation alarm system sensitive to clinically-effective treatments with the panicolytics clonazepam and fluoxetine. J Psychopharmacol 2014; 28:1184-8. [PMID: 25277323 DOI: 10.1177/0269881114552714] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dyspnea, 'hunger for air', and the urge to flee are the cardinal symptoms of respiratory-type panic attacks. Patients also show baseline respiratory abnormalities and a higher rate of comorbid and antecedent respiratory diseases. Panic attacks are also precipitated by both the infusion of 0.5 M sodium lactate and the inhalation of 5-7% carbon dioxide (CO2) in predisposed patients, but not in healthy volunteers nor patients without panic disorder. Further studies show that patients with panic are also hyper-responsive to hypoxia. These and other observations led Klein (1993) to suggest that clinical panic is the misfiring of a suffocation alarm system. In rats, cytotoxic hypoxia of chemoreceptor cells by intravenous injection of potassium cyanide (KCN) produces short-lasting flight behaviors reminiscent of panic attacks. KCN-induced flight behaviors are blocked both by denervation of chemoreceptor cells and lesion of dorsal periaqueductal gray matter, a likely substrate of panic. Herein, we show that KCN-evoked flight behaviors are also attenuated by both acute and chronic treatment with clonazepam (0.01-0.3 mg/kg, intraperitoneally (i.p.)) and fluoxetine (1-4 mg/kg/day, i.p. for 21 days), respectively. Attenuation of KCN-evoked panic-like behaviors by clinically-effective treatment with panicolytics adds fresh evidence to the false suffocation alarm theory of panic disorder.
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Affiliation(s)
- Fagna Giacomin Schimitel
- Department of Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, Brazil
| | | | - Sérgio Tufik
- Department of Psychobiology, Federal University of São Paulo (UFSP), São Paulo, Brazil
| | - Luiz Carlos Schenberg
- Department of Physiological Sciences, Federal University of Espírito Santo (UFES), Vitória, Brazil
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Pini S, Abelli M, Troisi A, Siracusano A, Cassano GB, Shear KM, Baldwin D. The relationships among separation anxiety disorder, adult attachment style and agoraphobia in patients with panic disorder. J Anxiety Disord 2014; 28:741-6. [PMID: 25218272 DOI: 10.1016/j.janxdis.2014.06.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2012] [Revised: 06/20/2014] [Accepted: 06/30/2014] [Indexed: 11/30/2022]
Abstract
Epidemiological studies indicate that separation anxiety disorder occurs more frequently in adults than children. It is unclear whether the presence of adult separation anxiety disorder (ASAD) is a manifestation of anxious attachment, or a form of agoraphobia, or a specific condition with clinically significant consequences. We conducted a study to examine these questions. A sample of 141 adult outpatients with panic disorder participated in the study. Participants completed standardized measures of separation anxiety, attachment style, agoraphobia, panic disorder severity and quality of life. Patients with ASAD (49.5% of our sample) had greater panic symptom severity and more impairment in quality of life than those without separation anxiety. We found a greater rate of symptoms suggestive of anxious attachment among panic patients with ASAD compared to those without ASAD. However, the relationship between ASAD and attachment style is not strong, and adult ASAD occurs in some patients who report secure attachment style. Similarly, there is little evidence for the idea that separation anxiety disorder is a form of agoraphobia. Factor analysis shows clear differentiation of agoraphobic and separation anxiety symptoms. Our data corroborate the notion that ASAD is a distinct condition associated with impairment in quality of life and needs to be better recognized and treated in patients with panic disorder.
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Affiliation(s)
- Stefano Pini
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, via Roma 65, I-56100 Pisa, Italy.
| | - Marianna Abelli
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, via Roma 65, I-56100 Pisa, Italy
| | - Alfonso Troisi
- Department of Neurosciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Alberto Siracusano
- Department of Neurosciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Giovanni B Cassano
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, via Roma 65, I-56100 Pisa, Italy
| | - Katherine M Shear
- Columbia University, Department of Social Work, School of Social Work, Columbia University, New York, NY, USA
| | - David Baldwin
- Department of Psychiatry, University of Southampton, Faculty of Medicine, Academic Centre, College Keep, 4-12 Terminus Terrace, Southampton SO14 3DT, United Kingdom
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Serotonin in anxiety and panic: Contributions of the elevated T-maze. Neurosci Biobehav Rev 2014; 46 Pt 3:397-406. [DOI: 10.1016/j.neubiorev.2014.03.007] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 02/05/2014] [Accepted: 03/03/2014] [Indexed: 11/21/2022]
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Paul ED, Johnson PL, Shekhar A, Lowry CA. The Deakin/Graeff hypothesis: focus on serotonergic inhibition of panic. Neurosci Biobehav Rev 2014; 46 Pt 3:379-96. [PMID: 24661986 PMCID: PMC4170046 DOI: 10.1016/j.neubiorev.2014.03.010] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Revised: 02/15/2014] [Accepted: 03/01/2014] [Indexed: 12/20/2022]
Abstract
The Deakin/Graeff hypothesis proposes that different subpopulations of serotonergic neurons through topographically organized projections to forebrain and brainstem structures modulate the response to acute and chronic stressors, and that dysfunction of these neurons increases vulnerability to affective and anxiety disorders, including panic disorder. We outline evidence supporting the existence of a serotonergic system originally discussed by Deakin/Graeff that is implicated in the inhibition of panic-like behavioral and physiological responses. Evidence supporting this panic inhibition system comes from the following observations: (1) serotonergic neurons located in the 'ventrolateral dorsal raphe nucleus' (DRVL) as well as the ventrolateral periaqueductal gray (VLPAG) inhibit dorsal periaqueductal gray-elicited panic-like responses; (2) chronic, but not acute, antidepressant treatment potentiates serotonin's panicolytic effect; (3) contextual fear activates a central nucleus of the amygdala-DRVL/VLPAG circuit implicated in mediating freezing and inhibiting panic-like escape behaviors; (4) DRVL/VLPAG serotonergic neurons are central chemoreceptors and modulate the behavioral and cardiorespiratory response to panicogenic agents such as sodium lactate and CO2. Implications of the panic inhibition system are discussed.
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Affiliation(s)
- Evan D Paul
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA.
| | - Philip L Johnson
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA.
| | - Anantha Shekhar
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA.
| | - Christopher A Lowry
- Department of Integrative Physiology and Center for Neuroscience, University of Colorado Boulder, Boulder, CO 80309-0354, USA.
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Rahman MM, Kerskens CM, Chattarji S, O'Mara SM. Chronic immobilization stress occludes in vivo cortical activation in an animal model of panic induced by carbon dioxide inhalation. Front Behav Neurosci 2014; 8:311. [PMID: 25278852 PMCID: PMC4165356 DOI: 10.3389/fnbeh.2014.00311] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2014] [Accepted: 08/25/2014] [Indexed: 11/13/2022] Open
Abstract
Breathing high concentrations of carbon dioxide (CO2) can trigger panic and anxiety in humans. CO2 inhalation has been hypothesized to activate neural systems similar to those underlying fear learning, especially those involving the amygdala. Amygdala activity is also upregulated by stress. Recently, however, a separate pathway has been proposed for interoceptive panic and anxiety signals, as patients exhibited CO2-inhalation induced panic responses despite bilateral lesions of the amygdala. This paradoxical observation has raised the possibility that cortical circuits may underlie these responses. We sought to examine these divergent models by comparing in vivo brain activation in unstressed and chronically-stressed rats breathing CO2. Regional cerebral blood flow measurements using functional Magnetic Resonance Imaging (fMRI) in lightly-anaesthetized rats showed especially strong activation of the somatosensory cortex by CO2 inhalation in the unstressed group. Strikingly, prior exposure to chronic stress occluded this effect on cortical activity. This lends support to recent clinical observations and highlights the importance of looking beyond the traditional focus on limbic structures, such as the hippocampus and amygdala, to investigate a role for cortical areas in panic and anxiety in humans.
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Affiliation(s)
| | - Christian M Kerskens
- Trinity College Institute of Neuroscience, Trinity College Dublin Dublin, Ireland
| | - Sumantra Chattarji
- National Center for Biological Sciences, Tata Institute of Fundamental Research Bangalore, India
| | - Shane M O'Mara
- Trinity College Institute of Neuroscience, Trinity College Dublin Dublin, Ireland
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Narcissistic disorder and the failure of symbolisation: A Relational Affective Hypothesis. Med Hypotheses 2014; 83:254-62. [DOI: 10.1016/j.mehy.2014.05.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Revised: 05/11/2014] [Accepted: 05/15/2014] [Indexed: 11/20/2022]
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Preter M, Klein DF. Lifelong opioidergic vulnerability through early life separation: a recent extension of the false suffocation alarm theory of panic disorder. Neurosci Biobehav Rev 2014; 46 Pt 3:345-51. [PMID: 24726574 DOI: 10.1016/j.neubiorev.2014.03.025] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2013] [Revised: 03/03/2014] [Accepted: 03/14/2014] [Indexed: 12/11/2022]
Abstract
The present paper is the edited version of our presentations at the "First World Symposium On Translational Models Of Panic Disorder", in Vitoria, E.S., Brazil, on November 16-18, 2012. We also review relevant work that appeared after the conference. Suffocation-False Alarm Theory (Klein, 1993) postulates the existence of an evolved physiologic suffocation alarm system that monitors information about potential suffocation. Panic attacks maladaptively occur when the alarm is erroneously triggered. The expanded Suffocation-False Alarm Theory (Preter and Klein, 2008) hypothesizes that endogenous opioidergic dysregulation may underlie the respiratory pathophysiology and suffocation sensitivity in panic disorder. Opioidergic dysregulation increases sensitivity to CO2, separation distress and panic attacks. That sudden loss, bereavement and childhood separation anxiety are also antecedents of "spontaneous" panic requires an integrative explanation. Our work unveiling the lifelong endogenous opioid system impairing effects of childhood parental loss (CPL) and parental separation in non-ill, normal adults opens a new experimental, investigatory area.
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Affiliation(s)
- Maurice Preter
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
| | - Donald F Klein
- Phyllis Green and Randolph Cowen Institute for Pediatric Neuroscience, Department of Child and Adolescent Psychiatry, New York University Langone Medical Center, 550 1st Ave, New York, NY 10016, USA.
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Canteras NS, Graeff FG. Executive and modulatory neural circuits of defensive reactions: implications for panic disorder. Neurosci Biobehav Rev 2014; 46 Pt 3:352-64. [PMID: 24709069 DOI: 10.1016/j.neubiorev.2014.03.020] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 02/08/2014] [Accepted: 03/27/2014] [Indexed: 01/20/2023]
Abstract
The present review covers two independent approaches, a neuroanatomical and a pharmacological (focused on serotonergic transmission), which converge in highlighting the critical role of the hypothalamus and midbrain periaqueductal gray matter in the generation of panic attacks and in the mechanism of action of current antipanic medication. Accordingly, innate and learned fear responses to different threats (i.e., predator, aggressive members of the same species, interoceptive threats and painful stimuli) are processed by independent circuits involving corticolimbic regions (the amygdala, the hippocampus and the prefrontal and insular cortices) and downstream hypothalamic and brainstem circuits. As for the drug treatment, animal models of panic indicate that the drugs currently used for treating panic disorder should work by enhancing 5-HT inhibition of neural systems that command proximal defense in both the dorsal periaqueductal gray and in the medial hypothalamus. For the anticipatory anxiety, the reviewed evidence points to corticolimbic structures, such as the amygdala, the septo-hippocampus and the prefrontal cortex, as its main neural substrate, modulated by stimulation of 5-HT2C and 5-HT1A receptors.
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Affiliation(s)
- Newton S Canteras
- Departamento de Anatomia, Instituto de Ciências Biomédicas, Universidade de São Paulo, 05508-000 São Paulo, Brazil; Núcleo de Apoio à Pesquisa em Neurobiologia das Emoções (NAP-NuPNE), Universidade de São Paulo, 14049-900 Ribeirão Preto, SP, Brazil.
| | - Frederico G Graeff
- Instituto de Neurociências e Comportamento (INeC), Universidade de São Paulo, 14049-900 Ribeirão Preto, SP, Brazil; Núcleo de Apoio à Pesquisa em Neurobiologia das Emoções (NAP-NuPNE), Universidade de São Paulo, 14049-900 Ribeirão Preto, SP, Brazil
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Quintino-dos-Santos JW, Müller CJT, Bernabé CS, Rosa CA, Tufik S, Schenberg LC. Evidence that the periaqueductal gray matter mediates the facilitation of panic-like reactions in neonatally-isolated adult rats. PLoS One 2014; 9:e90726. [PMID: 24594924 PMCID: PMC3980704 DOI: 10.1371/journal.pone.0090726] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 02/03/2014] [Indexed: 01/22/2023] Open
Abstract
Plenty of evidence suggests that childhood separation anxiety (CSA) predisposes the subject to adult-onset panic disorder (PD). As well, panic is frequently comorbid with both anxiety and depression. The brain mechanisms whereby CSA predisposes to PD are but completely unknown in spite of the increasing evidence that panic attacks are mediated at midbrain's dorsal periaqueductal gray matter (DPAG). Accordingly, here we examined whether the neonatal social isolation (NSI), a model of CSA, facilitates panic-like behaviors produced by electrical stimulations of DPAG of rats as adults. Eventual changes in anxiety and depression were also assessed in the elevated plus-maze (EPM) and forced-swimming test (FST) respectively. Male pups were subjected to 3-h daily isolations from post-natal day 2 (PN2) until weaning (PN21) allotting half of litters in individual boxes inside a sound-attenuated chamber (NSI, n = 26) whilst siblings (sham-isolated rats, SHAM, n = 27) and dam were moved to another box in a separate room. Non-handled controls (CTRL, n = 18) remained undisturbed with dams until weaning. As adults, rats were implanted with electrodes into the DPAG (PN60) and subjected to sessions of intracranial stimulation (PN65), EPM (PN66) and FST (PN67-PN68). Groups were compared by Fisher's exact test (stimulation sites), likelihood ratio chi-square tests (stimulus-response threshold curves) and Bonferroni's post hoc t-tests (EPM and FST), for P<0.05. Notably, DPAG-evoked panic-like responses of immobility, exophthalmus, trotting, galloping and jumping were markedly facilitated in NSI rats relative to both SHAM and CTRL groups. Conversely, anxiety and depression scores either did not change or were even reduced in neonatally-handled groups relative to CTRL, respectively. Data are the first behavioral evidence in animals that early-life separation stress produces the selective facilitation of panic-like behaviors in adulthood. Most importantly, results implicate the DPAG not only in panic attacks but also in separation-anxious children's predispositions to the late development of PD.
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Affiliation(s)
- Jeyce Willig Quintino-dos-Santos
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
- Department of Sports, Federal University of Espírito Santo, Vitória, ES, Brazil
| | | | - Cristie Setúbal Bernabé
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Caroline Azevedo Rosa
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
| | - Sérgio Tufik
- Department of Psychobiology, Federal University of São Paulo, São Paulo, SP, Brazil
| | - Luiz Carlos Schenberg
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, ES, Brazil
- * E-mail:
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Ramirez JM. The integrative role of the sigh in psychology, physiology, pathology, and neurobiology. PROGRESS IN BRAIN RESEARCH 2014; 209:91-129. [PMID: 24746045 DOI: 10.1016/b978-0-444-63274-6.00006-0] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
"Sighs, tears, grief, distress" expresses Johann Sebastian Bach in a musical example for the relationship between sighs and deep emotions. This review explores the neurobiological basis of the sigh and its relationship with psychology, physiology, and pathology. Sighs monitor changes in brain states, induce arousal, and reset breathing variability. These behavioral roles homeostatically regulate breathing stability under physiological and pathological conditions. Sighs evoked in hypoxia evoke arousal and thereby become critical for survival. Hypoarousal and failure to sigh have been associated with sudden infant death syndrome. Increased breathing irregularity may provoke excessive sighing and hyperarousal, a behavioral sequence that may play a role in panic disorders. Essential for generating sighs and breathing is the pre-Bötzinger complex. Modulatory and synaptic interactions within this local network and between networks located in the brainstem, cerebellum, cortex, hypothalamus, amygdala, and the periaqueductal gray may govern the relationships between physiology, psychology, and pathology. Unraveling these circuits will lead to a better understanding of how we balance emotions and how emotions become pathological.
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Affiliation(s)
- Jan-Marino Ramirez
- Center for Integrative Brain Research, Seattle Children's Research Institute, Seattle, WA, USA; Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
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Roncon CM, Biesdorf C, Coimbra NC, Audi EA, Zangrossi H, Graeff FG. Cooperative regulation of anxiety and panic-related defensive behaviors in the rat periaqueductal grey matter by 5-HT1A and μ-receptors. J Psychopharmacol 2013; 27:1141-8. [PMID: 23598399 DOI: 10.1177/0269881113485144] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Previous results with the elevated T-maze (ETM) test indicate that the antipanic action of serotonin (5-HT) in the dorsal periaqueductal grey (dPAG) depends on the activation endogenous opioid peptides. The aim of the present work was to investigate the interaction between opioid- and serotonin-mediated neurotransmission in the modulation of defensive responses in rats submitted to the ETM. The obtained results showed that intra-dPAG administration of morphine significantly increased escape latency, a panicolytic-like effect that was blocked by pre-treatment with intra-dPAG injection of either naloxone or the 5-HT1A antagonist N-[2-[4-(2-methoxyphenyl)-1 piperazinyl] ethyl] -N- 2- pyridinyl-ciclohexanecarboxamide maleate (WAY-100635). In addition, previous administration of naloxone antagonized both the anti-escape and the anti-avoidance (anxiolytic-like) effect of the 5-HT1A agonist (±)-8-hydroxy-2-(di-n-propylamino)tetralin hydrobromide (8-OH-DPAT), but did not affect the anti-escape effect of the 5-HT2A agonist (±)-2,5-dimethoxy-4-iodoamphetamine hydrochloride (DOI). Moreover, the combination of sub-effective doses of locally administered 5-HT and morphine significantly impaired ETM escape performance. Finally, the µ-antagonist D-PHE-CYS-TYR-D-TRP-ORN-THR-PEN (CTOP) blocked the anti-avoidance as well as the anti-escape effect of 8-OHDPAT, and the association of sub-effective doses of the µ-opioid receptor agonist [D-Ala(2), N-Me-Phe(4), Gly(5)-ol]-enkephalin acetate salt (DAMGO) and of 8-OHDPAT had anti-escape and anti-avoidance effects in the ETM. These results suggest a synergic interaction between the 5-HT1A and the µ-opioid receptor at post-synaptic level on neurons of the dPAG that regulate proximal defense, theoretically related to panic attacks.
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Affiliation(s)
- Camila M Roncon
- 1Department of Pharmacology and Therapeutics, State University of Maringá, Brazil
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Carbon dioxide inhalation as a human experimental model of panic: The relationship between emotions and cardiovascular physiology. Biol Psychol 2013; 94:331-40. [DOI: 10.1016/j.biopsycho.2013.06.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Revised: 05/28/2013] [Accepted: 06/19/2013] [Indexed: 11/23/2022]
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50
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Moylan S, Gustavson K, Karevold E, Øverland S, Jacka FN, Pasco JA, Berk M. The impact of smoking in adolescence on early adult anxiety symptoms and the relationship between infant vulnerability factors for anxiety and early adult anxiety symptoms: the TOPP Study. PLoS One 2013; 8:e63252. [PMID: 23696803 PMCID: PMC3655993 DOI: 10.1371/journal.pone.0063252] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2012] [Accepted: 03/30/2013] [Indexed: 11/18/2022] Open
Abstract
Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18 months to age 18-19 years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety. Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (β = 0.17, p<0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: β = 0.85, p<0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: β = 0.55, p<0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and significant health burden imposed by anxiety disorders, this study supports the importance of smoking prevention and cessation programs targeting children and adolescence.
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Affiliation(s)
- Steven Moylan
- School of Medicine, Deakin University, Geelong, Victoria, Australia.
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