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Liu H, Hao Z, Qiu S, Wang Q, Zhan L, Huang L, Shao Y, Wang Q, Su C, Cao Y, Sun J, Wang C, Lv Y, Li M, Shen W, Li H, Jia X. Grey matter structural alterations in anxiety disorders: a voxel-based meta-analysis. Brain Imaging Behav 2023:10.1007/s11682-023-00842-x. [PMID: 38150133 DOI: 10.1007/s11682-023-00842-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2023] [Indexed: 12/28/2023]
Abstract
Anxiety disorders (ADs) are a group of prevalent and destructive mental illnesses, but the current understanding of their underlying neuropathology is still unclear. Employing voxel-based morphometry (VBM), previous studies have demonstrated several common brain regions showing grey matter volume (GMV) abnormalities. However, contradictory results have been reported among these studies. Considering that different subtypes of ADs exhibit common core symptoms despite different diagnostic criteria, and previous meta-analyses have found common core GMV-altered brain regions in ADs, the present research aimed to combine the results of individual studies to identify common GMV abnormalities in ADs. Therefore, we first performed a systematic search in PubMed, Embase, and Web of Science on studies investigating GMV differences between patients with ADs and healthy controls (HCs). Then, the anisotropic effect-size signed differential mapping (AES-SDM) was applied in this meta-analysis. A total of 24 studies (including 25 data sets) were included in the current study, and 906 patients with ADs and 1003 HCs were included. Compared with the HCs, the patients with ADs showed increased GMV in the left superior parietal gyrus, right angular gyrus, left precentral gyrus, and right lingual gyrus, and decreased GMV in the bilateral insula, bilateral thalamus, left caudate, and right putamen. In conclusion, the current study has identified some abnormal GMV brain regions that are related to the pathological mechanisms of anxiety disorders. These findings could contribute to a better understanding of the underlying neuropathology of ADs.
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Affiliation(s)
- Han Liu
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Zeqi Hao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Shasha Qiu
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Qianqian Wang
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Linlin Zhan
- School of Western Languages, Heilongjiang University, Heilongjiang, China
| | - Lina Huang
- Department of Radiology, Changshu No.2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Youbin Shao
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Qing Wang
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China
| | - Chang Su
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Yikang Cao
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Jiawei Sun
- School of Information and Electronics Technology, Jiamusi University, Jiamusi, China
| | - Chunjie Wang
- Institute of Brain Science, Department of Psychology, School of Education, Hangzhou Normal University, Hangzhou, China
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Yating Lv
- Center for Cognition and Brain Disorders, the Affiliated Hospital, Hangzhou Normal University, Hangzhou, China
| | - Mengting Li
- School of Psychology, Zhejiang Normal University, Jinhua, China
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China
| | - Wenbin Shen
- Department of Radiology, Changshu No.2 People's Hospital, The Affiliated Changshu Hospital of Xuzhou Medical University, Changshu, Jiangsu, China
| | - Huayun Li
- School of Psychology, Zhejiang Normal University, Jinhua, China.
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China.
| | - Xize Jia
- School of Psychology, Zhejiang Normal University, Jinhua, China.
- Intelligent Laboratory of Zhejiang Province in Mental Health and Crisis Intervention for Children and Adolescents, Zhejiang Normal University, Jinhua, China.
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Liu X, Klugah-Brown B, Zhang R, Chen H, Zhang J, Becker B. Pathological fear, anxiety and negative affect exhibit distinct neurostructural signatures: evidence from psychiatric neuroimaging meta-analysis. Transl Psychiatry 2022; 12:405. [PMID: 36151073 PMCID: PMC9508096 DOI: 10.1038/s41398-022-02157-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/04/2022] [Accepted: 09/06/2022] [Indexed: 11/24/2022] Open
Abstract
Internalizing disorders encompass anxiety, fear and depressive disorders, which exhibit overlap at both conceptual and symptom levels. Given that a neurobiological evaluation is lacking, we conducted a Seed-based D-Mapping comparative meta-analysis including coordinates as well as original statistical maps to determine common and disorder-specific gray matter volume alterations in generalized anxiety disorder (GAD), fear-related anxiety disorders (FAD, i.e., social anxiety disorder, specific phobias, panic disorder) and major depressive disorder (MDD). Results showed that GAD exhibited disorder-specific altered volumes relative to FAD including decreased volumes in left insula and lateral/medial prefrontal cortex as well as increased right putamen volume. Both GAD and MDD showed decreased prefrontal volumes compared to controls and FAD. While FAD showed less robust alterations in lingual gyrus compared to controls, this group presented intact frontal integrity. No shared structural abnormalities were found. Our study is the first to provide meta-analytic evidence for distinct neuroanatomical abnormalities underlying the pathophysiology of anxiety-, fear-related and depressive disorders. These findings may have implications for determining promising target regions for disorder-specific neuromodulation interventions (e.g. transcranial magnetic stimulation or neurofeedback).
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Affiliation(s)
- Xiqin Liu
- grid.54549.390000 0004 0369 4060The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, P. R. China
| | - Benjamin Klugah-Brown
- grid.54549.390000 0004 0369 4060The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, P. R. China
| | - Ran Zhang
- grid.54549.390000 0004 0369 4060The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, P. R. China
| | - Huafu Chen
- grid.54549.390000 0004 0369 4060The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People’s Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731 Chengdu, P. R. China
| | - Jie Zhang
- grid.8547.e0000 0001 0125 2443Institute of Science and Technology for Brain Inspired Intelligence, Fudan University, 200433 Shanghai, P. R. China ,grid.8547.e0000 0001 0125 2443Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence, Fudan University, Ministry of Education, 200433 Shanghai, P. R. China
| | - Benjamin Becker
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, 611731, Chengdu, P. R. China.
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Wu Y, Zhong Y, Zheng G, Liu Y, Pang M, Xu H, Ding H, Wang C, Zhang N. Disrupted fronto-temporal function in panic disorder: a resting-state connectome study. Brain Imaging Behav 2021; 16:888-898. [PMID: 34668168 DOI: 10.1007/s11682-021-00563-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 12/21/2022]
Abstract
Recent neuroimaging studies have identified alterations in activity and connectivity among many brain regions as potential biomarkers for panic disorder. However, the functional connectome of panic disorder is not well understood. Therefore, a graph-theoretical approach was applied in this study to construct functional networks of patients and healthy controls in order to discover topological changes in panic disorder. 31 patients and 33 age and sex matched healthy controls underwent resting-state functional magnetic resonance imaging. Brain networks for each participant were structured using nodes from the Anatomical Automatic Labeling template and edges from connectivity matrices. Then, topological organizations of networks were calculated. Network-based statistical analysis was conducted, and global and nodal properties were compared between patients and controls. Unlike controls, patients with panic disorder displayed a small-world network. Patients also revealed decreased nodal efficiency in right superior frontal gyrus (SFG), middle frontal gyrus (MFG), right superior temporal gyrus (STG), and left middle temporal gyrus (MTG). Decreased functional connectivity was found in panic disorder between right MTG and extensive temporal regions. Among these disrupted regions, the decreased nodal efficiency of SFG showed a positive correlation with clinical symptoms while nodal betweenness centrality in angular gyrus showed a negative correlation. Our results indicated decreased function of global and regional information transmission in panic disorder and emphasized the role of temporal regions in its pathology.
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Affiliation(s)
- Yun Wu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, No.264 Guangzhou Road, Gulou District, Nanjing, 210029, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.,Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, Nanjing, 210097, PR China
| | - Gang Zheng
- Department of Medical Imaging, Medical School of Nanjing University, Nanjing, Jiangsu, China.,College of Civil Aviation, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Ya Liu
- Department of Medical Imaging, Medical School of Nanjing University, Nanjing, Jiangsu, China.,College of Civil Aviation, Nanjing University of Aeronautics and Astronautics, Nanjing, Jiangsu, China
| | - Manlong Pang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, No.264 Guangzhou Road, Gulou District, Nanjing, 210029, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Huazhen Xu
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, No.264 Guangzhou Road, Gulou District, Nanjing, 210029, China.,Nanjing Medical University, Nanjing, Jiangsu, China
| | - Huachen Ding
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, No.264 Guangzhou Road, Gulou District, Nanjing, 210029, China.,Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, No.264 Guangzhou Road, Gulou District, Nanjing, 210029, China. .,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China. .,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China.
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, No.264 Guangzhou Road, Gulou District, Nanjing, 210029, China.,Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China.,Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
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Kim HJ, Kim JE, Lee SH. Pathological Worry is Related to Poor Long-Term Pharmacological Treatment Response in Patients With Panic Disorder. Psychiatry Investig 2021; 18:904-912. [PMID: 34500504 PMCID: PMC8473858 DOI: 10.30773/pi.2021.0227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 07/19/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Several predictors of unfavorable pharmacological treatment response (PTR) in panic disorder (PD) patients have been suggested, such as the duration of the illness, presence of agoraphobia, depression, being a woman, and early trauma. This study aimed to examine whether pathological worry is associated with PTR in PD patients. METHODS This study included 335 PD patients and 418 healthy controls (HCs). The Penn State Worry Questionnaire (PSWQ), the Early Trauma Inventory Self Report-Short Form (ETISR-SF), Beck Depression Inventory (BDI), Panic Disorder Severity Scale (PDSS), and Anxiety Sensitivity Inventory-Revised (ASI-R) were administered. We measured the PTR at 8 weeks and 6 months. Student t-test, chisquare tests, Pearson's correlation analyses, and binary logistic regression model were used. RESULTS Our results showed that the total scores of the PSWQ correlated with the ETISR-SF, BDI, and ASI-R were significantly higher in patients with PD compared with HCs. The PSWQ and BDI could predict unfavorable PTR at 6 months in PD patients. CONCLUSION This is the first study to demonstrate that pathological worry may contribute to poor long-term PTR in PD patients. Therefore, our research suggests that clinicians must be aware of worry to optimize PTR for PD patients.
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Affiliation(s)
- Hyun-Ju Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Ji Eun Kim
- Graduate School of Social Welfare, Yonsei University, Seoul, Republic of Korea
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.,Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
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Abstract
The hippocampus is thought to play an important role in conveying contextual information to the amygdala as the neural basis of panic disorder (PD). Previous studies have revealed functional abnormalities in the hippocampus in patients with PD compared with healthy control subjects (HC), but no study has reported volume abnormalities in the hippocampus or evaluated minute structural changes in the hippocampus in such patients. We thus investigated volume abnormalities in the subfields of the hippocampus to better understand the neurobiological basis of PD. The hippocampus was extracted from structural brain magnetic resonance images obtained from 38 patients with PD and 38 HC and then segmented into six subfields. The relative volume of each subfield was compared between the two groups. The severity of symptoms was assessed using the Panic Disorder Severity Scale (PDSS) and social functioning was assessed using the Global Assessment of Functioning (GAF) scale. Our results revealed that patients with PD had a significantly smaller volume of the right cornu ammonis (CA) 2/3 hippocampal subfield compared with HC. No significant associations were found between the volumes of the right CA 2/3 and the PDSS or GAF scores in correlation analyses. In conclusion, CA2/3 is thought to be related to contextual memory function, and our results suggest that this particular hippocampal subfield plays a role in the development of PD symptoms.
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Affiliation(s)
- Masao Takaishi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Takeshi Asami
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan.
| | - Haruhisa Yoshida
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Ryota Nakamura
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
| | - Yoshio Hirayasu
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, Japan
- Heian Hospital, Okinawa, Japan
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Song CR, Kang NO, Bang M, Park CI, Choi TK, Lee SH. Initial white matter connectivity differences between remitters and non-remitters of patients with panic disorder after 6 months of pharmacotherapy. Neurosci Lett 2021; 751:135826. [PMID: 33727131 DOI: 10.1016/j.neulet.2021.135826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 03/05/2021] [Accepted: 03/09/2021] [Indexed: 12/28/2022]
Abstract
Panic disorder (PD) is a harmful mental condition that causes relapsed and persistent impairment. In the treatment of PD, the prognosis for PD should be considered. However, the relationship between pharmacotherapy and biomarkers, for predicting a better response through neuroimaging, is a little known. The purpose of the present study was to examine whether there would be the initial white matter (WM) regions associated with the remission in 6 months. A total of 104 patients with PD were investigated in the study. After six months, there were 17 remission patients with PD and 81 non-remission patients. The Panic Disorder Severity Scale, Albany Panic and Phobia Questionnaire, Anxiety Sensitivity Inventory-Revised, Beck Anxiety Inventory, and Beck Depression Inventory were assessed for all patients at baseline. We compared the diffusion indices between remission and non-remission group at 6 months using Tract-Based Spatial Statistics. The results showed that the fractional anisotropy (FA) values were significantly higher in the non-remitter group compared with those in the remitter group in the WM regions, such as the posterior corona radiata and superior longitudinal fasciculus, at the 6 month evaluation. The logistic regression analysis with clinical symptom severity and FA values of the WM regions as covariates showed that FA values in those regions and the Beck Depression Inventory-II predicted poor remission. This study suggests that posterior corona radiata and superior longitudinal fasciculus are related to potential predictive factors of 6-month remission in patients with PD. WM regions associated with the long-term remission should be verified with further investigations.
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Affiliation(s)
- Chae Rim Song
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Clinical Counseling Psychology Graduate School, CHA University, Seongnam, Republic of Korea
| | - Na-Ok Kang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Minji Bang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Chun Il Park
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - Tae-Kiu Choi
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
| | - Sang-Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea; Department of Clinical Pharmacology and Therapeutics, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea.
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Wang X, Cheng B, Wang S, Lu F, Luo Y, Long X, Kong D. Distinct grey matter volume alterations in adult patients with panic disorder and social anxiety disorder: A systematic review and voxel-based morphometry meta-analysis. J Affect Disord 2021; 281:805-823. [PMID: 33243552 DOI: 10.1016/j.jad.2020.11.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/18/2020] [Accepted: 11/08/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND The paradox of similar diagnostic criteria but potentially different neuropathologies in panic disorder (PD) and social anxiety disorder (SAD) needs to be clarified. METHODS We performed a qualitative systematic review and a quantitative whole-brain voxel-based morphometry (VBM) meta-analysis with an anisotropic effect-size version of seed-based D mapping (AES-SDM) to explore whether the alterations of grey matter volume (GMV) in PD are similar to or different from those in SAD, together with potential confounding factors. RESULTS A total of thirty-one studies were eligible for inclusion, eighteen of which were included in the meta-analysis. Compared to the respective healthy controls (HC), qualitative and quantitative analyses revealed smaller cortical-subcortical GMVs in PD patients in brain areas including the prefrontal and temporal-parietal cortices, striatum, thalamus and brainstem, predominantly right-lateralized regions, and larger GMVs in the prefrontal and temporal-parietal-occipital cortices, and smaller striatum and thalamus in SAD patients. Quantitatively, the right inferior frontal gyrus (IFG) deficit was specifically implicated in PD patients, whereas left striatum-thalamus deficits were specific to SAD patients, without shared GMV alterations in both disorders. Sex, the severity of clinical symptoms, psychiatric comorbidity, and concomitant medication use were negatively correlated with smaller regional GMV alterations in PD patients. CONCLUSION PD and SAD may represent different anxiety sub-entities at the neuroanatomical phenotypes level, with different specific neurostructural deficits in the right IFG of PD patients, and the left striatum and thalamus of SAD patients. This combination of differences and specificities can potentially be used to guide the development of diagnostic biomarkers for these disorders.
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Affiliation(s)
- Xiuli Wang
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu 610036, China.
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital of Sichuan University, Chengdu 610041, China
| | - Song Wang
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Fengmei Lu
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu 610036, China
| | - Ya Luo
- Mental Health Center, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Di Kong
- Department of Psychiatry, the Fourth People's Hospital of Chengdu, Chengdu 610036, China
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Abstract
Background:
Panic disorder (PD) is a kind of anxiety disorder that impacts the life quality
and functional perspectives in patients. However, the pathophysiological study of PD seems still
inadequate and many unresolved issues need to be clarified.
Objectives:
In this review article of biomarkers in PD, the investigator will focus on the findings of
magnetic resonance imaging (MRI) of the brain in the pathophysiology study. The MRI biomarkers
would be divided into several categories, on the basis of structural and functional perspectives.
Methods:
The structural category would include the gray matter and white matter tract studies. The
functional category would consist of functional MRI (fMRI), resting-state fMRI (Rs-fMRI), and
magnetic resonance spectroscopy (MRS). The PD biomarkers revealed by the above methodologies
would be discussed in this article.
Results:
For the gray matter perspectives, the PD patients would have alterations in the volumes of
fear network structures, such as the amygdala, parahippocampal gyrus, thalamus, anterior cingulate
cortex, insula, and frontal regions. For the white matter tract studies, the PD patients seemed to have
alterations in the fasciculus linking the fear network regions, such as the anterior thalamic radiation,
uncinate fasciculus, fronto-occipital fasciculus, and superior longitudinal fasciculus. For the fMRI
studies in PD, the significant results also focused on the fear network regions, such as the amygdala,
hippocampus, thalamus, insula, and frontal regions. For the Rs-fMRI studies, PD patients seemed to
have alterations in the regions of the default mode network and fear network model. At last, the
MRS results showed alterations in neuron metabolites of the hippocampus, amygdala, occipital
cortex, and frontal regions.
Conclusion:
The MRI biomarkers in PD might be compatible with the extended fear network model
hypothesis in PD, which included the amygdala, hippocampus, thalamus, insula, frontal regions, and
sensory-related cortex.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan
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Won E, Kim YK. Neuroinflammation-Associated Alterations of the Brain as Potential Neural Biomarkers in Anxiety Disorders. Int J Mol Sci 2020; 21:ijms21186546. [PMID: 32906843 PMCID: PMC7555994 DOI: 10.3390/ijms21186546] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 08/30/2020] [Accepted: 09/02/2020] [Indexed: 02/06/2023] Open
Abstract
Stress-induced changes in the immune system, which lead to neuroinflammation and consequent brain alterations, have been suggested as possible neurobiological substrates of anxiety disorders, with previous literature predominantly focusing on panic disorder, agoraphobia, and generalized anxiety disorder, among the anxiety disorders. Anxiety disorders have frequently been associated with chronic stress, with chronically stressful situations being reported to precipitate the onset of anxiety disorders. Also, chronic stress has been reported to lead to hypothalamic–pituitary–adrenal axis and autonomic nervous system disruption, which may in turn induce systemic proinflammatory conditions. Preliminary evidence suggests anxiety disorders are also associated with increased inflammation. Systemic inflammation can access the brain, and enhance pro-inflammatory cytokine levels that have been shown to precipitate direct and indirect neurotoxic effects. Prefrontal and limbic structures are widely reported to be influenced by neuroinflammatory conditions. In concordance with these findings, various imaging studies on panic disorder, agoraphobia, and generalized anxiety disorder have reported alterations in structure, function, and connectivity of prefrontal and limbic structures. Further research is needed on the use of inflammatory markers and brain imaging in the early diagnosis of anxiety disorders, along with the possible efficacy of anti-inflammatory interventions on the prevention and treatment of anxiety disorders.
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Affiliation(s)
- Eunsoo Won
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam 13496, Korea;
| | - Yong-Ku Kim
- Department of Psychiatry, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Korea
- Correspondence: ; Tel.: +82-31-412-5140; Fax: +82-31-412-5144
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Kirk-Provencher KT, Nelson-Aguiar RJ, Spillane NS. Neuroanatomical Differences Among Sexual Offenders: A Targeted Review with Limitations and Implications for Future Directions. Violence Gend 2020; 7:86-97. [PMID: 32939353 PMCID: PMC7488205 DOI: 10.1089/vio.2019.0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
As sexual assault and child sexual abuse continue to be worldwide public health concerns, research has continued to explore factors associated with sexual offending. Structural and functional neuroanatomical brain differences have been examined in an effort to differentiate sexual offenders and their behavior. This targeted review searched PubMed and Google Scholar for empirical studies using brain imaging techniques to examine possible structural or functional differences among control groups compared with at least one group of sexual offenders with contact offenses. This targeted review summarizes the structural and functional findings of 15 brain imaging studies (i.e., computed tomography, diffusion tensor imaging, magnetic resonance imaging, positron emission tomography, and functional magnetic resonance imaging), which suggest possible differences in brain size and gray matter volume, cortical thickness, white matter connectivity, and specific structural and functional differences among brain regions (fronto-temporal region, amygdala, prefrontal cortex, etc.). The methodological limitations of brain imaging studies and the associated findings with regard to sexual offenders are highlighted, as research indicates that many of the proposed differences in brain structure and function are not unique to this population. We further highlight several limitations to using neuroimaging studies to examine this population of interest, including publication bias, small sample size, underpowered studies, and all-male samples. As these results are mixed and findings are not seemingly unique to sexual offenders, we suggest future sexual offender research may benefit from focusing on more financially feasible options, such as neuropsychological assessment approaches, to assess for and attend to offenders' criminogenic and rehabilitative/therapeutic needs in alignment with the risk-need-responsivity model.
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Affiliation(s)
| | | | - Nichea S. Spillane
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
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11
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Laird KT, Siddarth P, Krause B, Kilpatrick L, Milillo M, Aguilar Y, Narr KL, Lavretsky H. Anxiety symptoms are associated with smaller insular and orbitofrontal cortex volumes in late-life depression. J Affect Disord 2019; 256:282-287. [PMID: 31200165 PMCID: PMC6750975 DOI: 10.1016/j.jad.2019.05.066] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 04/19/2019] [Accepted: 05/27/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Increasing understanding of the neural correlates of anxiety symptoms in late-life depression (LLD) could inform the development of more targeted and effective treatments. METHODS Grey matter volume (GMV) was assessed with volumetric magnetic resonance imaging in a sample of 113 adults ≥60 years with MDD using the following regions of interest: amygdala, anterior cingulate cortex (ACC), insula, orbitofrontal cortex (OFC), and temporal cortex. RESULTS After controlling for demographic (age, sex, education) and clinical variables (antidepressant use, anxiolytic use, duration of illness, medical comorbidity, cognitive functioning), greater severity of anxiety symptoms was associated with lower GMV bilaterally in the insula, F(1,102) = 6.63, p = 0.01, and OFC, F(1,102) = 8.35, p = 0.005. By contrast, depressive symptom severity was significantly associated with lower bilateral insula volumes, F(1,102) = 6.43, p = 0.01, but not OFC volumes, F(1,102) = 5.37, p = 0.02. LIMITATIONS Limitations include (1) the relatively mild nature of anxiety symptoms in our sample; (2) the cross-sectional research design, which prohibits inferences of directionality; (3) the relatively homogenous demographic of the sample, and (4) the exclusion of participants with significant psychiatric comorbidity, suicidality, or cognitive impairment. CONCLUSIONS Decreased OFC volumes may serve as a unique biomarker of anxiety symptoms in LLD. Future longitudinal and clinical studies with long-term follow up and more diverse samples will help further elucidate the biological, psychological, and social factors affecting associations between anxiety and brain morphology in LLD.
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Affiliation(s)
| | | | | | | | | | | | | | - Helen Lavretsky
- Department of Psychology and Human Development, University of California, Los Angeles (UCLA), 760 Westwood Plaza, Los Angeles, CA 90095, United States.
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12
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Cheng CH, Chan PYS, Hsu SC, Liu CY. Abnormal frontal generator during auditory sensory gating in panic disorder: An MEG study. Psychiatry Res Neuroimaging 2019; 288:60-66. [PMID: 31014913 DOI: 10.1016/j.pscychresns.2019.04.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/17/2019] [Accepted: 04/17/2019] [Indexed: 01/08/2023]
Abstract
Patients with panic disorder (PD) exhibit abnormalities in early-stage information processing, even for the nonthreatening stimuli. A previous event-related potential study reported that PD patients show a deficit in sensory gating (SG), a protective mechanism of the brain to filter out irrelevant sensory inputs. However, there is no clear understanding about the neural correlates of SG deficits in PD. Moreover, whether SG deficits, if any, are associated with clinical manifestations remain unknown. In this study, 18 patients with PD and 20 age- and gender-matched healthy controls were recruited to perform auditory paired-stimulus paradigm using magnetoencephalographic (MEG) recordings. Results showed that PD patients demonstrated significantly higher M50 SG ratios in the right inferior frontal gyrus (RIFG) and higher M100 SG ratios in both RIFG and right superior temporal gyrus (RSTG) than those of the control group. It was important to note that in the RIFG, the M50 SG ratios correlated significantly with the scores of Body Sensation Questionnaire (BSQ) and Distractibility scale of Sensory Gating Inventory among patients with PD. In conclusion, this study suggests that PD patients exhibited a deficient ability to filter out irrelevant information, and such a defect might lead to cognitive misinterpretation of somatic sensations and distractibility.
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Affiliation(s)
- Chia-Hsiung Cheng
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; Laboratory of Brain Imaging and Neural Dynamics (BIND Lab), Chang Gung University, Taoyuan, Taiwan.
| | - Pei-Ying S Chan
- Department of Occupational Therapy and Graduate Institute of Behavioral Sciences, Chang Gung University, Taoyuan, Taiwan; Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan; Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Shih-Chieh Hsu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Yih Liu
- Department of Psychiatry, Chang Gung Memorial Hospital, Linkou, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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13
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Sparaco M, Lavorgna L, Bonavita S. Psychiatric disorders in multiple sclerosis. J Neurol 2021; 268:45-60. [PMID: 31197511 DOI: 10.1007/s00415-019-09426-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 06/06/2019] [Accepted: 06/07/2019] [Indexed: 01/04/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) is characterized by a large spectrum of symptoms, involving all functional systems. Psychiatric symptoms are common in people with MS (pwMS) having an important impact on quality of life and on some features of MS (fatigue, sleep, disability, adherence to disease-modifying drugs). The main psychiatric disturbances in MS are depressive, bipolar, anxiety, schizophrenic and obsessive-compulsive syndromes. METHODS Literature search for original articles and review in the databases, including PubMed and Scopus from 1959 to 2019. RESULTS AND CONCLUSION Studies answering the aim of this review were selected and reported. Epidemiological and clinical aspects of psychiatric syndromes (PS) in MS as well as self-report diagnostic scales and radiological correlates of PS in MS are described. Moreover, some radiological studies about primary psychiatric disorders (PD) are reported to underline how gray matter atrophy, white matter abnormalities and corpus callosum involvement in these diseases, as features in common with MS, may explain the more frequent occurrence of PD in MS than in the general population.
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14
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Lai CH. The neural markers of MRI to differentiate depression and panic disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 91:72-8. [PMID: 29705713 DOI: 10.1016/j.pnpbp.2018.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/05/2018] [Accepted: 04/23/2018] [Indexed: 12/23/2022]
Abstract
Depression and panic disorder (PD) share the common pathophysiology from the perspectives of neurotransmitters. The relatively high comorbidity between depression and PD contributes to the substantial obstacles to differentiate from depression and PD, especially for the brain pathophysiology. There are significant differences in the diagnostic criteria between depression and PD. However, the paradox of similar pathophysiology and different diagnostic criteria in these two disorders were still the issues needing to be addressed. Therefore the clarification of potential difference in the field of neuroscience and pathophysiology between depression and PD can help the clinicians and scientists to understand more comprehensively about significant differences between depression and PD. The researchers should be curious about the underlying difference of pathophysiology beneath the significant distinction of clinical symptoms. In this review article, I tried to find some evidences for the differences between depression and PD, especially for neural markers revealed by magnetic resonance imaging (MRI). The distinctions of structural and functional alterations in depression and PD are reviewed. From the structural perspectives, PD seems to have less severe gray matter alterations in frontal and temporal lobes than depression. The study of white matter microintegrity reveals more widespread alterations in fronto-limbic circuit of depression patients than PD patients, such as the uncinate fasciculus and anterior thalamic radiation. PD might have a more restrictive pattern of structural alterations when compared to depression. For the functional perspectives, the core site of depression pathophysiology is the anterior subnetwork of resting-state network, such as anterior cingulate cortex, which is not significantly altered in PD. A possibly emerging pattern of fronto-limbic distinction between depression and PD has been revealed by these explorative reports. The future trend for machine learning and pattern recognition might confirm the differentiation pattern between depression and PD based on the explorative results.
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15
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Suffren S, Chauret M, Nassim M, Lepore F, Maheu FS. On a continuum to anxiety disorders: Adolescents at parental risk for anxiety show smaller rostral anterior cingulate cortex and insula thickness. J Affect Disord 2019; 248:34-41. [PMID: 30711867 DOI: 10.1016/j.jad.2019.01.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 01/03/2019] [Accepted: 01/19/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Having a parent with an anxiety disorder increases the risk of anxiety symptoms and anxiety disorders during the lifespan. Moreover, childhood and adolescence anxiety disorders and symptoms have been linked to a range of brain structure abnormalities. However, to date, no study has investigated brain anatomy in adolescents at high risk based on parental anxiety disorders and in adolescents with an anxiety disorder but without any treatment or therapy. METHODS Anatomical images from magnetic resonance imaging of 68 adolescents with anxiety disorders without any treatment (N = 20), at risk for anxiety because of their parents' anxiety disorders (N = 21), and comparison youths (N = 27), were analyzed using Freesurfer. RESULTS Compared to comparison group, smaller cortical thickness of the rostral anterior cingulate cortex and of the insula was observed in anxious and at-risk groups; smaller amygdala volume was observed in the anxious group only. LIMITATIONS The age range studied is large (10 to 17 years old). Moreover, this study is cross-sectional. Since adolescence is one of the biggest periods of cerebral reorganization, longitudinal follow-up of these youths would be necessary. CONCLUSIONS Smaller rostral anterior cingulate cortex and insula cortical thickness appear to be cerebral markers of the risk of developing an anxiety disorder in adolescence. The reduction of the amygdala volume seems to be linked to the onset of the disorder.
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Affiliation(s)
- Sabrina Suffren
- Research Center, Sainte-Justine Hospital, University of Montreal, 3175 Côte Ste-Catherine, Montréal, Québec H3T 1C5, Canada; Research Center in Neuropsychology and Cognition, University of Montreal, Canada; Department of Psychology, University of Montreal, Canada.
| | - Mélissa Chauret
- Research Center, Sainte-Justine Hospital, University of Montreal, 3175 Côte Ste-Catherine, Montréal, Québec H3T 1C5, Canada; Department of Psychology, University of Quebec in Montreal, Canada
| | - Marouane Nassim
- Research Center, Sainte-Justine Hospital, University of Montreal, 3175 Côte Ste-Catherine, Montréal, Québec H3T 1C5, Canada
| | - Franco Lepore
- Research Center, Sainte-Justine Hospital, University of Montreal, 3175 Côte Ste-Catherine, Montréal, Québec H3T 1C5, Canada; Research Center in Neuropsychology and Cognition, University of Montreal, Canada; Department of Psychology, University of Montreal, Canada
| | - Françoise S Maheu
- Research Center, Sainte-Justine Hospital, University of Montreal, 3175 Côte Ste-Catherine, Montréal, Québec H3T 1C5, Canada; Research Center in Neuropsychology and Cognition, University of Montreal, Canada; Department of Psychiatry, University of Montreal, Canada
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16
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Abstract
The core concept for pathophysiology in panic disorder (PD) is the fear network model (FNM). The alterations in FNM might be linked with disturbances in the autonomic nervous system (ANS), which is a common phenomenon in PD. The traditional FNM included the frontal and limbic regions, which were dysregulated in the feedback mechanism for cognitive control of frontal lobe over the primitive response of limbic system. The exaggerated responses of limbic system are also associated with dysregulation in the neurotransmitter system. The neuroimaging studies also corresponded to FNM concept. However, more extended areas of FNM have been discovered in recent imaging studies, such as sensory regions of occipital, parietal cortex and temporal cortex and insula. The insula might integrate the filtered sensory information via thalamus from the visuospatial and other sensory modalities related to occipital, parietal and temporal lobes. In this review article, the traditional and advanced FNM would be discussed. I would also focus on the current evidences of insula, temporal, parietal and occipital lobes in the pathophysiology. In addition, the white matter and functional connectome studies would be reviewed to support the concept of advanced FNM. An emerging dysregulation model of fronto-limbic-insula and temporooccipito-parietal areas might be revealed according to the combined results of recent neuroimaging studies. The future delineation of advanced FNM model can be beneficial from more extensive and advanced studies focusing on the additional sensory regions of occipital, parietal and temporal cortex to confirm the role of advanced FNM in the pathophysiology of PD.
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Affiliation(s)
- Chien-Han Lai
- Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.,PhD Psychiatry & Neuroscience Clinic, Taoyuan, Taiwan.,Department of Psychiatry, Yeezen General Hospital, Taoyuan, Taiwan
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Wu Y, Zhong Y, Ma Z, Lu X, Zhang N, Fox PT, Wang C. Gray matter changes in panic disorder: A voxel-based meta-analysis and meta-analytic connectivity modeling. Psychiatry Res Neuroimaging 2018; 282:82-89. [PMID: 30340800 DOI: 10.1016/j.pscychresns.2018.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 09/26/2018] [Accepted: 09/27/2018] [Indexed: 01/03/2023]
Abstract
Magnetic resonance imaging (MRI) studies of panic disorder (PD) have discovered various damaged brain regions, with heterogeneous results across studies. The present study used meta-analytic approaches to discover gray matter (GM) changes consistently detected in PD and to characterize the functional and connectivity profiles of these regions. In the present study we first conducted an activation likelihood estimation (ALE) meta-analysis of eight eligible whole-brain VBM studies. Then, meta-analytic connectivity modeling analyses (MACMs) were used to provide co-atrophy and co-activation profiles across all the experiments stored in BrainMap. Lastly, the co-atrophied and co-activated regions were analyzed using functional decoding to reveal their functions. Lower gray matter volume was found in the bilateral dorsomedial prefrontal cortex (DMPFC), left dorsolateral prefrontal cortex (DLPFC), right insula, right superior temporal gyrus (STG), right middle temporal gyrus (MTG) and right superior orbital frontal cortex (OFC). Significant co-atrophies were found in the STG, DMPFC and OFC and co-activations were found between the left DLPFC and bilateral DMPFC. Decreased gray matter volume in STG, OFC, DLPFC and DMPFC and their co-atrophy and co-activation patterns indicate the damaged higher cognitive functions in PD and suggest that cortical regions are important structural imaging biomarkers in PD.
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Affiliation(s)
- Yun Wu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China; Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuan Zhong
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China
| | - Zijuan Ma
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Xin Lu
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China; Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Ning Zhang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Peter T Fox
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; South Texas Veterans Healthcare System; University of Texas Health San Antonio, United States; Research Imaging Institute, University of Texas Health San Antonio, United States
| | - Chun Wang
- Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China; Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China; Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China.
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18
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Asami T, Yoshida H, Takaishi M, Nakamura R, Yoshimi A, Whitford TJ, Hirayasu Y. Thalamic shape and volume abnormalities in female patients with panic disorder. PLoS One 2018; 13:e0208152. [PMID: 30566534 PMCID: PMC6300210 DOI: 10.1371/journal.pone.0208152] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 11/12/2018] [Indexed: 12/27/2022] Open
Abstract
The thalamus is believed to play crucial role in processing viscero-sensory information, and regulating the activity of amygdala in patients with panic disorder (PD). Previous functional neuroimaging studies have detected abnormal activation in the thalamus in patients with PD compared with healthy control subjects (HC). Very few studies, however, have investigated for volumetric abnormalities in the thalamus in patients with PD. Furthermore, to the best of our knowledge, no previous study has investigated for shape abnormalities in the thalamus in patients with PD. Twenty-five patients with PD and 25 HC participants (all female) were recruited for the study. A voxel-wise volume comparison analysis and a vertex-wise shape analysis were conducted to evaluate structural abnormalities in the PD patients compared to HC. The patients with PD demonstrated significant gray matter volume reductions in the thalamus bilaterally, relative to the HC. The shape analysis detected significant inward deformation in some thalamic regions in the PD patients, including the anterior nucleus, mediodorsal nucleus, and pulvinar nucleus. PD patients showed shape deformations in key thalamic regions that are believed to play a role in regulating emotional and cognitive functions.
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Affiliation(s)
- Takeshi Asami
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
- * E-mail:
| | - Haruhisa Yoshida
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Masao Takaishi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Ryota Nakamura
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Thomas J. Whitford
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Yoshio Hirayasu
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
- Heian Hospital, Urazoe, Japan
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Asami T, Nakamura R, Takaishi M, Yoshida H, Yoshimi A, Whitford TJ, Hirayasu Y. Smaller volumes in the lateral and basal nuclei of the amygdala in patients with panic disorder. PLoS One 2018; 13:e0207163. [PMID: 30403747 PMCID: PMC6221356 DOI: 10.1371/journal.pone.0207163] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 10/25/2018] [Indexed: 12/30/2022] Open
Abstract
The amygdala plays an important functional role in fear and anxiety. Abnormalities in the amygdala are believed to be involved in the neurobiological basis of panic disorder (PD). Previous structural neuroimaging studies have found global volumetric and morphological abnormalities in the amygdala in patients with PD. Very few studies, however, have explored for structural abnormalities in various amygdala sub-regions, which consist of various sub-nuclei, each with different functions. This study aimed to evaluate for volumetric abnormalities in the amygdala sub-nuclei, in order to provide a better understanding neurobiological basis of PD. Thirty-eight patients with PD and 38 matched healthy control (HC) participants underwent structural MRI scanning. The volume of the whole amygdala, as well as its consistent sub-nuclei, were calculated using FreeSurfer software. Relative volumes of these amygdala sub-regions were compared between the two groups. Results showed significantly smaller volumes in the right lateral and basal nuclei in the patients with PD compared with the HC. Lateral and basal nuclei are thought to play crucial role for processing sensory information related with anxiety and fear. Our results suggest that these particular amygdala sub-regions play a role in the development of PD symptoms.
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Affiliation(s)
- Takeshi Asami
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
- * E-mail:
| | - Ryota Nakamura
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Masao Takaishi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Haruhisa Yoshida
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Asuka Yoshimi
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Thomas J. Whitford
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Yoshio Hirayasu
- Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan
- Heian Hospital, Okinawa, Japan
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20
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Abstract
PURPOSE OF REVIEW To summarize recent research investigating the interaction between obstructive sleep apnea (OSA) and anxiety, and contextualize their bidirectional relationship. RECENT FINDINGS Recent investigations corroborate the bidirectional relationship between sleep-disordered breathing (SDB) and anxiety, evaluate the etiological and clinical manifestations through different mechanisms, and provide insight into clinical implications of this interaction. Much of the literature about anxiety as it relates to SDB is from small samples, using different tools of symptom measurement that are often subjectively quantified. The objective severity of OSA does not appear to be associated with subjectively reported sleepiness and fatigue, whereas physiological manifestations of anxiety are associated with the severity of subjective symptoms reported. Recent findings support that women are more likely to have comorbid SDB and anxiety than men. SDB may precipitate and perpetuate anxiety, whereas anxiety in OSA negatively impacts quality-of-life. Treating SDB may improve anxiety symptoms, whereas anxiety symptoms can be an obstacle and deterrent to appropriate treatment. SUMMARY The interaction between anxiety and SDB is still poorly elucidated. Being aware of the clinical associations, risk factors, and treatment implications for SDB as related to anxiety disorders in different populations can help clinicians with the diagnosis and management of both SDB and anxiety.
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Maron E, Lan CC, Nutt D. Imaging and Genetic Approaches to Inform Biomarkers for Anxiety Disorders, Obsessive-Compulsive Disorders, and PSTD. Curr Top Behav Neurosci 2018; 40:219-292. [PMID: 29796838 DOI: 10.1007/7854_2018_49] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Anxiety disorders are the most common mental health problem in the world and also claim the highest health care cost among various neuropsychiatric disorders. Anxiety disorders have a chronic and recurrent course and cause significantly negative impacts on patients' social, personal, and occupational functioning as well as quality of life. Despite their high prevalence rates, anxiety disorders have often been under-diagnosed or misdiagnosed, and consequently under-treated. Even with the correct diagnosis, anxiety disorders are known to be difficult to treat successfully. In order to implement better strategies in diagnosis, prognosis, treatment decision, and early prevention for anxiety disorders, tremendous efforts have been put into studies using genetic and neuroimaging techniques to advance our understandings of the underlying biological mechanisms. In addition to anxiety disorders including panic disorder, generalised anxiety disorder (GAD), specific phobias, social anxiety disorders (SAD), due to overlapping symptom dimensions, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD) (which were removed from the anxiety disorder category in DSM-5 to become separate categories) are also included for review of relevant genetic and neuroimaging findings. Although the number of genetic or neuroimaging studies focusing on anxiety disorders is relatively small compare to other psychiatric disorders such as psychotic disorders or mood disorders, various structural abnormalities in the grey or white matter, functional alterations of activity during resting-state or task conditions, molecular changes of neurotransmitter receptors or transporters, and genetic associations have all been reported. With continuing effort, further genetic and neuroimaging research may potentially lead to clinically useful biomarkers for the prevention, diagnosis, and management of these disorders.
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Affiliation(s)
- Eduard Maron
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK.
- Department of Psychiatry, University of Tartu, Tartu, Estonia.
- Department of Psychiatry, North Estonia Medical Centre, Tallinn, Estonia.
| | - Chen-Chia Lan
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - David Nutt
- Neuropsychopharmacology Unit, Centre for Academic Psychiatry, Division of Brain Sciences, Imperial College London, London, UK
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22
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Kang EK, Lee KS, Lee SH. Reduced Cortical Thickness in the Temporal Pole, Insula, and Pars Triangularis in Patients with Panic Disorder. Yonsei Med J 2017; 58:1018-1024. [PMID: 28792148 PMCID: PMC5552629 DOI: 10.3349/ymj.2017.58.5.1018] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Revised: 03/31/2017] [Accepted: 05/09/2017] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Recent neuroimaging findings have revealed that paralimbic and prefrontal regions are involved in panic disorder (PD). However, no imaging studies have compared differences in cortical thickness between patients with PD and healthy control (HC) subjects. MATERIALS AND METHODS Forty-seven right-handed patients with PD who met the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders-4th edition-text revision, and 30 HC subjects were enrolled. We used the FreeSurfer software package for estimating the cortical thickness of regions of interest, including the temporal pole, insula, and pars triangularis (mid-ventrolateral prefrontal cortex). RESULTS Cortical thickness of the temporal pole (p=0.033, right), insula (p=0.017, left), and pars triangularis (p=0.008, left; p=0.025, right) in patients with PD was significantly lower, compared with HC subjects (Benjamini-Hochberg false discovery rate correction). Exploratory analysis revealed a significant negative correlation between the cortical thickness of the right temporal pole and Beck Depression Inventory scores (r=-0.333, p=0.027) in patients with PD and positive correlations between the cortical thickness of the left pars triangularis and Panic Disorder Severity Scale (r=0.429, p=0.004), Anxiety Sensitivity Index-Revised (r=0.380, p=0.011), and Beck Anxiety Inventory (r=0.421, p=0.004) scores using Pearson's correlation. CONCLUSION Ours study is the first to demonstrate cortical thickness reduction in the temporal pole, insula, and pars triangularis in patients with PD, compared with the HC subjects. These findings suggest that reduced cortical thickness could play an important role in the pathophysiology of PD.
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Affiliation(s)
- Eun Kyoung Kang
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Kang Soo Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Sang Hyuk Lee
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
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Sobanski T, Wagner G. Functional neuroanatomy in panic disorder: Status quo of the research. World J Psychiatry 2017; 7:12-33. [PMID: 28401046 PMCID: PMC5371170 DOI: 10.5498/wjp.v7.i1.12] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 11/16/2016] [Accepted: 01/14/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To provide an overview of the current research in the functional neuroanatomy of panic disorder.
METHODS Panic disorder (PD) is a frequent psychiatric disease. Gorman et al (1989; 2000) proposed a comprehensive neuroanatomical model of PD, which suggested that fear- and anxiety-related responses are mediated by a so-called “fear network” which is centered in the amygdala and includes the hippocampus, thalamus, hypothalamus, periaqueductal gray region, locus coeruleus and other brainstem sites. We performed a systematic search by the electronic database PubMed. Thereby, the main focus was laid on recent neurofunctional, neurostructural, and neurochemical studies (from the period between January 2012 and April 2016). Within this frame, special attention was given to the emerging field of imaging genetics.
RESULTS We noted that many neuroimaging studies have reinforced the role of the “fear network” regions in the pathophysiology of panic disorder. However, recent functional studies suggest abnormal activation mainly in an extended fear network comprising brainstem, anterior and midcingulate cortex (ACC and MCC), insula, and lateral as well as medial parts of the prefrontal cortex. Interestingly, differences in the amygdala activation were not as consistently reported as one would predict from the hypothesis of Gorman et al (2000). Indeed, amygdala hyperactivation seems to strongly depend on stimuli and experimental paradigms, sample heterogeneity and size, as well as on limitations of neuroimaging techniques. Advanced neurochemical studies have substantiated the major role of serotonergic, noradrenergic and glutamatergic neurotransmission in the pathophysiology of PD. However, alterations of GABAergic function in PD are still a matter of debate and also their specificity remains questionable. A promising new research approach is “imaging genetics”. Imaging genetic studies are designed to evaluate the impact of genetic variations (polymorphisms) on cerebral function in regions critical for PD. Most recently, imaging genetic studies have not only confirmed the importance of serotonergic and noradrenergic transmission in the etiology of PD but also indicated the significance of neuropeptide S receptor, CRH receptor, human TransMEMbrane protein (TMEM123D), and amiloride-sensitive cation channel 2 (ACCN2) genes.
CONCLUSION In light of these findings it is conceivable that in the near future this research will lead to the development of clinically useful tools like predictive biomarkers or novel treatment options.
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Bae S, Kang I, Lee BC, Jeon Y, Cho HB, Yoon S, Lim SM, Kim J, Lyoo IK, Kim JE, Choi IG. Prefrontal Cortical Thickness Deficit in Detoxified Alcohol-dependent Patients. Exp Neurobiol 2016; 25:333-341. [PMID: 28035184 PMCID: PMC5195819 DOI: 10.5607/en.2016.25.6.333] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 12/14/2016] [Accepted: 12/23/2016] [Indexed: 01/30/2023] Open
Abstract
Alcohol dependence is a serious disorder that can be related with a number of potential health-related and social consequences. Cortical thickness measurements would provide important information on the cortical structural alterations in patients with alcohol dependence. Twenty-one patients with alcohol dependence and 22 healthy comparison subjects have been recruited and underwent high-resolution brain magnetic resonance (MR) imaging and clinical assessments. T1-weighted MR images were analyzed using the cortical thickness analysis program. Significantly thinner cortical thickness in patients with alcohol dependence than healthy comparison subjects was noted in the left superior frontal cortical region, correcting for multiple comparisons and adjusting with age and hemispheric average cortical thickness. There was a significant association between thickness in the cluster of the left superior frontal cortex and the duration of alcohol use. The prefrontal cortical region may particularly be vulnerable to chronic alcohol exposure. It is also possible that the pre-existing deficit in this region may have rendered individuals more susceptible to alcohol dependence.
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Affiliation(s)
- Sujin Bae
- Industry Academic Cooperation Foundation, Chung-Ang University, Seoul 06974, Korea
| | - Ilhyang Kang
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Boung Chul Lee
- Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul 07247, Korea
| | - Yujin Jeon
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
| | - Han Byul Cho
- The Brain Institute, University of Utah, Salt Lake City, UT 84108, USA
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Soo Mee Lim
- Department of Radiology, Ewha Womans University College of Medicine, Seoul 03760, Korea
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea.; College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Jieun E Kim
- Ewha Brain Institute, Ewha Womans University, Seoul 03760, Korea.; Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul 03760, Korea
| | - Ihn-Geun Choi
- Department of Psychiatry, Hallym University Kangnam Sacred Heart Hospital, Seoul 07441, Korea
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Yin P, Zhang M, Hou X, Tan Y, Fu Y, Qiu J. The brain structure and spontaneous activity baseline of the behavioral bias in trait anxiety. Behav Brain Res 2016; 312:355-61. [DOI: 10.1016/j.bbr.2016.06.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 06/17/2016] [Accepted: 06/18/2016] [Indexed: 11/17/2022]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Yoon S, Kim JE, Kim GH, Kang HJ, Kim BR, Jeon S, Im JJ, Hyun H, Moon S, Lim SM, Lyoo IK. Subregional Shape Alterations in the Amygdala in Patients with Panic Disorder. PLoS One 2016; 11:e0157856. [PMID: 27336300 PMCID: PMC4919046 DOI: 10.1371/journal.pone.0157856] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 06/06/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The amygdala has been known to play a pivotal role in mediating fear-related responses including panic attacks. Given the functionally distinct role of the amygdalar subregions, morphometric measurements of the amygdala may point to the pathophysiological mechanisms underlying panic disorder. The current study aimed to determine the global and local morphometric alterations of the amygdala related to panic disorder. METHODS Volumetric and surface-based morphometric approach to high-resolution three-dimensional T1-weighted images was used to examine the structural variations of the amygdala, with respect to extent and location, in 23 patients with panic disorder and 31 matched healthy individuals. RESULTS There were no significant differences in bilateral amygdalar volumes between patients with panic disorder and healthy individuals despite a trend-level right amygdalar volume reduction related to panic disorder (right, β = -0.23, p = 0.09, Cohen's d = 0.51; left, β = -0.18, p = 0.19, Cohen's d = 0.45). Amygdalar subregions were localized into three groups including the superficial, centromedial, and laterobasal groups based on the cytoarchitectonically defined probability map. Surface-based morphometric analysis revealed shape alterations in the laterobasal and centromedial groups of the right amygdala in patients with panic disorder (false discovery rate corrected p < 0.05). CONCLUSIONS The current findings suggest that subregion-specific shape alterations in the right amygdala may be involved in the development and maintenance of panic disorder, which may be attributed to the cause or effects of amygdalar hyperactivation.
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Affiliation(s)
- Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Jieun E. Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Geon Ha Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, South Korea
| | - Hee Jin Kang
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Bori R. Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Saerom Jeon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Jooyeon Jamie Im
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Interdisciplinary Program in Neuroscience, College of Natural Sciences, Seoul National University, Seoul, South Korea
| | - Heejung Hyun
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Sohyeon Moon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
| | - Soo Mee Lim
- Department of Radiology, Ewha Womans University College of Medicine, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
- College of Pharmacy, Graduate School of Pharmaceutical Sciences, Ewha Womans University, Seoul, South Korea
- * E-mail:
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Fonzo GA, Ramsawh HJ, Flagan TM, Simmons AN, Sullivan SG, Allard CB, Paulus MP, Stein MB. Early life stress and the anxious brain: evidence for a neural mechanism linking childhood emotional maltreatment to anxiety in adulthood. Psychol Med 2016; 46:1037-1054. [PMID: 26670947 PMCID: PMC4795156 DOI: 10.1017/s0033291715002603] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Childhood emotional maltreatment (CEM) increases the likelihood of developing an anxiety disorder in adulthood, but the neural processes underlying conferment of this risk have not been established. Here, we test the potential for neuroimaging the adult brain to inform understanding of the mechanism linking CEM to adult anxiety symptoms. METHOD One hundred eighty-two adults (148 females, 34 males) with a normal-to-clinical range of anxiety symptoms underwent structural and functional magnetic resonance imaging while completing an emotion-processing paradigm with facial expressions of fear, anger, and happiness. Participants completed self-report measures of CEM and current anxiety symptoms. Voxelwise mediation analyses on gray-matter volumes and activation to each emotion condition were used to identify candidate brain mechanisms relating CEM to anxiety in adulthood. RESULTS During processing of fear and anger faces, greater amygdala and less right dorsolateral prefrontal (dlPFC) activation partially mediated the positive relationship between CEM and anxiety symptoms. Greater right posterior insula activation to fear also partially mediated this relationship, as did greater ventral anterior cingulate (ACC) and less dorsal ACC activation to anger. Responses to happy faces in these regions did not mediate the CEM-anxiety relationship. Smaller right dlPFC gray-matter volumes also partially mediated the CEM-anxiety relationship. CONCLUSIONS Activation patterns of the adult brain demonstrate the potential to inform mechanistic accounts of the CEM conferment of anxiety symptoms. Results support the hypothesis that exaggerated limbic activation to negative valence facial emotions links CEM to anxiety symptoms, which may be consequent to a breakdown of cortical regulatory processes.
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Affiliation(s)
- G A Fonzo
- Department of Psychiatry & Behavioral Sciences,Stanford University,Stanford, CA,USA
| | - H J Ramsawh
- Department of Clinical Effectiveness Research,Patient-Centered Outcomes Research Institute,Washington, DC,USA
| | - T M Flagan
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - A N Simmons
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - S G Sullivan
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - C B Allard
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - M P Paulus
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
| | - M B Stein
- Department of Psychiatry,University of California San Diego,La Jolla,CA,USA
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Cui H, Zhang J, Liu Y, Li Q, Li H, Zhang L, Hu Q, Cheng W, Luo Q, Li J, Li W, Wang J, Feng J, Li C, Northoff G. Differential alterations of resting-state functional connectivity in generalized anxiety disorder and panic disorder. Hum Brain Mapp 2016; 37:1459-73. [PMID: 26800659 DOI: 10.1002/hbm.23113] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 12/14/2015] [Accepted: 12/29/2015] [Indexed: 12/12/2022] Open
Abstract
Generalized anxiety disorder (GAD) and panic disorder (PD) are most common anxiety disorders with high lifetime prevalence while the pathophysiology and disease-specific alterations still remain largely unclear. Few studies have taken a whole-brain perspective in the functional connectivity (FC) analysis of these two disorders in resting state. It limits the ability to identify regionally and psychopathologically specific network abnormalities with their subsequent use as diagnostic marker and novel treatment strategy. The whole brain FC using a novel FC metric was compared, that is, scaled correlation, which they demonstrated to be a reliable FC statistics, but have higher statistical power in two-sample t-test of whole brain FC analysis. About 21 GAD and 18 PD patients were compared with 22 matched control subjects during resting-state, respectively. It was found that GAD patients demonstrated increased FC between hippocampus/parahippocampus and fusiform gyrus among the most significantly changed FC, while PD was mainly associated with greater FC between somatosensory cortex and thalamus. Besides such regional specificity, it was observed that psychopathological specificity in that the disrupted FC pattern in PD and GAD correlated with their respective symptom severity. The findings suggested that the increased FC between hippocampus/parahippocampus and fusiform gyrus in GAD were mainly associated with a fear generalization related neural circuit, while the greater FC between somatosensory cortex and thalamus in PD were more likely linked to interoceptive processing. Due to the observed regional and psychopathological specificity, their findings bear important clinical implications for the potential treatment strategy.
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Affiliation(s)
- Huiru Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jie Zhang
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China.,Department of Radiology, Jinling Hospital of Nanjing, Nanjing, People's Republic of China
| | - Yicen Liu
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China
| | - Qingwei Li
- Department of Psychiatry, Tongji Hospital of Tongji University, Shanghai, People's Republic of China
| | - Hui Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Lanlan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Qiang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Wei Cheng
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China
| | - Qiang Luo
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China
| | - Jianqi Li
- Shanghai Key Laboratory of Magnetic Resonance, Department of Physics, East China Normal University, Shanghai, People's Republic of China
| | - Wei Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Jianfeng Feng
- Centre for Computational Systems Biology, Fudan University, Shanghai, People's Republic of China.,Department of Computer Science, University of Warwick, Coventry, CV4 7AL, United Kingdom.,Collaborative Innovation Center for Brain Science, Fudan University, Shanghai, People's Republic of China.,Shanghai Center for Mathematical Sciences, Shanghai, People's Republic of China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Georg Northoff
- Institute of Mental Health Research, University of Ottawa, Ottawa, Canada.,Centre for Cognition and Brain Disorders, Hangzhou Normal University, Hangzhou, People's Republic of China.,Centre for Brain and Consciousness, Taipei Medical University (TMU), Taipei, Taiwan
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Potvin O, Catheline G, Bernard C, Meillon C, Bergua V, Allard M, Dartigues JF, Chauveau N, Celsis P, Amieva H. Gray matter characteristics associated with trait anxiety in older adults are moderated by depression. Int Psychogeriatr 2015; 27:1813-24. [PMID: 26059837 DOI: 10.1017/S1041610215000836] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Structural gray matter characteristics of anxiety remain unclear. The aim of this study was to assess the influence of current depressive symptoms and history of depression on the gray matter characteristics of trait anxiety. METHODS Structural magnetic resonance imaging (MRI) data from 393 individuals aged 65 years or older were used. Regions of interest (ROIs) included the amygdala, anterior cingulate cortex (ACC), insula, orbitofrontal cortex (OFC), and temporal cortex. Trait anxiety was measured by the State-Trait Anxiety Inventory (STAI). Depression and depressive symptoms were measured using DSM-IV criteria and the Center for Epidemiological Studies Depression Scale (CESD). RESULTS After adjustments for sociodemographics and health-related variables, anxiety had a significant influence on the gray matter characteristics in all cortical ROIs. First, in participants without depression antecedents, higher trait anxiety was associated with a larger cortical thickness in all cortical ROIs. Second, in participants with a previous history of depression, higher trait anxiety was associated with a smaller cortical thickness in all cortical ROIs. CONCLUSIONS These results suggest that anxiety is related to cortical thickness differently in healthy older adults and in older adults with psychiatric antecedents. Anxiety associated with thinner cortical areas could reflect symptoms of a specific type of depression or a vulnerability to develop depression.
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Abstract
OBJECTIVE This is a comprehensive study to establish a diagnosis-specific gray matter deficit model for major depressive disorder (MDD) and panic disorder (PD). METHOD We enrolled 53 patients with first-episode medication-naïve PD, 54 healthy controls and 53 patients with first-episode medication-naïve MDD in this study. They were age, handedness and gender matched. All participating subjects all received baseline structural scanning by the 3-Tesla magnetic resonance scanner. The optimized voxel-based morphometry was performed on the 3 groups of subjects and the ANOVA analysis was used to estimate the inter-group gray matter differences between each group. RESULTS The PD group had higher gray matter volume than MDD group in the right medial frontal cortex and right temporal gyrus. The PD group had gray matter reductions in the right inferior frontal gyrus and right insula. The MDD group had gray matter reductions in bilateral medial frontal cortex, right superior frontal gyrus, right superior temporal gyrus and bilateral cerebellums. CONCLUSION The gray matter alterations of fronto-insula and fronto-temporo-cerebellum regions probably would be specific for PD and MDD respectively. In addition, the differences of gray matter volume in the fronto-temporal regions would be helpful to differentiate MDD from PD.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei City, Taiwan, ROC; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC.
| | - Yu-Te Wu
- Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan, ROC; Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan, ROC; Brain Research Center, National Yang-Ming University, Taipei, Taiwan, ROC.
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Su VYF, Chen YT, Lin WC, Wu LA, Chang SC, Perng DW, Su WJ, Chen YM, Chen TJ, Lee YC, Chou KT. Sleep Apnea and Risk of Panic Disorder. Ann Fam Med 2015; 13. [PMID: 26195676 PMCID: PMC4508172 DOI: 10.1370/afm.1815] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
PURPOSE Epidemiological studies have identified a trend in the development of depressive and anxiety disorders following a diagnosis of sleep apnea. The relationship between sleep apnea and subsequent panic disorder, however, remains unclear. METHODS Using a nationwide database, the Taiwan National Health Insurance Research Database, patients with sleep apnea and age-, sex-, income-, and urbanization-matched control patients who did not have sleep apnea were enrolled between 2000 and 2010. Patients with a prior diagnosis of panic disorder before enrollment were excluded. The 2 cohorts were observed until December 31, 2010. The primary endpoint was occurrence of newly diagnosed panic disorder. RESULTS A total of 8,704 sleep apnea patients and 34,792 control patients were enrolled. Of the 43,496 patients, 263 (0.60%) suffered from panic disorder during a mean follow-up period of 3.92 years, including 117 (1.34%) from the sleep apnea cohort and 146 (0.42%) from the control group. The Kaplan-Meier analysis revealed a predisposition of patients with sleep apnea to develop panic disorder (log-rank test, P <.001). After multivariate adjustment, the hazard ratio for subsequent panic disorder among the sleep apnea patients was 2.17 (95% confidence interval, 1.68-2.81; P <.001). CONCLUSIONS Sleep apnea appears to confer a higher risk for future development of panic disorder.
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Affiliation(s)
- Vincent Yi-Fong Su
- Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yung-Tai Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Medicine, Heping-Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
| | - Wei-Chen Lin
- Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Li-An Wu
- Department of Radiology, Heping-Fuyou Branch, Taipei City Hospital, Taipei, Taiwan
| | - Shi-Chuan Chang
- Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Diahn-Warng Perng
- Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Juin Su
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Yuh-Min Chen
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yu-Chin Lee
- Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kun-Ta Chou
- Center of Sleep Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Department of Chest Medicine, Taipei Veterans General Hospital, Taipei, Taiwan School of Medicine, National Yang-Ming University, Taipei, Taiwan Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Picado M, Carmona S, Hoekzema E, Pailhez G, Bergé D, Mané A, Fauquet J, Hilferty J, Moreno A, Cortizo R, Vilarroya O, Bulbena A. The neuroanatomical basis of panic disorder and social phobia in schizophrenia: a voxel based morphometric study. PLoS One 2015; 10:e0119847. [PMID: 25774979 PMCID: PMC4361479 DOI: 10.1371/journal.pone.0119847] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Accepted: 01/20/2015] [Indexed: 11/18/2022] Open
Abstract
Objective It is known that there is a high prevalence of certain anxiety disorders among schizophrenic patients, especially panic disorder and social phobia. However, the neural underpinnings of the comorbidity of such anxiety disorders and schizophrenia remain unclear. Our study aims to determine the neuroanatomical basis of the co-occurrence of schizophrenia with panic disorder and social phobia. Methods Voxel-based morphometry was used in order to examine brain structure and to measure between-group differences, comparing magnetic resonance images of 20 anxious patients, 20 schizophrenic patients, 20 schizophrenic patients with comorbid anxiety, and 20 healthy control subjects. Results Compared to the schizophrenic patients, we observed smaller grey-matter volume (GMV) decreases in the dorsolateral prefrontal cortex and precentral gyrus in the schizophrenic-anxiety group. Additionally, the schizophrenic group showed significantly reduced GMV in the dorsolateral prefrontal cortex, precentral gyrus, orbitofrontal cortex, temporal gyrus and angular/inferior parietal gyrus when compared to the control group. Conclusions Our findings suggest that the comorbidity of schizophrenia with panic disorder and social phobia might be characterized by specific neuroanatomical and clinical alterations that may be related to maladaptive emotion regulation related to anxiety. Even thought our findings need to be replicated, our study suggests that the identification of neural abnormalities involved in anxiety, schizophrenia and schizophrenia-anxiety may lead to an improved diagnosis and management of these conditions.
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Affiliation(s)
- Marisol Picado
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- * E-mail:
| | - Susanna Carmona
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | | | - Guillem Pailhez
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Daniel Bergé
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Anna Mané
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Jordi Fauquet
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
- Departament de Psicobiologia i Metodologia de Ciències de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Joseph Hilferty
- Departament de Filologia Anglesa i Alemanya, Facultad de Filologia, Universitat de Barcelona, Barcelona, Spain
| | - Ana Moreno
- Fundación para la Investigación y la Docencia Maria Angustias Giménez, Germanes Hospitalàries, Barcelona, Spain
| | - Romina Cortizo
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
| | - Oscar Vilarroya
- Grup de Recerca en Neuroimatge, Fundació IMIM, Barcelona, Spain
| | - Antoni Bulbena
- Institut de Neuropsiquiatria i Addiccions, Parc de Salut Mar, Barcelona, Spain
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Johnson PL, Federici LM, Shekhar A. Etiology, triggers and neurochemical circuits associated with unexpected, expected, and laboratory-induced panic attacks. Neurosci Biobehav Rev 2014; 46 Pt 3:429-54. [PMID: 25130976 DOI: 10.1016/j.neubiorev.2014.07.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 06/24/2014] [Accepted: 07/31/2014] [Indexed: 12/18/2022]
Abstract
Panic disorder (PD) is a severe anxiety disorder that is characterized by recurrent panic attacks (PA), which can be unexpected (uPA, i.e., no clear identifiable trigger) or expected (ePA). Panic typically involves an abrupt feeling of catastrophic fear or distress accompanied by physiological symptoms such as palpitations, racing heart, thermal sensations, and sweating. Recurrent uPA and ePA can also lead to agoraphobia, where subjects with PD avoid situations that were associated with PA. Here we will review recent developments in our understanding of PD, which includes discussions on: symptoms and signs associated with uPA and ePAs; Diagnosis of PD and the new DSM-V; biological etiology such as heritability and gene×environment and gene×hormonal development interactions; comparisons between laboratory and naturally occurring uPAs and ePAs; neurochemical systems that are associated with clinical PAs (e.g. gene associations; targets for triggering or treating PAs), adaptive fear and panic response concepts in the context of new NIH RDoc approach; and finally strengths and weaknesses of translational animal models of adaptive and pathological panic states.
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Affiliation(s)
- Philip L Johnson
- Department of Anatomy & Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, USA; Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Lauren M Federici
- Department of Anatomy & Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA; Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Anantha Shekhar
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, USA; Stark Neuroscience Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Clinical and Translational Sciences Institute, Indiana University School of Medicine, Indianapolis, IN, USA
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Lai CH, Wu YT. Frontal-insula gray matter deficits in first-episode medication-naïve patients with major depressive disorder. J Affect Disord 2014; 160:74-9. [PMID: 24445133 DOI: 10.1016/j.jad.2013.12.036] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 12/17/2013] [Accepted: 12/17/2013] [Indexed: 12/22/2022]
Abstract
OBJECTIVE This study is designed to investigate the gray matter volume (GMV) deficits in patients with first-episode medication-naïve major depressive disorder (MDD). METHODS We enrolled 38 patients with first-episode medication-naïve MDD and 27 controls in this project. Voxel-based morphometry was used to compare GMV differences between two groups. Besides, the relationship between GMV of patients and the severity of clinical symptoms was estimated to confirm the role of GMV deficits in clinical symptoms. The correlation between total GMV and illness duration was also performed to elucidate the impacts of untreated duration on the GMV. RESULTS We found that first-episode medication-naïve MDD patients had significant GMV deficits in bilateral superior frontal gyri, left middle frontal gyrus, left medial frontal gyrus and left insula. The GMV of patient group was negatively correlated with the severity of clinical symptoms and the illness duration. CONCLUSION A pattern of GMV deficits in fronto-insula might represent the biomarker for first-episode medication-naïve MDD.
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Oudega ML, van Exel E, Stek ML, Wattjes MP, van der Flier WM, Comijs HC, Dols A, Scheltens P, Barkhof F, Eikelenboom P, van den Heuvel OA. The structure of the geriatric depressed brain and response to electroconvulsive therapy. Psychiatry Res 2014; 222:1-9. [PMID: 24686000 DOI: 10.1016/j.pscychresns.2014.03.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 02/25/2014] [Accepted: 03/06/2014] [Indexed: 02/08/2023]
Abstract
Electroconvulsive therapy (ECT) is the treatment of choice in severe geriatric depression. High remission rates may be influenced by specific brain morphology characteristic of geriatric depression. Our objective was to identify the relationship between brain structure, symptom profile, and ECT response. In a naturalistic cohort of 55 patients with a major depressive disorder, structural magnetic resonance imaging (MRI) was performed before ECT. Voxel-based morphometry was applied to determine regional differences in gray matter (GM) volume between patients and 23 matched healthy controls. Depressed patients with psychotic symptoms showed significantly higher remission rates and smaller regional GM volume of the left inferior frontal gyrus (IFG). Patients with late onset depression showed smaller regional GM volume of the bilateral lateral temporal cortex. Larger size of response in the whole patient group was related to smaller pretreatment regional GM volume of the right lateral temporal cortex, whereas faster speed of response was related to smaller pretreatment regional GM volume of the right IFG. ECT is most effective in depressed patients with psychotic symptoms. In this study the presence of psychotic symptoms was related to pretreatment smaller GM volume of the left IFG and bilateral temporal cortex. Smaller volume of the IFG pretreatment was related to faster treatment response, and smaller volume of the right lateral temporal cortex pretreatment was related to larger response to ECT. These results are possibly explained by the connectivity between these brain regions and an interconnected network that is particularly activated by the ECT-induced seizures.
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Kim B, Kim JH, Kim MK, Lee KS, Kim Y, Choi TK, Kim YT, Lee SH. Frontal white matter alterations in short-term medicated panic disorder patients without comorbid conditions: a diffusion tensor imaging study. PLoS One. 2014;9:e95279. [PMID: 24788587 PMCID: PMC4005735 DOI: 10.1371/journal.pone.0095279] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 03/25/2014] [Indexed: 01/04/2023] Open
Abstract
The frontal cortex might play an important role in the fear network, and white matter (WM) integrity could be related to the pathophysiology of panic disorder (PD). A few studies have investigated alterations of WM integrity in PD. The aim of this study was to determine frontal WM integrity differences between patients with PD without comorbid conditions and healthy control (HC) subjects by using diffusion tensor imaging. Thirty-six patients with PD who had used medication within 1 week and 27 age- and sex-matched HC subjects participated in this study. Structural brain magnetic resonance imaging was performed on all participants. Panic Disorder Severity Scale and Beck Anxiety Inventory (BAI) scores were assessed. Tract-based spatial statistics (TBSS) was used for image analysis. TBSS analysis showed decreased fractional anisotropy (FA) in frontal WM and WM around the frontal lobe, including the corpus callosum of both hemispheres, in patients with PD compared to HC subjects. Moreover, voxel-wise correlation analysis revealed that the BAI scores for patients with PD were positively correlated with their FA values for regions showing group differences in the FA of frontal WM of both hemispheres. Altered integrity in frontal WM of patients with PD without comorbid conditions might represent the structural pathophysiology in these patients, and these changes could be related to clinical symptoms of PD.
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Shang J, Fu Y, Ren Z, Zhang T, Du M, Gong Q, Lui S, Zhang W. The common traits of the ACC and PFC in anxiety disorders in the DSM-5: meta-analysis of voxel-based morphometry studies. PLoS One 2014; 9:e93432. [PMID: 24676455 PMCID: PMC3968149 DOI: 10.1371/journal.pone.0093432] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Accepted: 03/04/2014] [Indexed: 02/05/2023] Open
Abstract
Background The core domains of social anxiety disorder (SAD), generalized anxiety disorder (GAD), panic disorder (PD) with and without agoraphobia (GA), and specific phobia (SP) are cognitive and physical symptoms that are related to the experience of fear and anxiety. It remains unclear whether these highly comorbid conditions that constitute the anxiety disorder subgroups of the Diagnostic and Statistical Manual for Mental Disorders – Fifth Edition (DSM-5) represent distinct disorders or alternative presentations of a single underlying pathology. Methods A systematic search of voxel-based morphometry (VBM) studies of SAD, GAD, PD, GA, and SP was performed with an effect-size signed differential mapping (ES-SDM) meta-analysis to estimate the clusters of significant gray matter differences between patients and controls. Results Twenty-four studies were eligible for inclusion in the meta-analysis. Reductions in the right anterior cingulate gyrus and the left inferior frontal gyrus gray matter volumes (GMVs) were noted in patients with anxiety disorders when potential confounders, such as comorbid major depressive disorder (MDD), age, and antidepressant use were controlled for. We also demonstrated increased GMVs in the right dorsolateral prefrontal cortex (DLPFC) in comorbid depression-anxiety (CDA), drug-naïve and adult patients. Furthermore, we identified a reduced left middle temporal gyrus and right precentral gyrus in anxiety patients without comorbid MDD. Conclusion Our findings indicate that a reduced volume of the right ventral anterior cingulate gyrus and left inferior frontal gyrus is common in anxiety disorders and is independent of comorbid depression, medication use, and age. This generic effect supports the notion that the four types of anxiety disorders have a clear degree of overlap that may reflect shared etiological mechanisms. The results are consistent with neuroanatomical DLPFC models of physiological responses, such as worry and fear, and the importance of the ventral anterior cingulate (ACC)/medial prefrontal cortex (mPFC) in mediating anxiety symptoms.
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Affiliation(s)
- Jing Shang
- Mental Health Center, Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Yuchuan Fu
- Radiology Department of the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Zhengjia Ren
- Mental Health Center, Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Tao Zhang
- West China School of Public Health, Sichuan University, Chengdu, People's Republic of China
| | - Mingying Du
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Qiyong Gong
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China
| | - Su Lui
- Radiology Department of the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, People's Republic of China
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu, People's Republic of China
- * E-mail: (WZ); (SL)
| | - Wei Zhang
- Mental Health Center, Department of Psychiatry, West China Hospital of Sichuan University, Chengdu, People's Republic of China
- * E-mail: (WZ); (SL)
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Yoon S, Jun CS, Jeong HS, Lee S, Lim SM, Ma J, Ko E, Cho HB, Yeum TS, Lyoo IK. Altered cortical gyrification patterns in panic disorder: deficits and potential compensation. J Psychiatr Res 2013; 47:1446-54. [PMID: 23871448 DOI: 10.1016/j.jpsychires.2013.06.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2013] [Revised: 05/10/2013] [Accepted: 06/24/2013] [Indexed: 12/22/2022]
Abstract
Abnormal gyrification patterns may reflect aberrant cortical connectivity during an early period of brain maturation. We here investigated anatomical distribution of cortical gyrification deficits underlying panic disorder and the relationships of these potential neurodevelopmental markers with panic symptom severity. High-resolution three-dimensional T1-weighted structural images were obtained from 23 patients with panic disorder and 33 matched healthy individuals. Local gyrification indices were measured in each genetically-based parcellated cortical subregion and regional gyrification patterns were compared between groups. Cortical areas in which gyrification patterns were associated with panic symptom severity were also determined. Significant reductions in cortical gyrification were observed in panic patients compared with healthy individuals, which were mainly distributed in the lateral brain extending from the fronto-parietal to the temporal areas. In contrast, hyper-gyrification in the posteromedial cortical regions which exert interconnecting roles in the default mode network, was associated with less severe panic symptoms. Post-hoc analysis for the inter-regional covariance of local gyrification indices revealed that interconnections of the posteromedial cortical regions with other cortical areas which belong to the default mode network were reduced in panic patients with severe symptoms relative to either less severe patients or healthy individuals. Our findings suggest not only substantial perturbation in cortical gyrification patterns in panic disorder but also potential contribution of integrated cortical folding pattern of the default mode network to alleviated panic severity.
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Affiliation(s)
- Sujung Yoon
- Department of Psychiatry, The Catholic University of Korea College of Medicine, Seoul, South Korea
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Lai CH, Wu YT, Yu PL, Yuan W. Improvements in white matter micro-structural integrity of right uncinate fasciculus and left fronto-occipital fasciculus of remitted first-episode medication-naïve panic disorder patients. J Affect Disord 2013; 150:330-6. [PMID: 23680435 DOI: 10.1016/j.jad.2013.04.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Revised: 04/10/2013] [Accepted: 04/10/2013] [Indexed: 11/16/2022]
Abstract
OBJECTIVE We designed this study to investigate neural correlates of white matter micro-structural integrity of remitted patients with first-episode, medication-naïve and very late-onset panic disorder. METHOD Twenty-one remitted patients with panic disorder completed treatment course with treatment of escitalopram (dose range around 10-15 mg/d). Twenty-one healthy controls were also enrolled into this study. Patients and controls all received 3-Tesla magnetic resonance imaging diffusion tensor imaging scanning at baseline and 6th week. We utilized FDT (FMRIB's Diffusion Toolbox v2.0) function of FSL (FMRIB Software Library) to calculate fractional anisotropy (FA). We compared FA values of patients and controls at baseline and 6th week to estimate the changes of FA of remitted patient group and inter-scan bias of controls. FA outputs of remitted patients and controls were compared by independent t test. RESULTS We found increased FA in some regions of right uncinate fasciculus and left fronoto-occipital fasciculus after remission in patient group (corrected p<0.05). Reduced FA of other regions of right uncinate fasciculus was still observed in remitted patients when they were compared to the control group. CONCLUSION Subtle changes of white matter micro-structural integrity after remission might represent neural correlates of treatment effects for first-episode, medication-naïve and very late-onset panic disorder.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Cheng Hsin General Hospital, No. 45, Cheng Hsin St., Pai-Tou Destrict, Taipei City, Taiwan, ROC.
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Na KS, Ham BJ, Lee MS, Kim L, Kim YK, Lee HJ, Yoon HK. Decreased gray matter volume of the medial orbitofrontal cortex in panic disorder with agoraphobia: a preliminary study. Prog Neuropsychopharmacol Biol Psychiatry 2013; 45:195-200. [PMID: 23628432 DOI: 10.1016/j.pnpbp.2013.04.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2013] [Revised: 04/19/2013] [Accepted: 04/20/2013] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients with panic disorder with agoraphobia (PDA) have clinical symptoms such as the fear of being outside or of open spaces from which escape would be difficult. Although recent neurobiological studies have suggested that fear conditioning and extinction are associated with PDA, no study has examined the possible structural abnormalities in patients with PDA. METHODS This preliminary study compares the gray matter volume among patients with PDA, those with panic disorder without agoraphobia (PDW), and healthy controls (HC) using high-resolution 3.0 T magnetic resonance imaging (MRI) with voxel-based morphometry (VBM). RESULTS Compared with HC, patients with PDA showed decreased gray matter volume in their left medial orbitofrontal gyrus. However, differences were not found in the gray matter volumes of patients with PDW and whole panic disorder compared with HC. CONCLUSIONS These findings suggest that the phobic avoidance found in patients with PDA arise from abnormalities in the medial orbitofrontal cortex, which plays an important role in fear extinction. Future studies should investigate the neuroanatomical substrates of PDA and distinguish them from those of PDW.
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Affiliation(s)
- Kyoung-Sae Na
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, Republic of Korea
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Kim B, Kim MK, Yoo E, Lee JY, Choe AY, Yook KH, Lee KS, Choi TK, Lee SH. Comparison of panic disorder with and without comorbid major depression by using brain structural magnetic resonance imaging. Prog Neuropsychopharmacol Biol Psychiatry 2013; 43:188-96. [PMID: 23313294 DOI: 10.1016/j.pnpbp.2012.12.022] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Revised: 12/26/2012] [Accepted: 12/29/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Strong lifetime and current comorbidity occur between panic disorder and depression. However, no study has examined the influence of comorbid depression on brain structural characteristics in panic disorder patients. We aimed to compare gray matter (GM) volume and white matter (WM) connectivity in panic disorder patients with and without depression. METHODS Twenty-one panic disorder patients without comorbid major depression (PD-D) and seventeen panic disorder patients with major depression (PD+D) were investigated. The Panic Disorder Severity Scale (PDSS) and Beck Depression Inventory (BDI) were assessed for all subjects. Voxel Based Morphometry 5 toolbox and Tract-Based Spatial Statistics were used. RESULTS Compared to the PD-D group, GM volumes of patients with PD+D were significantly increased in a cluster located across the left cingulate gyrus, right medial frontal gyrus, and left paracentral lobule. Clinical symptom severity such as PDSS and BDI scores showed positive correlation with GM volumes in the PD+D group. Of the highlighted regions, the left posterior cingulate gyrus demonstrated both a GM volume difference between the groups and a positive correlation of GM volume with symptom severity in the PD+D group. Fractional anisotropy values were significantly higher across almost all the WM tracts in the PD+D group compared to the PD-D group. CONCLUSION Alteration of GM volume and WM connectivity was associated with comorbid depression in panic disorder patients in this study. These findings suggest that distinct structural characteristics may be related to comorbid depression occurring in the context of panic disorder.
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Affiliation(s)
- Borah Kim
- Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
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Lai CH, Wu YT. Fronto-occipital fasciculus, corpus callosum and superior longitudinal fasciculus tract alterations of first-episode, medication-naïve and late-onset panic disorder patients. J Affect Disord 2013; 146:378-82. [PMID: 23084185 DOI: 10.1016/j.jad.2012.09.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Revised: 09/23/2012] [Accepted: 09/24/2012] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Because of limited knowledge about white matter (WM) tract in panic disorder, we designed this study to investigate alterations of WM tracts in first-episode medication-naïve panic disorder patients. METHODS Thirty patients and 21 normal controls were enrolled into our study. They all received acquisitions of diffusion tensor imaging (DTI) in 30 directions. DTI images of patients and controls were preprocessed and analyzed to estimate differences of WM microintegrity between patients and controls. We obtained fractional anisotropy (FA) values from the DTI images. FA outputs of patients and controls were compared by non-parametric permutation-based method with global brain volume, age, gender and duration of illness as covariates. Correlations between severity of panic symptoms and FA values were also estimated. RESULTS First-episode, medication-naïve and late-onset panic disorder patients had altered integrity in WM tracts of right inferior fronto-occipital fasculi, left body of corpus callosum and left superior longitudinal fasciculus when compared to controls (corrected p<0.05). Negative correlations between PD symptoms and FA values were observed in corpus callosum of patient group (corrected p<0.05). CONCLUSIONS WM tract alterations might represent structural pathophysiology in WM of first-episode, medication-naïve and late-onset panic disorder patients.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei City, Taiwan, ROC.
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Richard JM, Berridge KC. Prefrontal cortex modulates desire and dread generated by nucleus accumbens glutamate disruption. Biol Psychiatry 2013; 73:360-70. [PMID: 22981656 PMCID: PMC3535675 DOI: 10.1016/j.biopsych.2012.08.009] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2012] [Revised: 08/01/2012] [Accepted: 08/08/2012] [Indexed: 12/28/2022]
Abstract
BACKGROUND Corticolimbic circuits, including direct projections from prefrontal cortex to nucleus accumbens (NAc), permit top-down control of intense motivations generated by subcortical circuits. In rats, localized disruptions of glutamate signaling within medial shell of NAc generate desire or dread, anatomically organized along a rostrocaudal gradient analogous to a limbic keyboard. At rostral locations in shell, these disruptions generate appetitive eating, but at caudal locations the disruptions generate progressively fearful behaviors (distress vocalizations, escape attempts, and antipredator reactions). Here, we asked whether medial prefrontal cortex can modulate intense motivations generated by subcortical NAc disruptions. METHODS We used simultaneous microinjections in medial prefrontal cortex regions and in NAc shell to examine whether the desire or dread generated by NAc shell disruptions is modulated by activation/inhibition of three specific regions of prefrontal cortex: medial orbitofrontal cortex, infralimbic cortex (homologous to area 25 or subgenual anterior cingulate in the human), or prelimbic cortex (midventral anterior cingulate). RESULTS We found that activation of medial orbitofrontal cortex biased intense bivalent motivation in an appetitive direction by amplifying generation of eating behavior by middle to caudal NAc disruptions, without altering fear. In contrast, activation of infralimbic prefrontal cortex powerfully and generally suppressed both appetitive eating and fearful behaviors generated by NAc shell disruptions. CONCLUSIONS These results suggest that corticolimbic projections from discrete prefrontal regions can either bias motivational valence or generally suppress subcortically generated intense motivations of desire or fear.
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Affiliation(s)
- Jocelyn M Richard
- Department of Psychology, University of Michigan, Ann Arbor, MI 48109, USA.
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Lai CH, Wu YT. Changes in gray matter volume of remitted first-episode, drug-naïve, panic disorder patients after 6-week antidepressant therapy. J Psychiatr Res 2013; 47:122-7. [PMID: 23079534 DOI: 10.1016/j.jpsychires.2012.09.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 09/19/2012] [Accepted: 09/19/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE This study aimed to investigate changes in the gray matter volume (GMV) of first-episode, remitted drug-naïve patients under 6 weeks of escitalopram treatment for panic disorder (PD). We also determined any persistent GMV deficits after remission to assess for "state-dependent brain changes" and "trait-like brain changes" for PD. METHOD 3-Tesla magnetic resonance imaging structural scans were performed on 21 PD patients at baseline and in their remitted state at week 6 of the study. To account for the inter-scanner bias, 21 healthy controls were also scanned twice within 6 weeks. All structural images were processed and analyzed to estimate GMV differences between patients and controls. We utilized optimized voxel-based morphometry with global brain volume, age, and gender as covariates. We also estimated the correlation between improvements in clinical rating scale scores and changes in total gray matter volumes to confirm the results of optimized voxel-based morphometry. RESULTS Rating scales of panic symptoms improved significantly (corrected p < 0.001). Remitted patients showed increased GMV in the left superior frontal gyrus (corrected p < 0.05) after escitalopram therapy. There were significant GMV deficits in the right precentral gyrus (corrected p < 0.05) after remission of PD symptoms. Changes in total GMV after remission were correlated with changes in clinical scores (r = 0.638; Spearman's rho p = 0.002). CONCLUSION The left superior frontal gyrus (state-dependent brain changes) and the right precentral gyrus (trait-like brain changes) might be implicated in the underlying pathophysiology of PD.
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Affiliation(s)
- Chien-Han Lai
- Department of Psychiatry, Cheng Hsin General Hospital, Taipei City, Taiwan, ROC.
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Lai CH, Wu YT. Fronto-temporo-insula gray matter alterations of first-episode, drug-naïve and very late-onset panic disorder patients. J Affect Disord 2012; 140:285-91. [PMID: 22386047 DOI: 10.1016/j.jad.2012.01.049] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Revised: 01/25/2012] [Accepted: 01/25/2012] [Indexed: 01/04/2023]
Abstract
OBJECTIVE There is no voxel-based morphometry study for first-episode, drug-naïve and very late-onset panic disorder patients. Besides, differences of onset age might represent different clinical subgroups. Therefore we designed this study to investigate gray matter deficits in this subgroup of patients. METHOD 30 patients and 21 normal controls were enrolled into our study. They all received 3T magnetic resonance imaging acquisition for the structural imaging of brain. All the structural images were processed and analyzed to estimate the differences of gray matter volumes between patients and controls. We utilized optimized voxel-based morphometry function implemented in the FSL (FMRIB Software Library) with the agoraphobia, global brain volume, age, gender and duration of illness as covariates. We also performed the voxel-wise linear regression between clinical rating scale scores and gray matter volumes of brain to confirm results of optimized voxel-based morphometry and significant region for physiopathology of very late-onset PD. RESULTS First-episode, drug-naïve and very late-onset panic disorder patients had lower gray matter volumes in left orbitofrontal cortex, left inferior frontal cortex, left superior temporal gyrus and right insula when they were compared to controls (corrected p<0.005, multiple comparisons, cluster threshold: 30 voxels). A negative correlation between PDSS and GMV was observed in right insula using general linear model voxel-wise analysis with age and gender corrected. CONCLUSION Fronto-temporo-insula gray matter deficits might represent the structural pathophysiology of first-episode, drug-naïve and very late-onset panic disorder.
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Dresler T, Guhn A, Tupak SV, Ehlis AC, Herrmann MJ, Fallgatter AJ, Deckert J, Domschke K. Revise the revised? New dimensions of the neuroanatomical hypothesis of panic disorder. J Neural Transm (Vienna). 2013;120:3-29. [PMID: 22692647 DOI: 10.1007/s00702-012-0811-1] [Citation(s) in RCA: 114] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Accepted: 04/16/2012] [Indexed: 12/14/2022]
Abstract
In 2000, Gorman et al. published a widely acknowledged revised version of their 1989 neuroanatomical hypothesis of panic disorder (PD). Herein, a 'fear network' was suggested to mediate fear- and anxiety-related responses: panic attacks result from a dysfunctional coordination of 'upstream' (cortical) and 'downstream' (brainstem) sensory information leading to heightened amygdala activity with subsequent behavioral, autonomic and neuroendocrine activation. Given the emergence of novel imaging methods such as fMRI and the publication of numerous neuroimaging studies regarding PD since 2000, a comprehensive literature search was performed regarding structural (CT, MRI), metabolic (PET, SPECT, MRS) and functional (fMRI, NIRS, EEG) studies on PD, which will be reviewed and critically discussed in relation to the neuroanatomical hypothesis of PD. Recent findings support structural and functional alterations in limbic and cortical structures in PD. Novel insights regarding structural volume increase or reduction, hyper- or hypoactivity, laterality and task-specificity of neural activation patterns emerged. The assumption of a generally hyperactive amygdala in PD seems to apply more to state than trait characteristics of PD, and involvement of further areas in the fear circuit, such as anterior cingulate and insula, is suggested. Furthermore, genetic risk variants have been proposed to partly drive fear network activity. Thus, the present state of knowledge generally supports limbic and cortical prefrontal involvement as originally proposed in the neuroanatomical hypothesis. Some modifications might be suggested regarding a potential extension of the fear circuit, genetic factors shaping neural network activity and neuroanatomically informed clinical subtypes of PD potentially guiding future treatment decisions.
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Fuentes P, Barrós-loscertales A, Bustamante JC, Rosell P, Costumero V, Ávila C. Individual differences in the Behavioral Inhibition System are associated with orbitofrontal cortex and precuneus gray matter volume. Cogn Affect Behav Neurosci 2012; 12:491-8. [DOI: 10.3758/s13415-012-0099-5] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Kühn S, Schubert F, Gallinat J. Structural correlates of trait anxiety: reduced thickness in medial orbitofrontal cortex accompanied by volume increase in nucleus accumbens. J Affect Disord 2011; 134:315-9. [PMID: 21705088 DOI: 10.1016/j.jad.2011.06.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 06/02/2011] [Accepted: 06/02/2011] [Indexed: 11/19/2022]
Abstract
Structural deficiencies within the medial prefrontal cortex have been shown in anxiety-related psychiatric disorders such as panic disorder, post traumatic stress disorder and obsessive compulsive disorder. In healthy subjects, trait anxiety as the individual's disposition to experience anxiety-relevant feelings or thoughts has been shown to be a risk factor for psychiatric disorders. We aimed at exploring the structural correlates of trait anxiety in normal participants. We acquired high-resolution MRI scans from 34 subjects and used FreeSurfer to obtain a measure of cortical thickness. We correlated cortical thickness with self-rated trait anxiety in a whole brain analysis. Automatic subcortical segmentations of the FreeSurfer pipeline were used to relate nucleus accumbens (NAcc) and amygdala volume to trait anxiety. Trait anxiety was negatively correlated with cortical thickness in the right medial orbitofrontal cortex (mOFC) and positively correlated with the bilateral volume of NAcc. Cortical thickness measures extracted from mOFC were negatively associated with the volume of left NAcc. Since, like in anxiety-related psychiatric disorders, in the healthy sample studied here, trait anxiety was associated with a reduction of cortical thickness in mOFC we suggest that this thinning is a structural precondition rather than a consequence of psychiatric illnesses.
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Affiliation(s)
- Simone Kühn
- Faculty of Psychology and Educational Sciences, Department of Experimental Psychology, Ghent University, Ghent Institute for Functional and Metabolic Imaging, Henri Dunantlaan 2, 9000 Gent, Belgium.
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Carless MA, Glahn DC, Johnson MP, Curran JE, Bozaoglu K, Dyer TD, Winkler AM, Cole SA, Almasy L, MacCluer JW, Duggirala R, Moses EK, Göring HH, Blangero J. Impact of DISC1 variation on neuroanatomical and neurocognitive phenotypes. Mol Psychiatry 2011; 16:1096-104, 1063. [PMID: 21483430 DOI: 10.1038/mp.2011.37] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Although disrupted in schizophrenia 1 (DISC1) has been implicated in many psychiatric disorders, including schizophrenia, bipolar disorder, schizoaffective disorder and major depression, its biological role in these disorders is unclear. To better understand this gene and its role in psychiatric disease, we conducted transcriptional profiling and genome-wide association analysis in 1232 pedigreed Mexican-American individuals for whom we have neuroanatomic images, neurocognitive assessments and neuropsychiatric diagnoses. SOLAR was used to determine heritability, identify gene expression patterns and perform association analyses on 188 quantitative brain-related phenotypes. We found that the DISC1 transcript is highly heritable (h(2)=0.50; P=1.97 × 10(-22)), and that gene expression is strongly cis-regulated (cis-LOD=3.89) but is also influenced by trans-effects. We identified several DISC1 polymorphisms that were associated with cortical gray matter thickness within the parietal, temporal and frontal lobes. Associated regions affiliated with memory included the entorhinal cortex (rs821639, P=4.11 × 10(-5); rs2356606, P=4.71 × 10(-4)), cingulate cortex (rs16856322, P=2.88 × 10(-4)) and parahippocampal gyrus (rs821639, P=4.95 × 10(-4)); those affiliated with executive and other cognitive processing included the transverse temporal gyrus (rs9661837, P=5.21 × 10(-4); rs17773946, P=6.23 × 10(-4)), anterior cingulate cortex (rs2487453, P=4.79 × 10(-4); rs3738401, P=5.43 × 10(-4)) and medial orbitofrontal cortex (rs9661837; P=7.40 × 10(-4)). Cognitive measures of working memory (rs2793094, P=3.38 × 10(-4)), as well as lifetime history of depression (rs4658966, P=4.33 × 10(-4); rs12137417, P=4.93 × 10(-4)) and panic (rs12137417, P=7.41 × 10(-4)) were associated with DISC1 sequence variation. DISC1 has well-defined genetic regulation and clearly influences important phenotypes related to psychiatric disease.
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