Uchida RR, Del-Ben CM, Busatto GF, Duran FL, Guimaraes FS, Crippa JA et al. Regional gray matter abnormalities in panic disorder: a voxel-based morphometry study. Psychiatry Res 163: 21-29

Division of Psychiatry, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil.
Psychiatry Research (Impact Factor: 2.47). 06/2008; 163(1):21-9. DOI: 10.1016/j.pscychresns.2007.04.015
Source: PubMed


Although abnormalities in brain structures involved in the neurobiology of fear and anxiety have been implicated in the pathophysiology of panic disorder (PD), relatively few studies have made use of voxel-based morphometry (VBM) magnetic resonance imaging (MRI) to determine structural brain abnormalities in PD. We have assessed gray matter volume in 19 PD patients and 20 healthy volunteers using VBM. Images were acquired using a 1.5 T MRI scanner, and were spatially normalized and segmented using optimized VBM. Statistical comparisons were performed using the general linear model. A relative increase in gray matter volume was found in the left insula of PD patients compared with controls. Additional structures showing differential increases were the left superior temporal gyrus, the midbrain, and the pons. A relative gray matter deficit was found in the right anterior cingulate cortex. The insula and anterior cingulate abnormalities may be relevant to the pathophysiology of PD, since these structures participate in the evaluation process that ascribes negative emotional meaning to potentially distressing cognitive and interoceptive sensory information. The abnormal brain stem structures may be involved in the generation of panic attacks.

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Available from: Fabio Luis De Souza Duran
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    • "Decreased right inferior temporal and frontal gyrus Decreased left superior temporal and frontal gyrus Protopopescu et al., 2006 Basal Increased brainstem volume, specifically in ventral and dorsal midbrain and rostral pons 10 PD (6F) vs. 23 healthy controls (11F) MRI-VBM Agoraphobia, secondary diagnoses included specific phobia, social phobia, GAD, MDD Increased left ventral hippocampal, right occipital, and right middle temporal volumes Decreased frontal (orbitofrontal, right superior frontal gyrus, middle frontal gyrus, precentral gyrus), left middle cingulate gyrus, right caudate, left fusiform gyrus Uchida et al., 2008 Basal Increased gray matter volume: (1) left insula extending to superior temporal gyrus, (2) left insula extending to claustrum and superior portions of temporal lobe, transverse temporal and superior temporal gyri, (3) left portions of the midbrain and pons "
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    • "Mostly involved were amygdala, hippocampus, insula, orbitofrontal (OFC), PFC, temporal and occipital cortical structures [Frick et al., 2013; Irle et al., 2010; Liao et al., 2011; Syal et al., 2012; Talati et al., 2013]. When considering studies in other specific anxiety disorders, the findings are similarly nonconclusive [Table I, Hayano et al., 2009; Rauch et al., 2004; Uchida et al., 2008]. One reason for these results can be the rather small sample sizes (usually between 10 and 30 patients and likewise numbers of healthy subjects). "
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