The vexing role of baseline: Implications for neuroimaging studies of panic disorder

Patterns of fractional amplitude of low-frequency oscillations in occipito-striato-thalamic regions of first-episode drug-naïve panic disorder

OBJECTIVE

This study was designed to investigate patterns of fractional amplitude of low-frequency fluctuations (fALFF, an indicator for the intensity of regional brain spontaneous activities) of patients with first-episode drug-naïve panic disorder (PD).

METHODS

Thirty patients (17 females, 13 males, age: 47.70±10.69 years old) and twenty healthy controls (10 females, 10 males, age: 41.40±13.94 years old) received 3-Tesla resting-state functional magnetic resonance imaging (RFMRI) scanning and the rating of clinical scales. RFMRI data was processed and analyzed by the REST toolbox (resting-state functional MRI data analysis toolbox) to calculate fALFF. fALFF were compared between patients and controls to detect endophenotype of fALFF in patients with first-episode drug-naïve PD.

RESULTS

We found decreased fALFF in right middle occipital gyrus [FDR (false discovery rate) corrected p<0.05, cluster >5 voxles, volume >135mm(3), T threshold: 6.1168, surface connected theory] and increased fALFF in right putamen and right ventral lateral nucleus of thalamus of patients (uncorrected p<0.00005, cluster >5 voxles, volume >135mm(3), T threshold: 4.5439, surface connected theory). fALFF of patients also showed a positive correlation with clinical rating scores of PD in right cuneus.

CONCLUSIONS

Occipito-striato-thalamic dysfunction of fALFF might represent a kind of endophenotype biomarker of first-episode drug-naïve PD.

The role of the amygdala in the pathophysiology of panic disorder: evidence from neuroimaging studies

Although the neurobiological mechanisms underlying panic disorder (PD) are not yet clearly understood, increasing amount of evidence from animal and human studies suggests that the amygdala, which plays a pivotal role in neural network of fear and anxiety, has an important role in the pathogenesis of PD. This article aims to (1) review the findings of structural, chemical, and functional neuroimaging studies on PD, (2) relate the amygdala to panic attacks and PD development, (3) discuss the possible causes of amygdalar abnormalities in PD, (4) and suggest directions for future research.