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de Vos JH, Schruers KRJ, Debard G, Bonroy B, Linden DEJ, Leibold NK. The role of the peripheral and central adrenergic system in the construction of the subjective emotional experience of panic. Psychopharmacology (Berl) 2024; 241:627-635. [PMID: 38363344 PMCID: PMC10884065 DOI: 10.1007/s00213-024-06548-2] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
RATIONALE Although the study of emotions can look back to over 100 years of research, it is unclear which information the brain uses to construct the subjective experience of an emotion. OBJECTIVE In the current study, we assess the role of the peripheral and central adrenergic system in this respect. METHODS Healthy volunteers underwent a double inhalation of 35% CO2, which is a well-validated procedure to induce an intense emotion, namely panic. In a randomized, cross-over design, 34 participants received either a β1-blocker acting selectively in the peripheral nervous system (atenolol), a β1-blocker acting in the peripheral and central nervous system (metoprolol), or a placebo before the CO2 inhalation. RESULTS Heart rate and systolic blood pressure were reduced in both β-blocker conditions compared to placebo, showing effective inhibition of the adrenergic tone. Nevertheless, the subjective experience of the induced panic was the same in all conditions, as measured by self-reported fear, discomfort, and panic symptom ratings. CONCLUSIONS These results indicate that information from the peripheral and central adrenergic system does not play a major role in the construction of the subjective emotion.
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Affiliation(s)
- Jette H de Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616 (VIJV-SN2), 6200 MD, Maastricht, The Netherlands
| | - Koen R J Schruers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616 (VIJV-SN2), 6200 MD, Maastricht, The Netherlands
- Department of Health Psychology, University of Leuven, Leuven, Belgium
- Mondriaan Mental Health Center, Maastricht, The Netherlands
| | - Glen Debard
- Mobilab & Care, Thomas More Kempen, Geel, Belgium
| | - Bert Bonroy
- Mobilab & Care, Thomas More Kempen, Geel, Belgium
| | - David E J Linden
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616 (VIJV-SN2), 6200 MD, Maastricht, The Netherlands
| | - Nicole K Leibold
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, P.O. Box 616 (VIJV-SN2), 6200 MD, Maastricht, The Netherlands.
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de Paula Rodrigues BM, Falconi-Sobrinho LL, de Campos AC, Kanashiro A, Coimbra NC. Panicolytic-like effects of environment enrichment on male mice threatened by Bothrops jararaca lancehead pit vipers. J Neurosci Res 2024; 102:e25300. [PMID: 38361409 DOI: 10.1002/jnr.25300] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 12/01/2023] [Accepted: 01/16/2024] [Indexed: 02/17/2024]
Abstract
Environment enrichment (EE) is a well-known eustress model showing beneficial effects in different psychiatric diseases, but its positive properties in panic disorders are not yet established. The confrontation between prey and predator in complex arenas has been validated as a putative panic attack model. The principal aim of this work was to investigate the role of the EE on panic-like defensive responses elicited by mice threatened by venomous snakes. After 6 weeks of exposure either to an enriched or standard environments, 36 male mice were habituated in a complex polygonal arena for snakes containing an artificial burrow and elevated platforms for escape. The animals were confronted by Bothrops jararaca for 5 min, and the following antipredatory responses were recorded: defensive attention, stretched attend posture, flat back approach, prey versus predator interaction, oriented escape behavior, time spent in a safe place, and number of crossings. Mice threatened by snakes displayed several antipredatory reactions as compared to the exploratory behavior of those animals submitted to a nonthreatening situation (toy snake) in the same environment. Notably, EE causes anxiolytic- and panicolytic-like effects significantly decreasing the defensive attention and time spent in safe places and significantly increasing both prey versus predator interaction and exploratory behavior. In conclusion, our data demonstrate that EE can alter the processing of fear modulation regarding both anxiety- and panic-like responses in a dangerous condition, significantly modifying the decision-making defensive strategy.
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Affiliation(s)
- Bruno Mangili de Paula Rodrigues
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- NAP-USP-Neurobiology of Emotions (NuPNE) Research Center, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- Ophidiarium LNN-FMRP-USP/INeC, Ribeirão Preto School of Medicine of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
| | - Luiz Luciano Falconi-Sobrinho
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- NAP-USP-Neurobiology of Emotions (NuPNE) Research Center, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- Ophidiarium LNN-FMRP-USP/INeC, Ribeirão Preto School of Medicine of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- Behavioural Neurosciences Institute (INeC), Ribeirão Preto, Brazil
| | - Alline Cristina de Campos
- Pharmacology of Neuroplasticity Laboratory, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo, Ribeirão Preto, Brazil
| | - Alexandre Kanashiro
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- Ophidiarium LNN-FMRP-USP/INeC, Ribeirão Preto School of Medicine of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- Behavioural Neurosciences Institute (INeC), Ribeirão Preto, Brazil
- Medical Sciences Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Norberto Cysne Coimbra
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- NAP-USP-Neurobiology of Emotions (NuPNE) Research Center, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- Ophidiarium LNN-FMRP-USP/INeC, Ribeirão Preto School of Medicine of the University of São Paulo (FMRP-USP), Ribeirão Preto, Brazil
- Behavioural Neurosciences Institute (INeC), Ribeirão Preto, Brazil
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Bernabe CS, Caliman IF, de Abreu ARR, Molosh AI, Truitt WA, Shekhar A, Johnson PL. Identification of a novel perifornical-hypothalamic-area-projecting serotonergic system that inhibits innate panic and conditioned fear responses. Transl Psychiatry 2024; 14:60. [PMID: 38272876 PMCID: PMC10811332 DOI: 10.1038/s41398-024-02769-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 01/06/2024] [Accepted: 01/10/2024] [Indexed: 01/27/2024] Open
Abstract
The serotonin (5-HT) system is heavily implicated in the regulation of anxiety and trauma-related disorders such as panic disorder and post-traumatic stress disorder, respectively. However, the neural mechanisms of how serotonergic neurotransmission regulates innate panic and fear brain networks are poorly understood. Our earlier studies have identified that orexin (OX)/glutamate neurons within the perifornical hypothalamic area (PFA) play a critical role in adaptive and pathological panic and fear. While site-specific and electrophysiological studies have shown that intracranial injection and bath application of 5-HT inhibits PFA neurons via 5-HT1a receptors, they largely ignore circuit-specific neurotransmission and its physiological properties that occur in vivo. Here, we investigate the role of raphe nuclei 5-HT inputs into the PFA in panic and fear behaviors. We initially confirmed that photostimulation of glutamatergic neurons in the PFA of rats produces robust cardioexcitation and flight/aversive behaviors resembling panic-like responses. Using the retrograde tracer cholera toxin B, we determined that the PFA receives discrete innervation of serotonergic neurons clustered in the lateral wings of the dorsal (lwDRN) and in the median (MRN) raphe nuclei. Selective lesions of these serotonergic projections with saporin toxin resulted in similar panic-like responses during the suffocation-related CO2 challenge and increased freezing to fear-conditioning paradigm. Conversely, selective stimulation of serotonergic fibers in the PFA attenuated both flight/escape behaviors and cardioexcitation responses elicited by the CO2 challenge and induced conditioned place preference. The data here support the hypothesis that PFA projecting 5-HT neurons in the lwDRN/MRN represents a panic/fear-off circuit and may also play a role in reward behavior.
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Affiliation(s)
- Cristian S Bernabe
- Department of Anatomy, Cellular Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
- Department of Medicine, Division of Clinical Pharmacology, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Izabela F Caliman
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Aline R R de Abreu
- Departamento de Alimentos, Escola de Nutrição da Universidade Federal de Ouro Preto, Ouro Preto, MG, Brazil
| | - Andrei I Molosh
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - William A Truitt
- Department of Anatomy, Cellular Biology & Physiology, Indiana University School of Medicine, Indianapolis, IN, USA.
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Anantha Shekhar
- School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Philip L Johnson
- Department of Biology, University of South Dakota, Vermillion, SD, USA
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Müller JC, Walter C, Leibold N, Wiedemann K, Kellner M, Demiralay C. Copeptin response to panic provocation with CO 2 in healthy adults. J Psychiatr Res 2023; 165:225-232. [PMID: 37517243 DOI: 10.1016/j.jpsychires.2023.07.006] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 06/27/2023] [Accepted: 07/06/2023] [Indexed: 08/01/2023]
Abstract
Repeated panic attacks are the core symptom of panic disorder and severely stressful for patients. Additional to the psychological response, the physiological symptoms are an important aspect of the experienced panic. However, data on the extent of hypothalamic-pituitary-adrenal (HPA)-axis activation during panic attacks is inconsistent. Therefore, in the present study, we aimed at investigating the stress-axis activity in more detail by including Copeptin (CoP) as a stable surrogate parameter for the vasopressinergic hypothalamic activity during experimentally induced panic attacks in healthy adults (N = 21). During a placebo-controlled panic challenge with 35% CO2 compared to normal air inhalation, we measured CoP and the peripheral effector hormones Adrenocorticotropic Releasing Hormone (ACTH) and cortisol in plasma along with the psychological response to panic anxiety. We analyzed hormonal secretion patterns, their correlations and individual panic ratings over time and explored differences between female and male participants. We found a significant CO2-induced increase of CoP plasma levels and psychological panic symptoms after CO2-administration, while no positive correlations of CoP levels with the peripheral HPA-axis hormones and with panic symptoms were present. No differences between female and male participants concerning their psychological response nor their baseline CoP levels, the release of CoP or its increase during the experiment were found. CoP could be a sensitive indicator for an organism's physiologic acute hypothalamic response during stress and panic attacks.
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Affiliation(s)
- Jana Christina Müller
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Straße 52, 20251, Hamburg, Germany.
| | - Charlotte Walter
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Straße 52, 20251, Hamburg, Germany
| | - Nicole Leibold
- Department of Psychiatry and Neuropsychology, Maastricht University, P.O. Box 616 (location Vijverdal), 6200, MD, Maastricht, Netherlands
| | - Klaus Wiedemann
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Straße 52, 20251, Hamburg, Germany
| | - Michael Kellner
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Straße 52, 20251, Hamburg, Germany; Department of Psychiatry and Psychotherapy, University Hospital rechts der Isar, Technical University Munich, Ismaninger Straße 22, 81675, München, Germany
| | - Cüneyt Demiralay
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martini Straße 52, 20251, Hamburg, Germany; Oberberg Tagesklinik Hamburg, Hermannstraße, 20095, Hamburg, Germany
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5
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Bentall RP, Lloyd A, Bennett K, McKay R, Mason L, Murphy J, McBride O, Hartman TK, Gibson-Miller J, Levita L, Martinez AP, Stocks TVA, Butter S, Vallières F, Hyland P, Karatzias T, Shevlin M. Pandemic buying: Testing a psychological model of over-purchasing and panic buying using data from the United Kingdom and the Republic of Ireland during the early phase of the COVID-19 pandemic. PLoS One 2021; 16:e0246339. [PMID: 33503049 PMCID: PMC7840055 DOI: 10.1371/journal.pone.0246339] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [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: 08/19/2020] [Accepted: 01/15/2021] [Indexed: 01/25/2023] Open
Abstract
The over-purchasing and hoarding of necessities is a common response to crises, especially in developed economies where there is normally an expectation of plentiful supply. This behaviour was observed internationally during the early stages of the Covid-19 pandemic. In the absence of actual scarcity, this behaviour can be described as 'panic buying' and can lead to temporary shortages. However, there have been few psychological studies of this phenomenon. Here we propose a psychological model of over-purchasing informed by animal foraging theory and make predictions about variables that predict over-purchasing by either exacerbating or mitigating the anticipation of future scarcity. These variables include additional scarcity cues (e.g. loss of income), distress (e.g. depression), psychological factors that draw attention to these cues (e.g. neuroticism) or to reassuring messages (eg. analytical reasoning) or which facilitate over-purchasing (e.g. income). We tested our model in parallel nationally representative internet surveys of the adult general population conducted in the United Kingdom (UK: N = 2025) and the Republic of Ireland (RoI: N = 1041) 52 and 31 days after the first confirmed cases of COVID-19 were detected in the UK and RoI, respectively. About three quarters of participants reported minimal over-purchasing. There was more over-purchasing in RoI vs UK and in urban vs rural areas. When over-purchasing occurred, in both countries it was observed across a wide range of product categories and was accounted for by a single latent factor. It was positively predicted by household income, the presence of children at home, psychological distress (depression, death anxiety), threat sensitivity (right wing authoritarianism) and mistrust of others (paranoia). Analytic reasoning ability had an inhibitory effect. Predictor variables accounted for 36% and 34% of the variance in over-purchasing in the UK and RoI respectively. With some caveats, the data supported our model and points to strategies to mitigate over-purchasing in future crises.
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Affiliation(s)
| | - Alex Lloyd
- Royal Holloway, University of London, Egham, England
| | | | - Ryan McKay
- Royal Holloway, University of London, Egham, England
| | - Liam Mason
- University College London, London, England
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Molosh AI, Dustrude ET, Lukkes JL, Fitz SD, Caliman IF, Abreu ARR, Dietrich AD, Truitt WA, Ver Donck L, Ceusters M, Kent JM, Johnson PL, Shekhar A. Panic results in unique molecular and network changes in the amygdala that facilitate fear responses. Mol Psychiatry 2020; 25:442-460. [PMID: 30108314 PMCID: PMC6410355 DOI: 10.1038/s41380-018-0119-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 10/13/2017] [Revised: 04/03/2018] [Accepted: 05/25/2018] [Indexed: 11/12/2022]
Abstract
Recurrent panic attacks (PAs) are a common feature of panic disorder (PD) and post-traumatic stress disorder (PTSD). Several distinct brain regions are involved in the regulation of panic responses, such as perifornical hypothalamus (PeF), periaqueductal gray, amygdala and frontal cortex. We have previously shown that inhibition of GABA synthesis in the PeF produces panic-vulnerable rats. Here, we investigate the mechanisms by which a panic-vulnerable state could lead to persistent fear. We first show that optogenetic activation of glutamatergic terminals from the PeF to the basolateral amygdala (BLA) enhanced the acquisition, delayed the extinction and induced the persistence of fear responses 3 weeks later, confirming a functional PeF-amygdala pathway involved in fear learning. Similar to optogenetic activation of PeF, panic-prone rats also exhibited delayed extinction. Next, we demonstrate that panic-prone rats had altered inhibitory and enhanced excitatory synaptic transmission of the principal neurons, and reduced protein levels of metabotropic glutamate type 2 receptor (mGluR2) in the BLA. Application of an mGluR2-positive allosteric modulator (PAM) reduced glutamate neurotransmission in the BLA slices from panic-prone rats. Treating panic-prone rats with mGluR2 PAM blocked sodium lactate (NaLac)-induced panic responses and normalized fear extinction deficits. Finally, in a subset of patients with comorbid PD, treatment with mGluR2 PAM resulted in complete remission of panic symptoms. These data demonstrate that a panic-prone state leads to specific reduction in mGluR2 function within the amygdala network and facilitates fear, and mGluR2 PAMs could be a targeted treatment for panic symptoms in PD and PTSD patients.
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Affiliation(s)
- A I Molosh
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
- Paul and Carol Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - E T Dustrude
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - J L Lukkes
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - S D Fitz
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - I F Caliman
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A R R Abreu
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A D Dietrich
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - W A Truitt
- Paul and Carol Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - L Ver Donck
- Janssen Research & Development, Beerse, Belgium
| | - M Ceusters
- Janssen Research & Development, Beerse, Belgium
| | - J M Kent
- Janssen Research & Development, LLC, Titusville, NJ, USA
| | - P L Johnson
- Paul and Carol Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - A Shekhar
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, IN, USA.
- Paul and Carol Stark Neurosciences 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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Uribe-Mariño A, Castiblanco-Urbina MA, Falconi-Sobrinho LL, Dos Anjos-Garcia T, de Oliveira RC, Mendes-Gomes J, da Silva Soares R, Matthiesen M, Almada RC, de Oliveira R, Coimbra NC. The alpha- and beta-noradrenergic receptors blockade in the dorsal raphe nucleus impairs the panic-like response elaborated by medial hypothalamus neurons. Brain Res 2019; 1725:146468. [PMID: 31541642 DOI: 10.1016/j.brainres.2019.146468] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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] [Received: 06/05/2019] [Revised: 09/13/2019] [Accepted: 09/17/2019] [Indexed: 12/16/2022]
Abstract
Dorsal raphe nucleus (DRN) neurons are reciprocally connected to the locus coeruleus (LC) and send neural pathways to the medial hypothalamus (MH). The aim of this work was to investigate whether the blockade of α1-, α2- or β-noradrenergic receptors in the DRN or the inactivation of noradrenergic neurons in the LC modify defensive behaviours organised by MH neurons. For this purpose, Wistar male rats received microinjections of WB4101, RX821002, propranolol (α1-, α2- and β-noradrenergic receptor antagonists, respectively) or physiological saline in the DRN, followed 10 min later by MH GABAA receptor blockade. Other groups of animals received DSP-4 (a noradrenergic neurotoxin), physiological saline or only a needle insertion (sham group) into the LC, and 5 days later, bicuculline or physiological saline was administered in the MH. In all these cases, after MH treatment, the frequency and duration of defensive responses were recorded over 15 min. An anterograde neural tract tracer was also deposited in the DRN. DRN neurons send pathways to lateral and dorsomedial hypothalamus. Blockade of α1- and β-noradrenergic receptors in the DRN decreased escape reactions elicited by bicuculline microinjections in the MH. In addition, a significant increase in anxiety-like behaviours was observed after the blockade of α2-noradrenergic receptors in the DRN. LC pretreatment with DSP-4 decreased both anxiety- and panic attack-like behaviours evoked by GABAA receptor blockade in the MH. In summary, the present findings suggest that the norepinephrine-mediated system modulates defensive reactions organised by MH neurons at least in part via noradrenergic receptors recruitment on DRN neurons.
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Affiliation(s)
- Andrés Uribe-Mariño
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Department of Stress Neurobiology and Neurogenetics, Max Planck Institute of Psychiatry, Kraepelinstraße 2-10, 80804 Munich, Germany
| | - Maria Angélica Castiblanco-Urbina
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Institute of Developmental Genetics, Helmholtz-Zentrum München-German Research Centre for Environmental Health (GmbH), Ingolstaedter Landstrasse 1, Neuherberg, Germany
| | - Luiz Luciano Falconi-Sobrinho
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Avenida do Café, 2450, Ribeirão Preto 14220-030, São Paulo, Brazil
| | - Tayllon Dos Anjos-Garcia
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Avenida do Café, 2450, Ribeirão Preto 14220-030, São Paulo, Brazil
| | - Rithiele Cristina de Oliveira
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Avenida do Café, 2450, Ribeirão Preto 14220-030, São Paulo, Brazil
| | - Joyce Mendes-Gomes
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Avenida do Café, 2450, Ribeirão Preto 14220-030, São Paulo, Brazil
| | - Raimundo da Silva Soares
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil
| | - Melina Matthiesen
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil
| | - Rafael Carvalho Almada
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Avenida do Café, 2450, Ribeirão Preto 14220-030, São Paulo, Brazil
| | - Ricardo de Oliveira
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Avenida do Café, 2450, Ribeirão Preto 14220-030, São Paulo, Brazil; Health Sciences Institute, Mato Grosso Federal University Medical School (UFMT), Av. Alexandre Ferronato, 1200, Reserva 35, Setor industrial, 78550-000 Sinop, Mato Grosso, Brazil
| | - Norberto Cysne Coimbra
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; NAP-USP-Neurobiology of Emotions Research Centre (NuPNE), Ribeirão Preto Medical School of the University of São Paulo (FMRP-USP), Av. Bandeirantes, 3900, Ribeirão Preto 14049-900, São Paulo, Brazil; Behavioural Neurosciences Institute (INeC), Avenida do Café, 2450, Ribeirão Preto 14220-030, São Paulo, Brazil.
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8
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Walton L. The panic triangle: onset of panic in scuba divers. Undersea Hyperb Med 2018; 45:505-509. [PMID: 30428239] [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] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Panic arising from physical or psychological stress is a common issue in reported incidents and accidents in scuba diving. Due to its effect on perception, thinking and diver behavior, the panic reaction is often a significant factor in the generation or escalation of problems, potentially leading to injuries and fatalities. The instinctive behaviors associated with panic are incompatible with the constraints of scuba diving (e.g., flight response to threat, leading to rapid ascent). Although the dangers are well known, the psychological mechanisms of panic and the implications for prevention/risk reduction are not sufficiently highlighted to recreational divers. In applied psychology, there are grounded theoretical models which describe the onset and maintenance of anxiety and panic, and an evidence base for approaches to anxiety management. For example, these models are used within structured psychological approaches for people experiencing anxiety disorders; and panic attacks are resolvable. Based on these models and underlying theory, this article proposes a new, accessible model for panic in divers. The potential uses of the model are to: (1) provide a simple framework for divers to understand the onset of panic; (2) promote the need for adequate training; (3) describe the importance of staying within training standards, qualifications and personal limitations; (4) support diver and dive educator understanding of individual factors in panic reactions (e.g. psychiatric conditions) placing greater emphasis on psychological fitness to dive; and (5) draw attention to approaches to improved regulation of emotion and promote individual responsibility.
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Abstract
This study looked at the prevalence of panic attacks and panic disorder in a British population. Three thousand people (aged 18–65) registered with a Leicester general practice were sent a postal questionnaire which screened for panic attacks. Where appropriate this was followed by a diagnostic interview. Preliminary results are reported for the first 1500 subjects sampled. Panic attacks are a common experience in the study population (7.5% of responders experienced them around the time of the interview). Panic disorder was diagnosed in about 3% of responders.
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Affiliation(s)
- R F Stirton
- Department of Psychiatry, University of Leicester
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10
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Medel-Matus JS, Shin D, Sankar R, Mazarati A. Kindling epileptogenesis and panic-like behavior: Their bidirectional connection and contribution to epilepsy-associated depression. Epilepsy Behav 2017; 77:33-38. [PMID: 29107199 PMCID: PMC5705456 DOI: 10.1016/j.yebeh.2017.10.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [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: 08/11/2017] [Revised: 09/28/2017] [Accepted: 10/01/2017] [Indexed: 11/17/2022]
Abstract
Anxiety is one of the most common comorbidities of epilepsy, which has major detrimental effects on the quality of life. Generalized anxiety disorder (GAD) associated with epilepsy has been receiving most attention. However, several other forms of anxiety reportedly present in patients with epilepsy, including panic disorder (PD). In this study, using an animal model of limbic epilepsy, we examined the interplay between epilepsy and panic-like behavior (PLB). Further, considering the high degree of comorbidity between depression on the one hand, and both epilepsy and PD on the other hand, we studied whether and how the presence of PLB in animals with epilepsy would affect their performance in depression-relevant tests. Fifty-day-old male Wistar rats were subjected to repeated alternating electrical stimulations of the basolateral amygdala (BLA) to induce kindling of limbic seizures, and the dorsal periaqueductal gray (DPAG) to induce panic-like episodes. Seizure susceptibility and panic reaction threshold were examined before the first and 24h after the last stimulation. At the end of the stimulations, the rats were examined in depression-relevant tests: saccharin preference test (SPT) for anhedonia and forced swimming test (FST) for despair/hopelessness. With regard to kindling, BLA+DPAG stimulation induced more profound increase of seizure susceptibility than BLA stimulation alone (evident as the reduction of the afterdischarge threshold and the increase of the afterdischarge duration). With regard to PLB, the BLA+DPAG stimulation exacerbated the severity of panic-like episodes, as compared with the DPAG stimulation alone. Basolateral amygdala stimulation alone had no effects on panic-like reactions, and DPAG stimulation alone did not modify kindling epileptogenesis. Combined stimulation of BLA and DPAG induced depressive-like behavioral impairments. This is the first experimental study showing bidirectional, mutually exacerbating effect of epilepsy and PLB, and the precipitation of depressive-like state by the epilepsy-PLB comorbidity.
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Affiliation(s)
| | - Don Shin
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Raman Sankar
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; UCLA Children's Discovery and Innovation Institute, Los Angeles, CA, USA
| | - Andrey Mazarati
- Department of Pediatrics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; UCLA Children's Discovery and Innovation Institute, Los Angeles, CA, USA
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11
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Shahhoseini Z, Sarvi M. Collective movements of pedestrians: How we can learn from simple experiments with non-human (ant) crowds. PLoS One 2017; 12:e0182913. [PMID: 28854221 PMCID: PMC5576663 DOI: 10.1371/journal.pone.0182913] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 04/26/2017] [Accepted: 07/26/2017] [Indexed: 11/27/2022] Open
Abstract
Introduction Understanding collective behavior of moving organisms and how interactions between individuals govern their collective motion has triggered a growing number of studies. Similarities have been observed between the scale-free behavioral aspects of various systems (i.e. groups of fish, ants, and mammals). Investigation of such connections between the collective motion of non-human organisms and that of humans however, has been relatively scarce. The problem demands for particular attention in the context of emergency escape motion for which innovative experimentation with panicking ants has been recently employed as a relatively inexpensive and non-invasive approach. However, little empirical evidence has been provided as to the relevance and reliability of this approach as a model of human behaviour. Methods This study explores pioneer experiments of emergency escape to tackle this question and to connect two forms of experimental observations that investigate the collective movement at macroscopic level. A large number of experiments with human and panicking ants are conducted representing the escape behavior of these systems in crowded spaces. The experiments share similar architectural structures in which two streams of crowd flow merge with one another. Measures such as discharge flow rates and the probability distribution of passage headways are extracted and compared between the two systems. Findings Our findings displayed an unexpected degree of similarity between the collective patterns emerged from both observation types, particularly based on aggregate measures. Experiments with ants and humans commonly indicated how significantly the efficiency of motion and the rate of discharge depend on the architectural design of the movement environment. Practical applications Our findings contribute to the accumulation of evidence needed to identify the boarders of applicability of experimentation with crowds of non-human entities as models of human collective motion as well as the level of measurements (i.e. macroscopic or microscopic) and the type of contexts at which reliable inferences can be drawn. This particularly has implications in the context of experimenting evacuation behaviour for which recruiting human subjects may face ethical restrictions. The findings, at minimum, offer promise as to the potential benefit of piloting such experiments with non-human crowds, thereby forming better-informed hypotheses.
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Affiliation(s)
- Zahra Shahhoseini
- Centre for Disaster Management and Public Safety, School of Engineering, The University of Melbourne, Australia
- * E-mail:
| | - Majid Sarvi
- Centre for Disaster Management and Public Safety, School of Engineering, The University of Melbourne, Australia
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12
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Abstract
BACKGROUND Distress intolerance is linked to the maintenance of panic disorder and cigarette smoking, and may underlie both problems. METHOD Smokers (n = 54; 40.7% panic disorder) were recruited for an experimental study; half were randomly assigned to 12-hour nicotine deprivation and half smoked as usual. The current investigation consisted of secondary, exploratory analyses from this larger experimental study. Four distress intolerance indices were examined as predictors of anxious responding to an emotional elicitation task (10% carbon dioxide (CO2)-enriched air challenge); anxious responding was in turn examined as a predictor of post-challenge panic and nicotine withdrawal symptoms. RESULTS The Distress Tolerance Scale (DTS) was significantly negatively associated with anxious responding to the challenge (β = -0.41, p = 0.017). The DTS was negatively associated with post-challenge increases nicotine withdrawal symptoms indirectly through the effect of anxious responding to the challenge (b = -0.485, CI95% (-1.095, -0.033)). This same indirect effect was found for post-challenge severity of panic symptoms (b = -0.515, CI95% (-0.888, -0.208)). The DTS was directly predictive of post-challenge increases nicotine withdrawal symptoms, in the opposite direction (β = 0.37, p = 0.009), but not panic symptom severity. CONCLUSIONS Anxious responding in response to stressful experiences may explain the impact of perceived distress intolerance on panic and nicotine withdrawal symptom expression.
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Affiliation(s)
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, USA Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael W Otto
- Department of Psychology, Boston University, Boston, MA, USA
| | - Teresa M Leyro
- Department of Psychology, Rutgers - The State University of New Jersey, New Brunswick, NJ, USA
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13
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Thordardottir EB, Valdimarsdottir UA, Hansdottir I, Resnick H, Shipherd JC, Gudmundsdottir B. Posttraumatic stress and other health consequences of catastrophic avalanches: A 16-year follow-up of survivors. J Anxiety Disord 2015; 32:103-11. [PMID: 25935315 DOI: 10.1016/j.janxdis.2015.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 09/24/2014] [Revised: 02/19/2015] [Accepted: 03/09/2015] [Indexed: 11/18/2022]
Abstract
To date, no study has investigated the effects of avalanches on survivor's health beyond the first years. The aim of this study was to examine long-term health status 16 years after exposure to avalanches using a matched cohort design. Mental health, sleep quality and somatic symptoms among avalanche survivors (n=286) and non-exposed controls (n=357) were examined. Results showed that 16% of survivors currently experience avalanche-specific PTSD symptoms (PDS score>14). In addition, survivors presented with increased risk of PTSD hyperarousal symptoms (>85th percentile) (aRR=1.83; 98.3% CI [1.23-2.74]); sleep-related problems (PSQI score>5) (aRR=1.34; 95% CI [1.05-1.70]); PTSD-related sleep disturbances (PSQI-A score≥4) (aRR=1.86; 95% CI [1.30-2.67]); musculoskeletal and nervous system problems (aRR 1.43; 99% CI 1.06-1.93) and gastrointestinal problems (aRR 2.16; 99% CI 1.21-3.86) compared to the unexposed group. Results highlight the need for treatment for long-term PTSD symptoms and sleep disruption in disaster communities.
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Affiliation(s)
- Edda Bjork Thordardottir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland.
| | - Unnur Anna Valdimarsdottir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA
| | - Ingunn Hansdottir
- Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Heidi Resnick
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, USA
| | - Jillian C Shipherd
- National Center for PTSD, VA Boston Healthcare System, USA; Department of Psychiatry, Boston University School of Medicine, USA
| | - Berglind Gudmundsdottir
- Centre of Public Health Sciences, Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Faculty of Psychology, School of Health Sciences, University of Iceland, Reykjavik, Iceland; Mental Health Services, Landspitali - The National University Hospital of Iceland, Iceland
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14
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Volchegorskiĭ IA, Miroshnichenko II, Rassokhina LM, Faĭzullin RM. [Experimental study of 3-oxypiridine and succinic acid derivates antidepressant activity in mice]. Eksp Klin Farmakol 2013; 76:6-10. [PMID: 24006608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Effect of Russian 3-oxypiridine and succinic acid derivatives (emoxipin, reamberin and mexidol) on duration of behavioral despair in mice in forced swimming test (by Porsolot) and tail suspension test (by Steru) was investigated. In addition impact assessment of studied medicinal products (MP) on animals' behavior in open field test was performed. Amitriptyline and alpha-lipoic acid were used as reference drugs. It was determined that single delivery of all studied drugs in optimal doses eqvivalent to therapeutic range for human reduces lasting of behavioral despair in Porsolot and Steru tests. This effect of reamberin, mexidol and alpha-lipoic acid indicates their antidepressant action unrelated to stimulatory activity, as far as these MPs like amitriptyline show sedative action in open field test. Reduction of behavioral despair due to effect of emoxipin in relative low doses was associated with increase of mice activity in open field test and so it can't be considered to be antidepressant action per se. Increase of emoxipin dose leads to progressive decrease of its stimulatory effect impact in behavioral despair reduction and induce antidepressant effect in the setting of sedation.
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15
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Brandt CP, Johnson KA, Schmidt NB, Zvolensky MJ. Main and interactive effects of emotion dysregulation and breath-holding duration in relation to panic-relevant fear and expectancies about anxiety-related sensations among adult daily smokers. J Anxiety Disord 2012; 26:173-81. [PMID: 22119451 PMCID: PMC3254822 DOI: 10.1016/j.janxdis.2011.10.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [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: 05/26/2011] [Revised: 10/27/2011] [Accepted: 10/30/2011] [Indexed: 11/21/2022]
Abstract
The current study investigated the main and interactive effects of emotion dysregulation and distress tolerance in relation to panic-relevant variables among daily smokers. The sample consisted of 172 adults (61.2% male; M(age)=31.58, SD=11.51), who reported smoking an average of 15.99 cigarettes per day (SD=10.00). Results indicated that both emotion dysregulation and distress tolerance were significantly related to interoceptive fear and agoraphobia. Additionally, emotion dysregulation, but not distress tolerance, was significantly related to anxiety sensitivity. All effects were evident above and beyond the variance accounted for by average cigarettes per day, tobacco-related physical illness, and panic attack history. The interaction between emotion dysregulation and distress tolerance significantly predicted interoceptive and agoraphobic fears as well as the cognitive component of anxiety sensitivity. Such findings underscore the importance of emotion dysregulation and distress tolerance in regard to panic-specific fear and expectancies about anxiety-related sensations among daily smokers.
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Affiliation(s)
- Charles P Brandt
- Department of Psychology, University of Houston, 126 Heyne Building, Houston, TX 77204-5502, USA
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16
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Abstract
A panic response is an adaptive response to deal with an imminent threat and consists of an integrated pattern of behavioral (aggression, fleeing, or freezing) and increased cardiorespiratory and endocrine responses that are highly conserved across vertebrate species. In the 1920s and 1940s, Philip Bard and Walter Hess, respectively, determined that the posterior regions of the hypothalamus are critical for a "fight-or-flight" reaction to deal with an imminent threat. Since the 1940s it was determined that the posterior hypothalamic panic area was located dorsal (perifornical hypothalamus: PeF) and dorsomedial (dorsomedial hypothalamus: DMH) to the fornix. This area is also critical for regulating circadian rhythms and in 1998, a novel wake-promoting neuropeptide called orexin (ORX)/hypocretin was discovered and determined to be almost exclusively synthesized in the DMH/PeF perifornical hypothalamus and adjacent lateral hypothalamus. The most proximally emergent role of ORX is in regulation of wakefulness through interactions with efferent systems that mediate arousal and energy homeostasis. A hypoactive ORX system is also linked to narcolepsy. However, ORX role in more complex emotional responses is emerging in more recent studies where ORX is linked to depression and anxiety states. Here, we review data that demonstrates ORX ability to mobilize a coordinated adaptive panic/defense response (anxiety, cardiorespiratory, and endocrine components), and summarize the evidence that supports a hyperactive ORX system being linked to pathological panic and anxiety states.
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Affiliation(s)
- Philip L Johnson
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA.
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17
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Barrera TL, Wilson KP, Norton PJ. The experience of panic symptoms across racial groups in a student sample. J Anxiety Disord 2010; 24:873-8. [PMID: 20621442 PMCID: PMC2956784 DOI: 10.1016/j.janxdis.2010.06.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2009] [Revised: 06/03/2010] [Accepted: 06/15/2010] [Indexed: 12/01/2022]
Abstract
While there is general agreement that, across cultures, panic disorder appears to be characterized by sudden onset of bodily sensations, such as dizziness and heart palpitations, followed by catastrophic misinterpretations of these symptoms, there remains a need for research investigating ethnic/cultural differences in the experience of panic attacks. In addition to investigating ethnic differences in the experience of panic, it is important to assess whether increased endorsement of panic symptoms translates into increased dysfunction. The present study investigated differences in the experience of panic attacks and examined the relation between symptom endorsement and overall distress and impairment in a large multiracial/ethnic student population. Preliminary analyses indicated that although overall endorsement of panic symptoms was similar across groups, differences did emerge on specific symptoms. Participants identifying as Asian tended to endorse symptoms such as dizziness, unsteadiness, choking, and feeling terrified more frequently than those identifying as Caucasian, and individuals identifying as African American reported feeling less nervous than those identifying as Caucasian. Participants of Hispanic/Latino(a) descent showed no differences from any other group on symptom endorsement. Panic symptom severity was not found to differ across racial/ethnic groups; however, the correlation between panic symptoms and panic severity was stronger for Asian and Caucasian participants than for African Americans. These results suggest that symptoms of panic may be experienced differently across racial/ethnic groups, and highlight the need for clinicians and researchers to assess panic symptoms within the context of culture.
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18
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Marshall EC, Johnson K, Bergman J, Gibson LE, Zvolensky MJ. Anxiety sensitivity and panic reactivity to bodily sensations: relation to quit-day (acute) nicotine withdrawal symptom severity among daily smokers making a self-guided quit attempt. Exp Clin Psychopharmacol 2009; 17:356-364. [PMID: 19803635 PMCID: PMC2913276 DOI: 10.1037/a0016883] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [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: 11/08/2022]
Abstract
The current investigation explored the main and interactive effects of panic attacks in response to laboratory-induced bodily sensations and anxiety sensitivity in predicting acute nicotine withdrawal symptoms among daily smokers making a self-guided quit attempt. Participants were 99 daily smokers (58% women; M(age) = 28.4 years, SD = 11.7) who completed a battery of questionnaires, a voluntary hyperventilation challenge, and a measure of nicotine withdrawal symptoms 12 hr after making a self-guided quit attempt. Results indicated that the interaction of anxiety sensitivity and panic responsivity to the challenge predicted quit-day nicotine withdrawal symptom severity above and beyond the main effects (p < .05). The form of the interaction indicated that the relationship between postchallenge panic attack status and acute nicotine withdrawal was more robust among individuals who were low in anxiety sensitivity. Individuals who did not experience a panic attack posthyperventilation who were also low in anxiety sensitivity reported the lowest levels of nicotine withdrawal. Results suggest that anxiety sensitivity may be less relevant with regard to acute nicotine withdrawal severity among individuals with panic-related problems.
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19
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Lim LW, Blokland A, Visser-Vandewalle V, Vlamings R, Sesia T, Steinbusch H, Schruers K, Griez E, Temel Y. High-frequency stimulation of the dorsolateral periaqueductal gray and ventromedial hypothalamus fails to inhibit panic-like behaviour. Behav Brain Res 2008; 193:197-203. [PMID: 18582503 DOI: 10.1016/j.bbr.2008.05.020] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2008] [Revised: 05/16/2008] [Accepted: 05/19/2008] [Indexed: 11/19/2022]
Abstract
Electrical stimulation of the dorsolateral periaqueductal gray (dlPAG) and one of its target structures, the ventromedial hypothalamus (VMH), produces a typical behaviour in rats consisting of vigorous running and jumping which is known as "escape behaviour". Escape behaviour in rodents closely mimics panic attacks in humans. Since electrical stimulation at higher frequencies generally inhibits the stimulated region, we tested in this study the hypothesis that deep brain stimulation (DBS) of the dlPAG and VMH at higher frequencies (> 100 Hz) would not induce escape behaviour. More specifically, we evaluated whether experimental DBS could be used to inhibit panic-like behaviour. Rats underwent implantation of DBS-electrodes at the level of the dlPAG and VMH and the effects of various stimulation parameters were assessed. In addition, we studied the neural activation pattern resulting from DBS of the dlPAG and VMH using c-Fos immunohistochemistry. We found that stimulation amplitude is the most important stimulation parameter in the induction of escape behaviour. Remarkably, stimulation frequency (1-300 Hz) had no effect on stimulation-induced escape behaviour and therefore it was not possible to prevent the induction of escape behaviour with higher frequencies. The neuronal activation pattern resulting from dlPAG and VMH DBS was similar. These findings suggest that DBS of the dlPAG and VMH induces panic-related behaviours even at higher frequencies.
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Affiliation(s)
- Lee Wei Lim
- Department of Neuroscience, Maastricht University, Maastricht, The Netherlands.
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20
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Abstract
The hypothalamic-pituitary-adrenal axis (HPA axis) plays a critical role in stress management. Involvement of this physiological axis in the underlying mechanisms of panic disorder (PD) has been suggested. Studies using 35% CO(2) inhalation to provoke panic found no evidence for robust increases in cortisol levels in PD. However, cortisol levels alone may not be conclusive, as this hormone is merely the end product of a complex physiological axis. Sixteen PD patients and 16 healthy control subjects underwent a 35% CO(2) inhalation and a placebo inhalation on separate days according to a fixed order, double-blind design. Both serum and salivary cortisol, as well as adrenocorticotropic hormone (ACTH) were measured at regular time intervals. Cortisol and ACTH levels increased in the patient and control groups following 35% CO(2) inhalation. The magnitude of the increase was similar in patients and controls despite marked differences in anxiety. This study is the first to document a clear HPA response following 35% CO(2) inhalation in both PD patients and controls. This effect occurs independently of the specific panicogenic properties of the CO(2) challenge. It remains to be clarified whether panic is initially accompanied by major HPA axis activation or whether other stress-responsive systems underlie panic.
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Affiliation(s)
- Marlies A van Duinen
- Maastricht University, Department of Psychiatry & Neuropsychology, and Vijverdal Academic Anxiety Center, The Netherlands
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21
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Affiliation(s)
- Stephen Maren
- Department of Psychology and Neuroscience Program, University of Michigan, Ann Arbor, MI 48109, USA.
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22
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Affiliation(s)
- Robin A Hurley
- Hefner VA Medical Center, 1601 Brenner Ave., Salisbury, NC 28144, USA.
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23
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Herdade KCP, Strauss CVDA, Zangrossi Júnior H, Viana MDB. Effects of medial amygdala inactivation on a panic-related behavior. Behav Brain Res 2006; 172:316-23. [PMID: 16806522 DOI: 10.1016/j.bbr.2006.05.021] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2006] [Revised: 05/15/2006] [Accepted: 05/17/2006] [Indexed: 11/16/2022]
Abstract
In the last years, the role played by the medial nucleus of the amygdala (MeA) in the modulation of fear- and anxiety-related behaviors has been increasingly investigated. This nucleus plays an important role in the processing of predator odor-induced defensive reactions, i.e. freezing and risk-assessment behaviors. Immunohistochemical evidence also indicates that the MeA may be involved in the regulation of escape, a defensive behavior related to panic attacks. In this study, we further addressed this question by investigating the effects of the reversible inactivation of the nucleus on escape behavior generated in male Wistar rats by two different aversive stimuli, electrical stimulation of the dorsal periaqueductal gray matter (dPAG) and exposure to one of the open arms of the elevated T-maze. Results showed that intra-MeA administration of either the reversible sodium channel blocker lidocaine (34 nmol/0.2 microl) or the GABA(A) receptor agonist muscimol (0.22 nmol/0.2 microl) raised the threshold of aversive electrical stimulation, increasing the amount of current that applied to the dPAG evokes escape, an antiaversive effect. Local microinjection of muscimol (0.22 nmol/0.2 microl) inhibited escape behavior in the elevated T-maze, also suggesting an antiaversive effect. In this latter test, muscimol did not affect inhibitory avoidance, a behavior associated with generalized anxiety disorder. Muscimol effect in the elevated T-maze was independent of changes in general exploratory activity as measured in an open-field. Taken together, our data corroborate previous evidences suggesting that the MeA is involved in the modulation of escape. Dysfunction of this regulatory mechanism may be of relevance in the genesis/maintenance of panic disorder.
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Affiliation(s)
- Karina Costa Paes Herdade
- Laboratório de Psicofarmacologia, FFCLRP, Universidade de São Paulo, 14040-901 Ribeirão Preto, Brazil
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Ashton JC, Darlington CL, Smith PF. Co-distribution of the cannabinoid CB1 receptor and the 5-HT transporter in the rat amygdale. Eur J Pharmacol 2006; 537:70-1. [PMID: 16624281 DOI: 10.1016/j.ejphar.2006.03.041] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2006] [Revised: 02/27/2006] [Accepted: 03/08/2006] [Indexed: 10/24/2022]
Abstract
Cannabis sometimes causes dysphoria rather than euphoria; however, evidence relating to the interaction between the cannabinoid and 5-hydroxtryptamine (5-HT) systems is limited, especially in areas of the brain such as the amygdale. Here we report that cannabinoid CB(1) receptors and 5-HT transporter proteins are co-distributed in the amygdale, suggesting the possibility that activation of cannabinoid CB(1) receptors might cause a reduction in 5-HT release, similar to its effect on other neurotransmitters, thereby resulting in dysphoria.
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Affiliation(s)
- John C Ashton
- Department of Pharmacology and Toxicology, School of Medical Sciences, University of Otago Medical School, University of Otago, Dunedin, New Zealand
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Shapira NA, Okun MS, Wint D, Foote KD, Byars JA, Bowers D, Springer US, Lang PJ, Greenberg BD, Haber SN, Goodman WK. Panic and fear induced by deep brain stimulation. J Neurol Neurosurg Psychiatry 2006; 77:410-2. [PMID: 16484657 PMCID: PMC2077710 DOI: 10.1136/jnnp.2005.069906] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.6] [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] [Indexed: 01/11/2023]
Abstract
BACKGROUND Mood, cognitive, and behavioural changes have been reported with deep brain stimulation (DBS) in the thalamus, globus pallidus interna, and anterior limb of the internal capsule/nucleus accumbens region. OBJECTIVE To investigate panic and fear resulting from DBS. METHODS Intraoperative DBS in the region of the right and then left anterior limb of the internal capsule and nucleus accumbens region was undertaken to treat a 52 year old man with treatment refractory obsessive-compulsive disorder (OCD). Mood, anxiety, OCD, alertness, heart rate, and subjective feelings were recorded during intraoperative test stimulation and at follow up programming sessions. RESULTS DBS at the distal (0) contact (cathode 0-, anode 2+, pulse width 210 ms, rate 135 Hz, at 6 volts) elicited a panic attack (only seen at the (0) contact). The patient felt flushed, hot, fearful, and described himself as having a "panic attack." His heart rate increased from 53 to 111. The effect (present with either device) was witnessed immediately after turning the device on, and abruptly ceased in the off condition CONCLUSIONS DBS of the anterior limb of the internal capsule and nucleus accumbens region caused severe "panic." This response may result from activation of limbic and autonomic networks.
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Affiliation(s)
- N A Shapira
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
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Ribeiro SJ, Ciscato JG, de Oliveira R, de Oliveira RC, D'Angelo-Dias R, Carvalho AD, Felippotti TT, Rebouças ECC, Castellan-Baldan L, Hoffmann A, Corrêa SAL, Moreira JE, Coimbra NC. Functional and ultrastructural neuroanatomy of interactive intratectal/tectonigral mesencephalic opioid inhibitory links and nigrotectal GABAergic pathways: Involvement of GABAA and μ1-opioid receptors in the modulation of panic-like reactions elicited by electrical stimulation of the dorsal midbrain. J Chem Neuroanat 2005; 30:184-200. [PMID: 16140499 DOI: 10.1016/j.jchemneu.2005.07.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2004] [Revised: 06/30/2005] [Accepted: 07/11/2005] [Indexed: 11/29/2022]
Abstract
In the present study, the functional neuroanatomy of nigrotectal-tectonigral pathways as well as the effects of central administration of opioid antagonists on aversive stimuli-induced responses elicited by electrical stimulation of the midbrain tectum were determined. Central microinjections of naloxonazine, a selective mu(1)-opiod receptor antagonist, in the mesencephalic tectum (MT) caused a significant increase in the escape thresholds elicited by local electrical stimulation. Furthermore, either naltrexone or naloxonazine microinjected in the substantia nigra, pars reticulata (SNpr), caused a significant increase in the defensive thresholds elicited by electrical stimulation of the continuum comprised by dorsolateral aspects of the periaqueductal gray matter (dlPAG) and deep layers of the superior colliculus (dlSC), as compared with controls. These findings suggest an opioid modulation of GABAergic inhibitory inputs controlling the defensive behavior elicited by MT stimulation, in cranial aspects. In fact, iontophoretic microinjections of the neurotracer biodextran into the SNpr, a mesencephalic structure rich in GABA-containing neurons, show outputs to neural substrate of the dlSC/dlPAG involved with the generation and organization of fear- and panic-like reactions. Neurochemical lesion of the nigrotectal pathways increased the sensitivity of the MT to electrical (at alertness, freezing and escape thresholds) and chemical (blockade of GABA(A) receptors) stimulation, suggesting a tonic modulatory effect of the nigrotectal GABAergic outputs on the neural networks of the MT involved with the organization of the defensive behavior and panic-like reactions. Labeled neurons of the midbrain tectum send inputs with varicosities to ipsi and contralateral dlSC/dlPAG and ipsilateral substantia nigra, pars reticulata and compacta, in which the anterograde and retrograde tracing from a single injection indicates that the substantia nigra has reciprocal connections with the dlSC/dlPAG featuring close axo-somatic and axo-dendritic appositions in both locations. In addition, ultrastructural approaches show inhibitory axo-axonic synapses in MT and inhibitory axo-somatic/axo-axonic synapses in the SNpr. These findings, in addition to the psychopharmacological evidence for the interaction between opioid and GABAergic mechanisms in the cranial aspects of the MT as well as in the mesencephalic tegmentum, offer a neuroanatomical basis of a pre-synaptic opioid inhibition of GABAergic nigrotectal neurons modulating fear in defensive behavior-related structures of the cranial mesencephalon, in a short link, and through a major neural circuit, also in GABA-containing perikarya and axons of nigrotectal neurons.
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Affiliation(s)
- S J Ribeiro
- Laboratory of Neuroanatomy and Neuropsychobiology, Department of Pharmacology, School of Medicine of Ribeirão Preto of the University of São Paulo FMRP-USP, Avenue of Bandeirantes, 3900, Ribeirão Preto SP 14049-900, Brazil
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Moreira FA, Guimarães FS. Role of serotonin receptors in panic-like behavior induced by nitric oxide in the rat dorsolateral periaqueductal gray: effects of chronic clomipramine treatment. Life Sci 2005; 77:1972-82. [PMID: 15916775 DOI: 10.1016/j.lfs.2005.02.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2004] [Accepted: 02/24/2005] [Indexed: 11/18/2022]
Abstract
Local administration of serotonin (5-HT) receptor agonists inhibits panic-like reactions induced by electrical stimulation of the rat dorsolateral periaqueductal grey (dlPAG). This anti-aversive effect is enhanced by chronic treatment with anti-panic drugs such as clomipramine. Since nitric oxide (NO) may mediate panic-like behavior in the dlPAG, we tested the hypothesis that chronic clomipramine treatment would also potentiate the effects of locally injected 5-HT-receptor agonists on panic-like reactions induced by intra-dlPAG injection of an NO-donor (SIN). After 21 days of daily i.p. injections of saline or clomipramine (10 mg/kg) male Wistar rats received local injections of saline, the 5-HT(1A)-receptor agonist 8-OH-DPAT (8 nmol) or the 5-HT2A/2C-receptor agonist DOI (16 nmol) followed by saline or SIN (150 nmol). NO-induced panic-like reactions were inhibited by DOI, but not by 8-OH-DPAT. Chronic clomipramine did not modify these effects but tended to produce anti-aversive effect by itself. In chronically clomipramine treated animals 8-OH-DPAT potentiated NO-induced panic-like reactions. The results indicate that the panic-like effects of NO in the dlPAG may be attenuated by 5-HT2A/2C-, but not by 5-HT1A-receptors. The anti-aversive effect of DOI is not modified by chronic clomipramine treatment.
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Pauli P, Amrhein C, Mühlberger A, Dengler W, Wiedemann G. Electrocortical evidence for an early abnormal processing of panic-related words in panic disorder patients. Int J Psychophysiol 2005; 57:33-41. [PMID: 15935260 DOI: 10.1016/j.ijpsycho.2005.01.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2004] [Revised: 01/17/2005] [Accepted: 01/24/2005] [Indexed: 11/18/2022]
Abstract
Panic patients are hypothesized to have particularly elaborated cortical networks for panic-related stimuli, and this characteristic should be associated with an abnormal automatic processing of these stimuli. Panic-related and neutral words were presented to 25 panic patients and 25 matched healthy controls either at individually determined perception thresholds (threshold condition) or for 1000 ms (above threshold condition). Word recognition for words presented at perception threshold (threshold words), and event-related brain potentials (ERPs) triggered by threshold and above threshold words were analyzed. In the threshold condition, both panic patients and control participants correctly recognized more panic-related than neutral words. An additional analysis restricted to participants who used an intuitive strategy for word identification revealed an enhanced frequency of correctly identified panic-related words in panic patients. In the ERPs, only panic patients exhibited enhanced positive potentials during early time windows (200-400 ms after stimulus presentation) triggered by panic-related compared to neutral threshold words. In late (400-600 ms) and very late (600-1000 ms) time windows, both groups showed a greater ERP positivity for panic-related than for neutral words. These data suggest that panic patients are characterized by an early automatic and elaborated processing of disorder-relevant stimuli.
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Affiliation(s)
- Paul Pauli
- Department of Psychology, Biological Psychology, Clinical Psychology, and Psychotherapy, University of Würzburg, Marcusstr. 9-11, D-97070 Würzburg, Germany.
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Zwanzger P, Rupprecht R. Selective GABAergic treatment for panic? Investigations in experimental panic induction and panic disorder. J Psychiatry Neurosci 2005; 30:167-75. [PMID: 15944741 PMCID: PMC1089777] [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] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/01/2023] Open
Abstract
gamma-Aminobutyric acid (GABA) is the most important inhibitory neurotransmitter in the central nervous system (CNS). It exerts its rapid inhibitory action mostly through GABA(A) receptors, which are targets for benzodiazepines, barbiturates, neuroactive steroids and distinct anticonvulsive agents. There is considerable evidence that dysfunction of GABA(A) receptors or dysregulation of GABA concentrations in the CNS (or both) plays an important role in the pathophysiology of panic disorder. Currently, benzodiazepines are the only drugs directly targeting the GABA(A) receptors that are approved for the treatment of anxiety disorders. Because of their well-known anxiolytic effects, they are widely used in this setting, but side effects limit their use in long-term treatment. The question of whether drugs that selectively increase GABA concentrations in the CNS could improve symptoms of anxiety has been discussed. Recent investigations by our group have demonstrated that enhancement of endogenous GABA (through blockade of GABA transaminase by vigabatrin or through inhibition of GABA transporters by tiagabine) exerts anxiolytic effects on experimentally induced panic. Our studies in healthy volunteers have shown that both compounds lead to a significant reduction in panic symptoms elicited by cholecystokinin-tetrapeptide. Moreover, benzodiazepine-like effects on the activity of the hypothalamic-pituitary-adrenal axis have been observed in association with vigabatrin treatment. Small open studies in patients with panic disorder also showed an improvement in panic and anxiety with both compounds. This review summarizes our recent research on the effects of selective GABAergic treatment in experimentally induced panic and outlines the possible role of compounds targeting the GABA binding site of the GABA(A)-benzodiazepine receptor for the treatment of panic and anxiety.
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Affiliation(s)
- Peter Zwanzger
- Anxiety Research Unit and Anxiety Outpatient Clinic, Department of Psychiatry, Ludwig-Maximilians-Universität, Munich, Germany.
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Eser D, di Michele F, Zwanzger P, Pasini A, Baghai TC, Schüle C, Rupprecht R, Romeo E. Panic induction with cholecystokinin-tetrapeptide (CCK-4) Increases plasma concentrations of the neuroactive steroid 3alpha, 5alpha tetrahydrodeoxycorticosterone (3alpha, 5alpha-THDOC) in healthy volunteers. Neuropsychopharmacology 2005; 30:192-5. [PMID: 15467707 DOI: 10.1038/sj.npp.1300572] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.0] [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] [Indexed: 11/09/2022]
Abstract
3alpha-reduced neuroactive steroids such as 3alpha, 5alpha-tetrahydroprogesterone (3alpha, 5alpha-THP) and 3alpha, 5alpha-tetrahydrodeoxycorticosterone (3alpha, 5alpha-THDOC) are potent positive allosteric modulators of gamma-aminobutyric acid type A (GABAA) receptors and display pronounced anxiolytic activity in animal models. Experimental panic induction with cholecystokinin-tetrapeptide (CCK-4) and sodium lactate is accompanied by a decrease in 3alpha, 5alpha-THP concentrations in patients with panic disorder, but not in healthy controls. However, no data are available on 3alpha, 5alpha-THDOC concentrations during experimental panic induction. Therefore, we quantified 3alpha, 5alpha-THDOC concentrations in 10 healthy volunteers (nine men, one woman) before and after panic induction with CCK-4 by means of a highly sensitive and specific gas chromatography/mass spectrometry analysis. CCK-4 elicited a strong panic response as assessed by the Acute Panic Inventory. This was accompanied by an increase in 3alpha, 5alpha-THDOC, ACTH and cortisol concentrations. This increase in 3alpha, 5alpha-THDOC might be a consequence of hypothalamic-pituitary-adrenal (HPA) axis activation following CCK-4-induced panic, and might contribute to the termination of the anxiety/stress response following challenge with CCK-4 through enhancement of GABAA receptor function.
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Affiliation(s)
- Daniela Eser
- Department of Psychiatry, Ludwig-Maximilian-University, Munich, Germany
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Khan S, Liberzon I, Abelson JL. Effects of propranolol on symptom and endocrine responses to pentagastrin. Psychoneuroendocrinology 2004; 29:1163-71. [PMID: 15219640 DOI: 10.1016/j.psyneuen.2004.01.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2003] [Revised: 01/13/2004] [Accepted: 01/26/2004] [Indexed: 10/26/2022]
Abstract
Intravenous injections of CCK-B agonists, such as pentagastrin, produce symptoms of panic and potent activation of the human hypothalamic-pituitary-adrenal (HPA) axis. It is unclear whether these psychological and endocrine effects are mediated by similar or independent processes. Independence is supported by prior evidence that beta-adrenergic receptor blockade attenuates cardiovascular and symptom but not vasopressin responses to CCK-4. To further explore associations between somatic, emotional and endocrine responses to CCK-B agents, and potential beta-adrenergic mediating mechanisms, symptom and endocrine responses to pentagastrin were examined after propranolol pre-treatment. Cardiovascular, symptom, and endocrine (ACTH, cortisol, epinephrine) responses to pentagastrin were measured in 16 healthy adult subjects randomly assigned to receive propranolol or placebo pre-treatment. Propranolol significantly blocked the normal cardiac acceleration produced by pentagastrin, but did not reduce panic symptom or anxiety effects. It delayed and perhaps enhanced the cortisol response. No relationship between HPA and symptom responses following pentagastrin could be detected, though pre-pentagastrin cortisol was inversely related to post-injection panic symptom intensity. Endocrine, cardiovascular and symptom responses to pentagastrin appear to be separately mediated, as they did not change in concert in response to propranolol pre-treatment, nor were they correlated with one another. The results are consistent with the presence of inhibitory beta-adrenergic mediation of the HPA axis in humans. They support the hypothesis that the HPA response to pentagastrin is not secondary to the psychological stress of its side effects.
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Affiliation(s)
- Samir Khan
- Trauma, Stress and Anxiety Research Center, Department of Psychiatry, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109-0118, USA
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Vickers K, McNally RJ. Respiratory symptoms and panic in the National Comorbidity Survey: a test of Klein's suffocation false alarm theory. Behav Res Ther 2004; 43:1011-8. [PMID: 15967172 DOI: 10.1016/j.brat.2004.06.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2004] [Indexed: 10/26/2022]
Abstract
According to suffocation false alarm theory (Arch. Gen. Psychiatry 50 (1993) 31), respiratory symptoms are the symptoms that best distinguish the panic attacks of individuals with panic disorder (PD) from those of individuals without PD. Using National Comorbidity Survey data from those 609 respondents who had lifetime histories of panic attacks or PD, we tested this prediction. Neither respiratory symptom (smothering; dyspnea) strongly differentiated between respondents with PD and those with only panic attacks. Respiratory symptom endorsement was unrelated to PD when the number of other symptoms endorsed was controlled; furthermore, respiratory symptoms had slight effect sizes and were not included in a multivariate context. In contrast, fear of dying had the largest effect size, an association with PD that persisted after control for other symptom endorsement, and a continuing importance in multivariate analyses. Strikingly, panic attack respondents who reported having had only one panic attack were as likely as PD respondents to report respiratory symptoms during panic. These findings, although based on retrospective self-report and thus subject to recall bias, are inconsistent with the hypothesis that respiratory symptoms during panic have diagnostic significance.
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Abstract
BACKGROUND The aim of this study was to investigate the existence of associations between bruxism and psychic and occlusal factors. METHODS Participants in this study (n=85) were recruited from the Section of Odontostomatology, Deparent of Neuroscience, University of Pisa, Italy. They were split into two groups, bruxers (n=34) and non-bruxers (n=51), on the basis of the presence of both clinical and anamnestical indicators of bruxim. All participants were administered two self-reported validated questionnaires to evaluate (MOODS-SR) and panic-agoraphobic (PAS-SR) spetra. A number of occlusal variables (deep-bite: cross-bite, open-bite, mediotrusive and laterotrusive interferences, slide RCP-ICP, laterotrutsive guides, canine and molar classes) were also recorded. RESULTS With regards to occlusal factors, the only association was revealed between bruxism mediotrusive interferences (p < 0.05). As for psychiatric investigation, significant differences between bruxers and controls emerged for the presence of both depressive (p < 0.01) and manic symptoms (p < 0.01) in MOODS-SR, and for stress sensitivity (p < 0.01), anxious expectation (p < 0.05), and reassurance sensitivity symptoms (p < 0.05) in PAS-SR. In particular, both mood (p < 0.01) and panic-agoraphobic (p < 0.05) spectra symptoms seem to differentiate bruxers from controls in males, while in females strong differences emerged for stress sensitivity symptoms (p < 0.05). CONCLUSIONS It can be confirmed that certain psychic traits are present in bruxers, while occlusal factors are not useful parameters to discern bruxers from non-bruxers.
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Affiliation(s)
- D Manfredini
- Department of Neuroscience, University of Pisa, Italy.
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Magierek V, Ramos PL, da Silveira-Filho NG, Nogueira RL, Landeira-Fernandez J. Context fear conditioning inhibits panic-like behavior elicited by electrical stimulation of dorsal periaqueductal gray. Neuroreport 2003; 14:1641-4. [PMID: 14502092 DOI: 10.1097/00001756-200308260-00020] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Context fear conditioning has been widely used as an animal model of anxiety whereas electrical stimulation of the dorsal portion of the periaqueductal gray (DPAG) as a model of panic attack. The present study employed these two animal models in order to investigate the influence of anxiety in the occurrence of panic attack. Results indicated that animals exposed to contextual cues that were previously associated with electrical footshocks engaged in robust defensive freezing behavior and were less likely to display flight evoked by electrical stimulation of the DPAG when compared with control animals that were not exposed to the context fear conditioning procedure. These results indicate that activation of the brain mechanisms that underlie anxiety produces an inhibitory effect on panic attack.
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Affiliation(s)
- Valeska Magierek
- Laboratório de Farmacologia Comportamental, Departamento de Psicobiologia, Universidade Federal de São Paulo, SP, Brazil
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Eifert GH, Heffner M. The effects of acceptance versus control contexts on avoidance of panic-related symptoms. J Behav Ther Exp Psychiatry 2003; 34:293-312. [PMID: 14972675 DOI: 10.1016/j.jbtep.2003.11.001] [Citation(s) in RCA: 201] [Impact Index Per Article: 9.6] [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: 10/22/2002] [Revised: 10/08/2003] [Accepted: 11/07/2003] [Indexed: 12/01/2022]
Abstract
The present study compared the effects of creating an acceptance versus a control treatment context on the avoidance of aversive interoceptive stimulation. Sixty high anxiety sensitive females were exposed to two 10-min periods of 10% carbon dioxide enriched air, an anxiogenic stimulus. Before each inhalation period, participants underwent a training procedure aimed at encouraging them either to mindfully observe (acceptance context) or to control symptoms via diaphragmatic breathing (control context). A third group was given no particular training or instructions. We hypothesized that an acceptance rather than control context would be more useful in the reduction of anxious avoidance. Compared to control context and no-instruction participants, acceptance context participants were less avoidant behaviorally and reported less intense fear and cognitive symptoms and fewer catastrophic thoughts during the CO(2) inhalations. We discuss the implications of our findings for an acceptance-focused vs. control-focused context when conducting clinical interventions for panic and other anxiety disorders.
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Affiliation(s)
- Georg H Eifert
- Department of Psychology, Chapman University, Orange, CA 92808, USA.
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37
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Abstract
Terrorism is not a new concept but our need to prepare for the effects of bioterrorism has achieved a particular urgency. The use of biological agents provides a new set of challenges to professional caregivers, emergency personnel and Governments. These agents are generally not readily identified through the senses, have delayed effects and have the power to generate fear and panic. They are also intended to demonstrate that Governments and other organisations are not able to protect their citizens and members. What evidence there is suggests bioterrorist incidents have the potential to create higher levels of psychopathology than physical injury. Therefore, the authorities must identify and rehearse suitable methods of psychoprophylaxis and intervention.
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Affiliation(s)
- D A Alexander
- Medical School, University of Aberdeen, Foresterhill, Aberdeen.
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38
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Zwanzger P, Eser D, Aicher S, Schüle C, Baghai TC, Padberg F, Ella R, Möller HJ, Rupprecht R. Effects of alprazolam on cholecystokinin-tetrapeptide-induced panic and hypothalamic-pituitary-adrenal-axis activity: a placebo-controlled study. Neuropsychopharmacology 2003; 28:979-84. [PMID: 12700707 DOI: 10.1038/sj.npp.1300131] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.0] [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] [Indexed: 11/08/2022]
Abstract
Cholecystokinin-tetrapeptide (CCK-4) induces panic attacks both in patients with panic disorder (PD) and healthy volunteers. It has been shown that panic elicited by CCK-4 is improved after treatment with antidepressants. Moreover, a reduction of CCK-4-induced panic has also been demonstrated after treatment with lorazepam in single subjects and after selective GABAergic treatment with vigabatrin. Although benzodiazepines are widely used as anxiolytics, no controlled study on the effects of benzodiazepines on CCK-4-induced panic symptoms is available so far. Therefore, we investigated the effects of alprazolam and placebo on CCK-4-induced panic symptoms in a double-blind, placebo-controlled study. A total of 30 healthy subjects were challenged with 50 microg CCK-4. Out of these 30 subjects, 26 showed a marked panic response to CCK-4. Subjects were rechallenged after a 7-day interval and treated with 1 mg alprazolam or placebo 1 h prior to the second CCK-4 challenge. Panic was assessed using the acute panic inventory (API) and a DSM-IV-derived panic symptom scale (PSS). Moreover, the number of reported symptoms and self-rated anxiety and arousal were recorded. We found a significant reduction of the API and PSS scores and of the number of reported symptoms compared to placebo. Moreover, compared to placebo the CCK-4-induced ACTH and cortisol release were significantly attenuated during the CCK-4 challenge after alprazolam treatment. However, also placebo treatment reduced CCK-4-induced anxiety and HPA-axis activation to a certain extent. In conclusion, our data show that alprazolam reduces CCK-4-induced panic, which supports the hypothesis of a possible interaction between the GABA and the CCK system.
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Affiliation(s)
- P Zwanzger
- Department of Psychiatry, Ludwig Maximilian University of Munich, Nussbaumstrasse 7, 80336 Munich, Germany.
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Abstract
Defensive burying refers to the typical rodent behavior of displacing bedding material with vigorous treading-like movements of their forepaws and shoveling movements of their heads directed towards a variety of noxious stimuli that pose a near and immediate threat, such as a wall-mounted electrified shock-prod. Since its introduction 25 years ago by Pinel and Treit [J. Comp. Physiol. Psychol. 92 (1978) 708], defensive (shock-prod) burying has been the focus of a considerable amount of research effort delineating the methodology/ethology, psychopharmacology and neurobiology of this robust and species-specific active avoidance or coping response. The present review gives a summary of this research with special reference to the behavioral (face and construct) and pharmacological (predictive) validity of the shock-prod burying test as an animal model for human anxiety. Emphasis is also placed on some recent modifications of the paradigm that may increase its utility and reliability as to individual differences in expressed emotional coping responses and sensitivity to pharmacological treatments. Overall, the behavioral and physiological responses displayed in the shock-prod paradigm are expressions of normal and functionally adaptive coping patterns and the extremes of either active (i.e., burying) or passive (i.e., freezing) forms of responding in this test cannot simply be regarded as inappropriate, maladaptive or pathological. For this reason, the shock-prod paradigm is not an animal model for anxiety disorder or for any other psychiatric disease, but instead possesses a high degree of face and construct validity for normal and functionally adaptive human fear and anxious apprehension. However, the apparent good pharmacological validation (predictive validity) of this test reinforces the view that normal and pathological anxiety involves, at least partly, common neurobiological substrates. Therefore, this paradigm is not only suitable for screening potential anxiolytic properties of new drugs, but seems to be especially valuable for unraveling the neural circuitry and neurochemical mechanisms underlying the generation of active and passive coping responses as different expressions of anxiety.
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Affiliation(s)
- Sietse F De Boer
- Department of Animal Physiology, Biological Center, University of Groningen, P.O. Box 14, 9750 AA Haren, The Netherlands.
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Schwizer B. [Tachypnea--when breathing induces panic]. Praxis (Bern 1994) 2003; 92:29-32. [PMID: 12577607 DOI: 10.1024/0369-8394.92.1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Eine gestörte Atmung macht Angst. Zur besseren Charakterisierung sind die Begriffe Tachypnoe, Dyspnoe und Hyperventilation zu differenzieren, welche verschiedene Zustände und Sensationen der Atmung beschreiben. Die wichtigsten pathophysiologischen Mechanismen der Atemnot, wie die Erhöhung der Atemimpedanz, die Störung der Atemmuskulatur, die abnorme Erhöhung der Ventilation und die abnormen Blutgase erklären die verschiedenen Differenzialdiagnosen und leiten über zu den Therapien, welche leider nicht selten symptomatisch bleiben. Möglichkeiten zur Symptomlinderung sind Rehabilitationstraining, Medikamente bzw. das Meiden verschlimmernder Substanzen, Sauerstoff und spezielle Ventilationshilfen. Am wichtigsten ist aber ein möglichst umfassender Therapieansatz mit Einbezug der psychischen und sozialen Patientenressourcen.
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Affiliation(s)
- B Schwizer
- Abteilung für Pneumologie, Kantonsspital Luzern.
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Weems CF, Hayward C, Killen J, Taylor CB. A longitudinal investigation of anxiety sensitivity in adolescence. J Abnorm Psychol 2002; 111:471-7. [PMID: 12150423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/26/2023]
Abstract
This investigation sought to expand existing knowledge of anxiety sensitivity in a sample of high school students (N = 2,365) assessed over 4 years. The stability of anxiety sensitivity levels across assessment periods was examined, and cluster analyses were used to identify different developmental pathways in levels of anxiety sensitivity. Groups of adolescents with stable low, stable high, and escalating anxiety sensitivity levels were identified. Adolescents with stable high or escalating anxiety sensitivity were significantly more likely to report experiencing a panic attack than individuals with stable low anxiety sensitivity. Results also indicated that Asian and Hispanic adolescents tended to report higher anxiety sensitivity but that their anxiety sensitivity was less strongly associated with panic than that of Caucasian adolescents.
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Affiliation(s)
- Carl F Weems
- Department of Psychology, University of New Orleans, Louisiana 70148, USA.
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Tait GR, McManus K, Bellavance F, Lara N, Chrapko W, Le Mellédo JM. Neuroactive steroid changes in response to challenge with the panicogenic agent pentagastrin. Psychoneuroendocrinology 2002; 27:417-29. [PMID: 11911996 DOI: 10.1016/s0306-4530(01)00051-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [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] [Indexed: 11/19/2022]
Abstract
BACKGROUND Female hormones and female hormone derivatives, including neuroactive steroids (NASs) have been suspected to play a role in the pathophysiology of panic disorder (PD). The panicogenic agent CO(2) has been shown to induce a delayed release of NASs in both brain and plasma of rats. In the present study, we measured NASs plasma levels in response to challenge with another panicogenic agent, pentagastrin, and assessed the effect of ethynil estradiol (EE) pretreatment. METHODS A double-blind cross-over placebo-controlled design with randomization of the order of a three day pretreatment of EE (50 microg/day) or placebo was used to assess the effect of a 30 microg iv bolus injection of pentagastrin on the release of allopregnanolone (ALLO) and dehydroepiandrosterone (DHEA) into plasma in 15 male PD patients and 10 male healthy volunteers (HV). RESULTS After pentagastrin challenge there was a significant release of DHEA and a trend for the release of ALLO. EE pretreatment did not affect the pentagastrin-induced panic response or NAS release. CONCLUSIONS Pentagastrin induced release of NASs into plasma, the purpose of which remains to be determined.
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Affiliation(s)
- Glendon R Tait
- Department of Psychiatry, 1E7.16 MacKenzie Centre, University of Alberta, Edmonton, Alberta, Canada T6G 2B7
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Abstract
Six subjects with panic disorder underwent sodium lactate infusions in conjunction with magnetic resonance spectroscopic imaging (MRSI) at study entrance when actively symptomatic and after clinical improvement while under treatment with gabapentin. MRSI was used to serially measure regional brain lactate levels from an axial section at the level of the lateral ventricles at baseline, during lactate infusion and postlactate infusion. Gabapentin treatment appeared to be effective in blocking a lactate-induced panic response but did not alter the magnitude or time course of an abnormal brain lactate response to lactate infusion in all subjects. Additionally, two subjects were reinfused while clinically improved on double-blind placebo and demonstrated a consistent pattern of abnormal brain lactate response.
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Affiliation(s)
- M E Layton
- The Center for Anxiety and Depression, University of Washington, Seattle, Washington 98105-6099, USA
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Abstract
Paradoxically, the pituitary-adrenal axis is not activated during sodium lactate-induced panic. We measured the response of another stress-sensitive hormone, prolactin, to standard lactate and placebo infusion in a double-blind randomised design in eight patients with panic disorder and eight matched normal controls. Prolactin release was significantly elevated (P < 0.05) in panickers compared with non-panickers, whereas ACTH secretion was not activated at all. This differential stress response needs further investigation.
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Affiliation(s)
- Christian Otte
- University Hospital Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Martinistrasse 52, 20246, Germany.
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Abstract
Blockade of gamma-aminobutyric acid-A (GABA(A)) receptors in the dorsomedial hypothalamus (DMH) elicits a panic-like response that includes increases in heart rate (HR), blood pressure (BP), respiration rate (RR), and anxiety. Norepinephrine (NE) has been postulated to be critical in regulating panic and anxiety responses. Therefore, the first study sought to determine changes in extracellular NE levels within the DMH following acute blockade of GABA(A) receptors in the DMH using in vivo microdialysis. Rats were implanted with femoral arterial catheters and microdialysis probes into the DMH. Following recovery, the DMH of conscious rats were perfused with 100, 150, or 200 microM solutions of the GABA(A) receptor antagonist bicuculline methiodide (BMI) via the microdialysis probe. HR and BP responses were recorded and the changes in extracellular levels of NE in the dialysate samples from the DMH were determined by HPLC. Rats receiving BMI injections showed dose-dependent increases in both the extracellular NE levels in the DMH as well as HR and BP. The second study was conducted to test the functional importance of NE in the DMH to the BMI-induced physiological responses. The effects of BMI microinjection into the DMH were measured at baseline and 10 days after local injection of either vehicle or two doses of 6-hydroxydopamine (6-OHDA), a neurotoxin known to lesion NE terminals. There was a significant loss of tissue NE levels as well as BMI-induced HR, BP and RR responses in the 6-OHDA-treated but not vehicle-treated rats. Thus, blockade of GABA(A) receptors in the DMH results in NE release and the presence of NE appears to be necessary for eliciting the physiological components of the panic-like responses in this region.
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Affiliation(s)
- A Shekhar
- Department of Psychiatry, Institute of Psychiatric Research, Indiana University Medical Center, Indianapolis, IN 46202, USA.
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Abstract
Sleep-deprived rats exhibit defensive fighting as well as explosive flights very similar to the wild-running of audiogenic seizures. In order to determine why sleep deprivation is a common factor that facilitates both panic and convulsive manifestations, the present study was undertaken to investigate whether rats that display sleep deprivation-induced fighting (SDIF) are the same as those that are susceptible to audiogenic wild-running (WR). Twenty-eight male adult Wistar rats were divided into two groups assigned to two experimental schemes. In the first, 18 subjects were submitted to REM-sleep deprivation for 5 days and had their SDIF evaluated in social grouping. After 1 week for recovery, their susceptibility to WR was tested in an acoustic stimulation trial (104 dB, 200 Hz, 60 s). Rats that did not present WR received a lactate infusion and were tested again by acoustic stimulation 40 min later. In the second experimental scheme, 10 subjects were initially evaluated for WR susceptibility and the number of SDIF was recorded in social grouping after 1 week. Three categories of WR-susceptibility were determined: WR-sensitive rats, intermediate WR-sensitive rats and WR-insensitive rats. The number of SDIF in each category was significantly different and there was a high positive correlation (r=0.89; Spearman test) between the number of SDIF and the level of WR-susceptibility. We conclude that the reasons why sleep deprivation exerts facilitatory effects on both panic and convulsive manifestations are due to overlappings of neural pathways responsible for both behavioral patterns and for the property of sleep deprivation to increase neuronal excitability.
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Abstract
Our aim was to determine whether panic disorder (PD) patients, major depressive patients without panic attacks (MD) and major depressive patients with panic attacks (MDP) respond similarly to hyperventilation challenge tests. We randomly selected 35 PD patients, 33 MDP patients, 27 MD patients and 30 normal volunteers with no family history of anxiety or mood disorder. The patients had not been treated with psychotropic drugs for at least 1 week. They were induced to hyperventilate (30 breaths/min) for 4 min, and anxiety was assessed before and after the test. A total of 16 (45.7%) PD patients, 12 (36.4%) MDP patients, four (11.1%) MD patients, and two (6.7%) normal volunteers had a panic attack after hyperventilating. The PD and MDP patients were significantly more responsive to hyperventilation than the MD patients and the normal volunteers. The MD patients had a significantly lower heart-rate response to the test than all the other groups. There is growing evidence that PD patients are more sensitive to the vasoconstrictive effects on basilar arterial blood flow caused by hyperventilation-induced hypocapnia than are comparison subjects. Our data suggest that there is an association between panic attacks and hyperreactivity to an acute hyperventilation challenge test.
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Affiliation(s)
- A E Nardi
- Laboratory of Panic and Respiration, Institute of Psychiatry, Federal University of Rio de Janeiro, R. Visconde de Pirajá, 407/702, RJ-22410-003, Rio de Janeiro, Brazil.
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Blanchard DC, Hynd AL, Minke KA, Minemoto T, Blanchard RJ. Human defensive behaviors to threat scenarios show parallels to fear- and anxiety-related defense patterns of non-human mammals. Neurosci Biobehav Rev 2001; 25:761-70. [PMID: 11801300 DOI: 10.1016/s0149-7634(01)00056-2] [Citation(s) in RCA: 220] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Defense patterns of rats and mice have been characterized in terms of the relationships between the type of defensive behavior (e.g. flight, freezing, hiding, defensive threat/attack, and risk assessment) and particular features of the eliciting (threat) stimulus and the situation in which it is encountered. Because the defense systems of rodents serve as major models for investigating and understanding both the physiology and the behavioral expression of emotional response to aversive stimuli, it is essential to evaluate whether these systems show strong parallels in human responsivity to threat. One hundred and sixty male and female undergraduate students read a set of 12 scenarios involving a present or potential threatening conspecific, and chose a primary defensive response to each. These scenarios were designed to vary features known to influence defensive responding in rodents: magnitude of threat; escapability of the situation; ambiguity of the threat stimulus; distance between the threat and the subject; presence of a hiding place. Male and female responses to the various scenarios were highly correlated, except for yell, scream, or call for help which was frequent for females, rare for males. However, a combination of this response category with 'attack' showed a highly positive (+0.96) male-female correlation, across scenarios.Correlations between manipulated (and rated) features of the threat stimulus and situation, and type of defensive behavior chosen, strongly supported a view that the patterning of defensive behavior is similar for humans and non-human mammals. Significant correlations were obtained relevant to eight specific hypotheses derived from the animal literature, with some support for two additional hypotheses (non-significant correlations averaging 0.4 or more in expected direction). While three predicted correlations were not supported in these findings, only a single significant correlation was obtained that had not been predicted on the basis of the animal literature. Although the scenario approach, and this application, have specific limitations, these results provide substantial suggestion of congruence between human and non-human mammal defense systems.
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Affiliation(s)
- D C Blanchard
- Pacific Biomedical Research Center, Bekesy Laboratory of Neurobiology, University of Hawaii, 193 East-West Road, Honolulu, HI 96822-2359, USA.
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Abstract
OBJECTIVE Because hyperventilation has figured prominently in theories of panic disorder (PD) but not of social phobia (SP), we compared predictions regarding diagnosis-specific differences in psychological and physiological measures before, during, and after voluntary hyperventilation. METHOD Physiological responses were recorded in 14 patients with PD, 24 patients with SP, and 24 controls during six cycles of 1-minute of fast breathing alternating with 1 minute of recovery, followed by 3 minutes of fast breathing and 10 minutes of recovery. Speed of fast breathing was paced by a tone modulated at 18 cycles/minute, and depth by feedback aimed at achieving an end-tidal pCO2 of 20 mm Hg. These values were reached equally by all groups. RESULTS During fast breathing, PD and SP patients reported more anxiety than controls, and their feelings of dyspnea and suffocation increased more from baseline. Skin conductance declined more slowly in PD over the six 1-minute fast breathing periods. At the end of the final 10-minute recovery, PD patients reported more awareness of breathing, dyspnea, and fear of being short of breath, and their pCO2s, heart rates, and skin conductance levels had returned less toward normal levels than in other groups. Their lower pCO2s were associated with a higher frequency of sigh breaths. CONCLUSIONS PD and SP patients report more distress than controls to equal amounts of hypocapnia, but PD differ from SP patients and controls in having slower symptomatic and physiological recovery. This finding was not specifically predicted by hyperventilation, cognitive-behavioral, or suffocation alarm theories of PD.
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Affiliation(s)
- F H Wilhelm
- Department of Psychiatry and Behavioral Sciences, Stanford University, California, USA.
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Coupland N, Zedkova L, Sanghera G, Leyton M, Le Mellédo JM. Response to pentagastrin after acute phenylalanine and tyrosine depletion in healthy men: a pilot study. J Psychiatry Neurosci 2001; 26:247-51. [PMID: 11394194 PMCID: PMC1408307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/20/2023] Open
Abstract
OBJECTIVE To assess the effects of the acute depletion of the catecholamine precursors phenylalanine and tyrosine on mood and pentagastrin-induced anxiety. DESIGN Randomized, double-blind controlled multiple crossover study. SETTING University department of psychiatry. PARTICIPANTS 6 healthy male volunteers. INTERVENTIONS 3 treatments were compared: pretreatment with a nutritionally balanced amino acid mixture, followed 5 hours later by a bolus injection of normal saline placebo; pretreatment with a balanced amino acid mixture, followed by a bolus injection of pentagastrin (0.6 microgram/kg); and pretreatment with an amino acid mixture without the catecholamine precursors phenylalanine or tyrosine, followed by pentagastrin (0.6 microgram/kg). OUTCOME MEASURES Scores on the panic symptom scale, a visual analogue scale for anxiety, the Borg scale of respiratory exertion and the Profile of Mood States Elation-Depression Scale. RESULTS Pentagastrin produced the expected increases in anxiety symptoms, but there was no significant or discernible influence of acute phenylalanine and tyrosine depletion on anxiety or mood. CONCLUSIONS These pilot data do not support further study using the same design in healthy men. Under these study conditions, phenylalanine and tyrosine depletion may have larger effects on dopamine than noradrenaline. Alternative protocols to assess the role of catecholamines in mood and anxiety are proposed.
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Affiliation(s)
- N Coupland
- Department of Psychiatry, University of Alberta, 1E7.13 Walter Mackenzie Centre, 8440-112 St., Edmonton AB T6G 2B7.
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