rCBF differences between panic disorder patients and control subjects during anticipatory anxiety and rest.
BACKGROUND
Our goal was to identify brain structures involved in anticipatory anxiety in panic disorder (PD) patients compared to control subjects.


METHODS
Seventeen PD patients and 21 healthy control subjects were studied with H(2)(15)O positron emission tomography scan, before and after a pentagastrin challenge.


RESULTS
During anticipatory anxiety we found hypoactivity in the precentral gyrus, the inferior frontal gyrus, the right amygdala, and the anterior insula in PD patients compared to control subjects. Hyperactivity in patients compared to control subjects was observed in the parahippocampal gyrus, the superior temporal lobe, the hypothalamus, the anterior cingulate gyrus, and the midbrain. After the challenge, the patients showed decreases compared to the control subjects in the precentral gyrus, the inferior frontal gyrus, and the anterior insula. Regions of increased activity in the patients compared to the control subjects were the parahippocampal gyrus, the superior temporal lobe, the anterior cingulate gyrus, and the midbrain.


CONCLUSIONS
The pattern of regional cerebral blood flow activations and deactivations we observed both before and after the pentagastrin challenge was the same, although different in intensity. During anticipatory anxiety more voxels were (de)activated than during rest after the challenge.
Department of Psychiatry, Division of Biological Psychiatry, Graduate School of Behavioral and Cognitive Neurosciences, Groningen University Hospital, The Netherlands.
Marjolein L
ML
Boshuisen
Gert J
GJ
Ter Horst
Anne M J
AM
Paans
A A T Simone
AA
Reinders
Johan A
JA
den Boer
D000328:Adult; D000704:Analysis of Variance; D001007:Anxiety / Q000000981:diagnostic imaging / Q000523:psychology; D001794:Blood Pressure / Q000502:physiology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D016584:Panic Disorder / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000523:psychology*; D010418:Pentagastrin / Q000008:administration & dosage; D011569:Psychiatric Status Rating Scales; D012146:Rest / Q000523:psychology; D014055:Tomography, Emission-Computed
D010418:Pentagastrin