title: Functional magnetic resonance imaging characterization of CCK-4-induced panic attack and subsequent anticipatory anxiety.
abstract: The main objective of this work was to study the functional markers of the clinical response to cholecystokinin tetrapeptide (CCK-4). Twelve healthy male subjects were challenged with CCK-4 and simultaneously underwent functional magnetic resonance imaging (fMRI) recording. Since anticipatory anxiety (AA) is an intrinsic part of panic disorder, a behavioral paradigm, using the threat of being administered a second injection of CCK-4, has been developed to investigate induced AA. The study was composed of three fMRI scans according to an open design. During first and second scan, subjects were injected with placebo and CCK-4, respectively. The third scan was the AA challenge. CCK-4 administration induced physiological and psychological symptoms of anxiety that met the criteria for a panic attack in 8 subjects, as well as cerebral activation in anxiety-related brain regions. Clinical and physiological response intensity was consistent with cerebral activity extent and robustness. fMRI proved more sensitive than clinical assessment in evidencing the effects of the AA challenge. The latter induced brain activation, different from that obtained on CCK-4 and during placebo injection, that was likely related to anxiety. The method applied in this study is suitable for the study of anxiety using fMRI.
authors.affiliation: Forenap-Unité RMN, 27, rue du 4ème RSM, 68250 Rouffach, France. Therese.Schunck@forenap.asso.fr
authors.forename: Thérèse
authors.initials: T
authors.lastname: Schunck
authors.forename: Gilles
authors.initials: G
authors.lastname: Erb
authors.forename: Alexandre
authors.initials: A
authors.lastname: Mathis
authors.forename: Christian
authors.initials: C
authors.lastname: Gilles
authors.forename: Izzie Jacques
authors.initials: IJ
authors.lastname: Namer
authors.forename: Yann
authors.initials: Y
authors.lastname: Hode
authors.forename: Agnès
authors.initials: A
authors.lastname: Demaziere
authors.forename: Rémy
authors.initials: R
authors.lastname: Luthringer
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Macher
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000139:chemically induced / Q000503:physiopathology; D001143:Arousal / Q000187:drug effects / Q000502:physiology; D001921:Brain / Q000187:drug effects* / Q000503:physiopathology*; D001931:Brain Mapping; D004292:Dominance, Cerebral / Q000502:physiology; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007275:Injections, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D016584:Panic Disorder / Q000139:chemically induced* / Q000503:physiopathology*; D013758:Tetragastrin / Q000494:pharmacology*
chemical_list: D013758:Tetragastrin