title: (1)H magnetic resonance spectroscopy imaging of the hippocampus in patients with panic disorder.
abstract: Recent theories of panic disorder propose an extensive involvement of limbic system structures, such as the hippocampus, in the pathophysiology of this condition. Despite this, no prior study has examined exclusively the hippocampal neurochemistry in this disorder. The current study used proton magnetic resonance spectroscopy imaging ((1)H-MRSI) to examine possible abnormalities in the hippocampus in panic disorder patients. Participants comprised 25 panic patients and 18 psychiatrically healthy controls. N-acetylaspartate (NAA, a putative marker of neuronal viability) and choline (Cho, involved in the synthesis and degradation of cell membranes) levels were quantified relative to creatine (Cr, which is thought to be relatively stable among individuals and in different metabolic condition) in both right and left hippocampi. Compared with controls, panic patients demonstrated significantly lower NAA/Cr in the left hippocampus. No other difference was detected. This result is consistent with previous neuroimaging findings of hippocampal alterations in panic and provides the first neurochemical evidence suggestive of involvement of this structure in the disorder. Moreover, lower left hippocampal NAA/Cr in panic disorder may possibly reflect neuronal loss and/or neuronal metabolic dysfunction, and could be related to a deficit in evaluating ambiguous cues.
authors.affiliation: Department of Neuroscience and Behavior, Division of Psychiatry, Faculty of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil. clarissaf@hotmail.com
authors.forename: Clarissa
authors.initials: C
authors.lastname: Trzesniak
authors.forename: Ricardo R
authors.initials: RR
authors.lastname: Uchida
authors.forename: David
authors.initials: D
authors.lastname: Araújo
authors.forename: Francisco S
authors.initials: FS
authors.lastname: Guimarães
authors.forename: Maria Cecília
authors.initials: MC
authors.lastname: Freitas-Ferrari
authors.forename: Alaor Santos
authors.initials: AS
authors.lastname: Filho
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Santos
authors.forename: Geraldo F
authors.initials: GF
authors.lastname: Busatto
authors.forename: Antonio W
authors.initials: AW
authors.lastname: Zuardi
authors.forename: Cristina M
authors.initials: CM
authors.lastname: Del-Ben
authors.forename: Frederico G
authors.initials: FG
authors.lastname: Graeff
authors.forename: José A
authors.initials: JA
authors.lastname: Crippa
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D001224:Aspartic Acid / Q000031:analogs & derivatives* / Q000378:metabolism; D002794:Choline / Q000378:metabolism*; D003401:Creatine / Q000378:metabolism*; D005260:Female; D006624:Hippocampus / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000503:physiopathology*; D011522:Protons; D055815:Young Adult
chemical_list: D011522:Protons; D001224:Aspartic Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline