title: (Don't) panic in the scanner! How panic patients with agoraphobia experience a functional magnetic resonance imaging session.
abstract: Although functional magnetic resonance imaging (fMRI) has gained increasing importance in investigating neural substrates of anxiety disorders, less is known about the stress eliciting properties of the scanner environment itself. The aim of the study was to investigate feasibility, self-reported distress and anxiety management strategies during an fMRI experiment in a comprehensive sample of patients with panic disorder and agoraphobia (PD/AG). Within the national research network PANIC-NET, n=89 patients and n=90 controls participated in a multicenter fMRI study. Subjects completed a retrospective questionnaire on self-reported distress, including a habituation profile and exploratory questions about helpful strategies. Drop-out rates and fMRI quality parameters were employed as markers of study feasibility. Different anxiety measures were used to identify patients particularly vulnerable to increased scanner anxiety and impaired data quality. Three (3.5%) patients terminated the session prematurely. While drop-out rates were comparable for patients and controls, data quality was moderately impaired in patients. Distress was significantly elevated in patients compared to controls; claustrophobic anxiety was furthermore associated with pronounced distress and lower fMRI data quality in patients. Patients reported helpful strategies, including motivational factors and cognitive coping strategies. The feasibility of large-scale fMRI studies on PD/AG patients could be proved. Study designs should nevertheless acknowledge that the MRI setting may enhance stress reactions. Future studies are needed to investigate the relationship between self-reported distress and fMRI data in patient groups that are subject to neuroimaging research.
authors.affiliation: Institute of Clinical Psychology and Psychotherapy, Department of Psychology, Technische Universität Dresden, Dresden, Germany. lueken@psychologie.tu-dresden.de
authors.forename: Ulrike
authors.initials: U
authors.lastname: Lueken
authors.forename: Markus
authors.initials: M
authors.lastname: Muehlhan
authors.forename: Hans-Ulrich
authors.initials: HU
authors.lastname: Wittchen
authors.forename: Thilo
authors.initials: T
authors.lastname: Kellermann
authors.forename: Isabelle
authors.initials: I
authors.lastname: Reinhardt
authors.forename: Carsten
authors.initials: C
authors.lastname: Konrad
authors.forename: Thomas
authors.initials: T
authors.lastname: Lang
authors.forename: André
authors.initials: A
authors.lastname: Wittmann
authors.forename: Andreas
authors.initials: A
authors.lastname: Ströhle
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Gerlach
authors.forename: Adrianna
authors.initials: A
authors.lastname: Ewert
authors.forename: Tilo
authors.initials: T
authors.lastname: Kircher
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000379:Agoraphobia / Q000523:psychology*; D001007:Anxiety / Q000523:psychology; D001008:Anxiety Disorders / Q000523:psychology*; D015928:Cognitive Behavioral Therapy; D035061:Control Groups; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010200:Panic; D016584:Panic Disorder / Q000523:psychology*; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult