title: Midbrain volume increase in patients with panic disorder.
abstract: OBJECTIVE
  Although recent studies suggest abnormalities of the cerebral cortex, limbic structures, and brain stem regions in panic disorder (PD), the extent to which the midbrain is associated with PD pathophysiology is unclear. The aim of this study was to investigate structural abnormalities of the midbrain using magnetic resonance imaging and to determine if there is a clinical correlation between midbrain volume and clinical measurements in patients with PD.
  
  
  METHODS
  Thirty-eight patients with PD (PD group) and 38 healthy controls (HC group) participated in this study. The midbrain was measured with a manual tracing method with high spatial resolution magnetic resonance imaging. The Panic Disorder Severity Scale and Global Assessment of Functioning were used to examine the correlation between volume abnormality and clinical symptoms and functioning in the PD group.
  
  
  RESULTS
  Relative midbrain volume was larger in the PD group than in the HC group. The relative volume of the dorsal midbrain was larger in the PD group, while the volume of the ventral midbrain was not. We found a significant positive correlation between relative dorsal midbrain volume and total Panic Disorder Severity Scale score, and a significant negative correlation between relative dorsal midbrain volume and Global Assessment of Functioning score in the PD group.
  
  
  CONCLUSIONS
  Our findings suggest that the dorsal midbrain is associated with PD pathophysiology. The midbrain volume increase may reflect PD severity.
authors.affiliation: Department of Psychiatry, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Fujiwara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yoshida
authors.forename: Tatsui
authors.initials: T
authors.lastname: Otsuka
authors.forename: Fumi
authors.initials: F
authors.lastname: Hayano
authors.forename: Takeshi
authors.initials: T
authors.lastname: Asami
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Narita
authors.forename: Motoaki
authors.initials: M
authors.lastname: Nakamura
authors.forename: Tomio
authors.initials: T
authors.lastname: Inoue
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Hirayasu
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008636:Mesencephalon / Q000473:pathology*; D008875:Middle Aged; D009929:Organ Size; D016584:Panic Disorder / Q000473:pathology*