Decreased hypothalamus volumes in generalized anxiety disorder but not in panic disorder.
BACKGROUND
The hypothalamus is a brain structure involved in the neuroendocrine aspect of stress and anxiety. Evidence suggests that generalized anxiety disorder (GAD) and panic disorder (PD) might be accompanied by dysfunction of the hypothalamus-pituitary-adrenal axis (HPA), but so far structural alterations were not studied. We investigated hypothalamic volumes in patients with either GAD or PD and in healthy controls.


METHODS
Twelve GAD patients, 11 PD patients and 21 healthy controls underwent a 1.5T MRI scan. Hypothalamus volumes were manually traced by a rater blind to subjects' identity. General linear model for repeated measures (GLM-RM) was used to compare groups on hypothalamic volumes, controlling for total intracranial volume, age and sex.


RESULTS
The hypothalamus volume was significantly reduced (p=0.04) in GAD patients, with significant reductions in both the left (p=0.02) and right side (p=0.04). Patients with PD did not differ significantly (p=0.73). Anxiety scores were inversely correlated with hypothalamic volumes.


CONCLUSIONS
The small sample size could reduce the generalizability of the results while the lack of stress hormone measurements renders functional assessment of the hypothalamus-pituitary-adrenal axis not feasible.


CONCLUSIONS
The present study showed decreased hypothalamic volumes in GAD patients but not in those with PD. Future longitudinal studies should combine volumetric data with measurements of stress hormones to better elucidate the role of the HPA axis in GAD.
Department of Experimental & Clinical Medical Sciences (DISM), Inter-University Centre for Behavioural Neurosciences, University of Udine, Udine, Italy.
Robert
R
Terlevic
Miriam
M
Isola
Maria
M
Ragogna
Martina
M
Meduri
Francesca
F
Canalaz
Laura
L
Perini
Gianluca
G
Rambaldelli
Luciana
L
Travan
Enrico
E
Crivellato
Stefania
S
Tognin
Giuseppe
G
Como
Chiara
C
Zuiani
Massimo
M
Bazzocchi
Matteo
M
Balestrieri
Paolo
P
Brambilla
D000328:Adult; D001008:Anxiety Disorders / Q000473:pathology* / Q000503:physiopathology; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007030:Hypothalamo-Hypophyseal System / Q000503:physiopathology; D007031:Hypothalamus / Q000033:anatomy & histology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D016584:Panic Disorder / Q000473:pathology* / Q000503:physiopathology; D010913:Pituitary-Adrenal System / Q000503:physiopathology; D055815:Young Adult