title: Improvements in white matter micro-structural integrity of right uncinate fasciculus and left fronto-occipital fasciculus of remitted first-episode medication-naïve panic disorder patients.
abstract: OBJECTIVE
  We designed this study to investigate neural correlates of white matter micro-structural integrity of remitted patients with first-episode, medication-naïve and very late-onset panic disorder.
  
  
  METHODS
  Twenty-one remitted patients with panic disorder completed treatment course with treatment of escitalopram (dose range around 10-15 mg/d). Twenty-one healthy controls were also enrolled into this study. Patients and controls all received 3-Tesla magnetic resonance imaging diffusion tensor imaging scanning at baseline and 6th week. We utilized FDT (FMRIB's Diffusion Toolbox v2.0) function of FSL (FMRIB Software Library) to calculate fractional anisotropy (FA). We compared FA values of patients and controls at baseline and 6th week to estimate the changes of FA of remitted patient group and inter-scan bias of controls. FA outputs of remitted patients and controls were compared by independent t test.
  
  
  RESULTS
  We found increased FA in some regions of right uncinate fasciculus and left fronoto-occipital fasciculus after remission in patient group (corrected p<0.05). Reduced FA of other regions of right uncinate fasciculus was still observed in remitted patients when they were compared to the control group.
  
  
  CONCLUSIONS
  Subtle changes of white matter micro-structural integrity after remission might represent neural correlates of treatment effects for first-episode, medication-naïve and very late-onset panic disorder.
authors.affiliation: Department of Psychiatry, Cheng Hsin General Hospital, No. 45, Cheng Hsin St., Pai-Tou Destrict, Taipei City, Taiwan, ROC. t122336257@yahoo.com.tw
authors.forename: Chien-Han
authors.initials: CH
authors.lastname: Lai
authors.forename: Yu-Te
authors.initials: YT
authors.lastname: Wu
authors.forename: Pei-Ling
authors.initials: PL
authors.lastname: Yu
authors.forename: Wei
authors.initials: W
authors.lastname: Yuan
mesh_terms: D000328:Adult; D017668:Age of Onset; D016880:Anisotropy; D015283:Citalopram / Q000627:therapeutic use*; D056324:Diffusion Tensor Imaging; D005260:Female; D005625:Frontal Lobe / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D009778:Occipital Lobe / Q000473:pathology* / Q000503:physiopathology; D016584:Panic Disorder / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D013702:Temporal Lobe / Q000473:pathology / Q000503:physiopathology
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors
keywords: Escitalopram; Fronto-occipital fasciculus; Panic disorder; Uncinate fasciculus; White matter