title: The neural representation of emotionally neutral faces and places in patients with panic disorder with agoraphobia.
abstract: BACKGROUND
  Panic disorder with agoraphobia (PD-A) has been associated with abnormal neural activity for threat-related stimuli (faces, places). Recent findings suggest a disturbed neural processing of emotionally neutral stimuli at a more general level.
  
  
  METHODS
  Using functional magnetic resonance imaging (fMRI) we investigated the neural processing of emotionally neutral faces and places in PD-A. Fifteen patients with PD-A and fifteen healthy subjects participated in the study.
  
  
  RESULTS
  When they perceived neutral faces and places, the patients with PD-A showed significantly less brain activity in the fusiform gyrus, the inferior occipital gyrus, the calcarine gyrus, the cerebellum, and the cuneus compared with the healthy controls. However, the patients with PD-A showed significantly more brain activity in the precuneus compared with controls subjects.
  
  
  CONCLUSIONS
  It was not possible to distinguish the agoraphobia-associated effects from possible contributions due to general anxiety induced by fMRI. For future investigations, an additional clinical control group with patients suffering from panic disorder without agoraphobia would be of interest. In addition, the psychopathology concerning the agoraphobic symptoms needs to be investigated in more detail.
  
  
  CONCLUSIONS
  The findings suggest altered neural processing of emotionally neutral faces and places in patients with PD-A. Reduced neural activity in different brain regions may indicate difficulties in recognizing the emotional content in face and place stimuli due to anxiety-related hyper-arousal.
authors.affiliation: Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Fetscherstrasse 74, 01307 Dresden, Germany. Electronic address: katja.petrowski@tu-dresden.de.
authors.forename: Katja
authors.initials: K
authors.lastname: Petrowski
authors.forename: Gloria
authors.initials: G
authors.lastname: Wintermann
authors.forename: Michael N
authors.initials: MN
authors.lastname: Smolka
authors.forename: Thomas
authors.initials: T
authors.lastname: Huebner
authors.forename: Markus
authors.initials: M
authors.lastname: Donix
mesh_terms: D000328:Adult; D000379:Agoraphobia / Q000503:physiopathology*; D001921:Brain / Q000503:physiopathology*; D016022:Case-Control Studies; D004644:Emotions; D005149:Facial Expression; D005260:Female; D059907:Functional Neuroimaging; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D016584:Panic Disorder / Q000503:physiopathology*; D010775:Photic Stimulation
keywords: Emotional processing; Neutral stimuli; Panic disorder with agoraphobia; fMRI