Neural correlates of spontaneous panic attacks
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In this report, we present two anxiety disorder patients who spontaneously experienced a panic attack during an fMRI examination and subsequently aborted the measurement. We analyzed the functional data gathered up to that point in relation to the patients’ subsequent verbal reports of the course of the panic attacks. Within prominent structures of the fear network (amygdala, insula, prefrontal cortex) neural dynamics mirrored the description of the attack very well for one of the patients. For the other patient who experienced a less intense attack and who was treated pharmacologically at the time of measurement, the relation was limited to the prefrontal cortex. Investigating the temporal dynamics of neural activation in an ecologically valid situation may point to the potentially different roles of the amygdala and the insula as well as the prefrontal cortex prior to and during a panic attack.
KeywordsPanic attack fMRI Insula Amygdala Prefrontal cortex
We would like to thank Drs. Blaimer and Breuer (Research Center for Magnetic Resonance Bavaria e.V.) for technical assistance. The study was supported by a grant from the Deutsche Forschungsgemeinschaft (Transregio-SFB TRR 58, grant No. TRR58-C4 to ACE & AJF, grant TRR58-Z2 to JD).
Conflict of Interest
The authors reported no biomedical financial interests or potential conflicts of interest.
- Hahn T, Marquand AF, Ehlis A-C, Dresler T, Kittel-Schneider S, Jarczok T, Lesch K-P, Jakob PM, Mourao-Miranda J, Brammer M, Fallgatter AJ (2011) Integrating neurobiological markers of depression. Arch Gen Psychiatry (in press)Google Scholar
- Hautzinger M, Keller F, Kühner C (2006) Beck Depressions-Inventar (BDI-II). Revision. Harcourt Test Services, Frankfurt/MainGoogle Scholar
- Kent JM, Coplan JD, Mawlawi O, Martinez JM, Browne ST, Slifstein M, Martinez D, Abi-Dargham A, Laruelle M, Gorman JM (2005) Prediction of panic response to a respiratory stimulant by reduced orbitofrontal cerebral blood flow in panic disorder. Am J Psychiatry 162:1379–1381PubMedCrossRefGoogle Scholar
- Krohne HW, Egloff B, Kohlmann CW, Tausch A (1996) Untersuchungen mit einer Deutschen Version der “Positive and Negative Affect Schedule” (PANAS) [Investigations with a German version of the Positive and Negative Affect Schedule]. Diagnostica 42:139–156Google Scholar
- Laux L, Glanzmann P, Schaffner P, Spielberger CD (1981) Das State-Trait-Angstinventar (STAI). Beltz, WeinheimGoogle Scholar
- Lundqvist D, Flykt A, Oehman A (1998) The karolinska directed emotional faces—KDEF, CD ROM from Department of Clinical Neuroscience. Psychology section, Karolinska InstitutetGoogle Scholar
- Penfield W, Faulk ME (1955) The insula. Further observations on its function. Brain 78:445–470Google Scholar
- Schunck T, Mathis A, Erb G, Namer IJ, Hode Y, Demazieres A, Luthringer R (2011) One milligram of lorazepam does not decrease anxiety induced by CCK-4 in healthy volunteers: investigation of neural correlates with BOLD MRI. J Psychopharmacol (in press)Google Scholar
- Schwenkmezger P, Hodapp V, Spielberger CD (1992) Das State-Trait-Ärgerausdrucks-Inventar (STAXI). Huber, BernGoogle Scholar
- Spiegelhalder K, Hornyak M, Kyle SD, Paul D, Blechert J, Seifritz E, Hennig J, Tebartz van Elst L, Riemann D, Feige B (2009) Cerebral correlates of heart rate variations during a spontaneous panic attack in the fMRI scanner. Neurocase 1–8Google Scholar
- van den Heuvel OA, Veltman DJ, Groenewegen HJ, Witter MP, Merkelbach J, Cath DC, van Balkom AJ, van Oppen P, van Dyck R (2005) Disorder-specific neuroanatomical correlates of attentional bias in obsessive-compulsive disorder, panic disorder, and hypochondriasis. Arch Gen Psychiatry 62:922–933PubMedCrossRefGoogle Scholar