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Resting-state causal connectivity of the bed nucleus of the stria terminalis in panic disorder

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Abstract

Panic disorder (PD) is associated with anticipatory anxiety, a sustained threat response that appears to be related to the bed nucleus of the stria terminalis (BNST). Individuals with panic disorder may demonstrate significant differences in causal connectivity of the BNST in comparison to healthy controls. To test this hypothesis, resting-state functional magnetic resonance imaging (fMRI) was used to identify aberrant causal connectivity of the BNST in PD patients. 19 PD patients and 18 healthy controls (HC) matched for gender, age and education were included. Granger causality analysis (GCA) utilizing the BNST as a seed region was used to investigate changes in directional connectivity. Relative to healthy controls, PD patients displayed abnormal directional connectivity of the BNST including enhanced causal connectivity between the left parahippocampal gyrus and left BNST, the right insula and the right BNST, the left BNST and the right dorsolateral prefrontal cortex (dlPFC) and right BNST to the left and right dlPFC. Furthermore, PD patients displayed weakened causal connectivity between the right dlPFC and the left BNST, the left dlPFC and the right BNST, the left BNST and the left dorsomedial prefrontal cortex (dmPFC), right insula, right fusiform, and right BNST to the right insula. The results suggest that PD strongly correlates with increased causal connectivity between emotional processing regions and the BNST and enhanced causal connectivity between the BNST and cognitive control regions.

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Abbreviations

PD:

panic disorder

BNST:

bed nucleus of the stria terminalis

fMRI:

functional magnetic resonance imaging

HC:

healthy controls

GCA:

Granger causality analysis

dlPFC:

dorsolateral prefrontal cortex

dmPFC:

dorsomedial prefrontal cortex

PFC:

prefrontal cortex

vmPFC:

ventromedial prefrontal cortex

ACC:

anterior cingulate cortex

PTSD:

post-traumatic stress disorder

CeA:

central amygdala

mPFC:

medial prefrontal cortex

vHPC:

ventral hippocampus

DSM-IV:

Diagnostic and Statistical Manual of Mental Disorders

MINI:

International Neuropsychiatric Interview

MPRAGE:

magnetization-prepared rapid acquisition gradient echo

EPI:

echo planar imaging

TR:

repetition time

TE:

echo time

FA:

flip angle

FOV:

field of view

HAMA:

Hamilton Anxiety Rating Scale

MNI:

Montreal Neurological Institute

PreCG:

precentral gyrus

ALFF:

amplitude of low frequency fluctuation

ReHo:

regional homogeneity

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Acknowledgements

This study was supported by National Natural Science Foundation of China (81571344, 81871344); Natural Science Foundation of Jiangsu Province (BK20161109, BK20191369); the Natural Science Foundation of the Higher Education Institutions of Jiangsu Province, China (18KJB190003); key research and development program (Social Development) project of Jiangsu province (BE2019609); Nanjing Medical Science and Technique Development Foundation, Outstanding Youth Project (JQX14008).

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  1. Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China

    Manlong Pang, Huazhen Xu, Yun Wu, Changjun Teng, Chaoyong Xiao, Peter T. Fox, Ning Zhang & Chun Wang

  2. School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China

    Manlong Pang, Yuan Zhong, Ziyu Hao, Yun Wu, Changjun Teng, Jian Li, Ning Zhang & Chun Wang

  3. Functional Brain Imaging Institute of Nanjing Medical University, Nanjing, Jiangsu, China

    Manlong Pang, Huazhen Xu, Yun Wu, Changjun Teng, Chaoyong Xiao, Peter T. Fox, Ning Zhang & Chun Wang

  4. Cognitive Behavioral Therapy Institute of Nanjing Medical University, Nanjing, Jiangsu, China

    Manlong Pang, Yun Wu, Changjun Teng, Peter T. Fox, Ning Zhang & Chun Wang

  5. Jiangsu Key Laboratory of Mental Health and Cognitive Science, Nanjing Normal University, Nanjing, Jiangsu, China

    Yuan Zhong

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Pang, M., Zhong, Y., Hao, Z. et al. Resting-state causal connectivity of the bed nucleus of the stria terminalis in panic disorder. Brain Imaging and Behavior 15, 25–35 (2021). https://doi.org/10.1007/s11682-019-00229-x

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