Neuroimaging and Neural Correlates in Panic Disorder

Panic disorder is characterised by recurrent and unprovoked panic attacks that often lead to persistent concerns about further episodes and maladaptive behavioural avoidance. Neuroimaging studies have steadily advanced understanding of the neural circuitry underlying these symptoms, implicating aberrant function and structure in a distributed fear network encompassing the amygdala, prefrontal cortex, anterior cingulate, thalamus and brainstem. Functional magnetic resonance imaging has revealed hyper-responsivity of subcortical fear centres and reduced regulatory control from medial and lateral prefrontal regions during threat processing. Structural investigations using voxel-based morphometry and shape analysis have documented volumetric and morphological alterations in the amygdala and thalamus that correlate with symptom severity. Diffusion tensor imaging further highlights compromised white matter integrity in fronto-limbic tracts, suggesting impaired communication across the network. Collectively, these findings portray panic disorder as a circuit-level dysfunction and point to potential biomarkers to track disease progression, predict treatment outcome and inform the development of targeted interventions.

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Neuroimaging and Neural Correlates in Panic Disorder publication trend

The graph below shows the total number of articles in neuroimaging and neural correlates in panic disorder across all publications each year (not limited to Nature Index journals).

Technical terms

Functional magnetic resonance imaging (fMRI): A non-invasive method for measuring brain activity by detecting changes associated with blood oxygenation.

Regional homogeneity (ReHo): A measure of the synchrony of spontaneous neural activity within a local cluster of brain voxels, used to assess functional connectivity.

Voxel-based morphometry (VBM): A neuroimaging analysis technique that enables voxelwise comparison of grey matter volume and concentration across individuals.

Support vector regression (SVR): A machine-learning algorithm that models the relationship between input features and continuous outcome variables, useful for predicting treatment response.

Amygdala sub-nuclei: Distinct anatomic subdivisions of the amygdala, such as the lateral and basal nuclei, each with specialised roles in emotion processing.

References

1. Breaking the Fear Barrier: Aberrant Activity of Fear Networks as a Prognostic Biomarker in Patients with Panic Disorder Normalized by Pharmacotherapy. Biomedicines (2023).
2. Unstable Prefrontal Response to Emotional Conflict and Activation of Lower Limbic Structures and Brainstem in Remitted Panic Disorder. PLOS ONE (2009).
3. Thalamic shape and volume abnormalities in female patients with panic disorder. PLOS ONE (2018).
4. Subregional Shape Alterations in the Amygdala in Patients with Panic Disorder. PLOS ONE (2016).
5. Smaller volumes in the lateral and basal nuclei of the amygdala in patients with panic disorder. PLOS ONE (2018).
6. Frontal White Matter Alterations in Short-Term Medicated Panic Disorder Patients without Comorbid Conditions: A Diffusion Tensor Imaging Study. PLOS ONE (2014).