Anticipating agoraphobic situations: the neural correlates of panic disorder with agoraphobia.

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  • Additional Information
    • Source:
      Publisher: Cambridge University Press Country of Publication: England NLM ID: 1254142 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1469-8978 (Electronic) Linking ISSN: 00332917 NLM ISO Abbreviation: Psychol Med Subsets: MEDLINE
    • Publication Information:
      Publication: London : Cambridge University Press
      Original Publication: London, British Medical Assn.
    • Subject Terms:
      Agoraphobia/*physiopathology ; Anticipation, Psychological/*physiology ; Cerebral Cortex/*physiopathology ; Panic Disorder/*physiopathology ; Ventral Striatum/*physiopathology; Adult ; Agoraphobia/epidemiology ; Comorbidity ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Panic Disorder/epidemiology
    • Abstract:
      Background: Panic disorder with agoraphobia is characterized by panic attacks and anxiety in situations where escape might be difficult. However, neuroimaging studies specifically focusing on agoraphobia are rare. Here we used functional magnetic resonance imaging (fMRI) with disorder-specific stimuli to investigate the neural substrates of agoraphobia.
      Method: We compared the neural activations of 72 patients suffering from panic disorder with agoraphobia with 72 matched healthy control subjects in a 3-T fMRI study. To isolate agoraphobia-specific alterations we tested the effects of the anticipation and perception of an agoraphobia-specific stimulus set. During fMRI, 48 agoraphobia-specific and 48 neutral pictures were randomly presented with and without anticipatory stimulus indicating the content of the subsequent pictures (Westphal paradigm).
      Results: During the anticipation of agoraphobia-specific pictures, stronger activations were found in the bilateral ventral striatum and left insula in patients compared with controls. There were no group differences during the perception phase of agoraphobia-specific pictures.
      Conclusions: This study revealed stronger region-specific activations in patients suffering from panic disorder with agoraphobia in anticipation of agoraphobia-specific stimuli. Patients seem to process these stimuli more intensively based on individual salience. Hyperactivation of the ventral striatum and insula when anticipating agoraphobia-specific situations might be a central neurofunctional correlate of agoraphobia. Knowledge about the neural correlates of anticipatory and perceptual processes regarding agoraphobic situations will help to optimize and evaluate treatments, such as exposure therapy, in patients with panic disorder and agoraphobia.
    • Molecular Sequence:
      ISRCTN ISRCTN80046034
    • Publication Date:
      Date Created: 20140109 Date Completed: 20160125 Latest Revision: 20150714
    • Publication Date:
      20221213
    • Accession Number:
      10.1017/S0033291713003085
    • Accession Number:
      24398049