Abnormal Threat Processing in Panic Disorder
Neurobiological models propose the modified processing of danger in PD (panic disorder) has a relationship to trouble within a brain network inclusive of the insula, the amygdala, the hippocampus the prefrontal cortex (PFC), and brainstem sites (such as the periaqueductal grey (PAG) region and locus coeruleus). A major contributor in aberrant threat processing in panic disorder has been ascribed to the amygdala, which is assumed to display greater watchfulness towards threat. Due to the fact that data holds doubt and abnormal threat-associated amygdala activity has not been reported constantly, it is important to understand abnormal activity in panic disorder patients.
An effective instrument to induce danger processing workings in individuals is script-driven imagery. Subjects normally hear an emotionally loaded narration and envision they are the main character. Emotional and somatic responses to danger envisioning have been shown to be close to physiological stimulation when coming up against real threat.
In the study by Burkhardt and colleagues (2019), functional magnetic resonance imaging (fMRI) was used to evaluate how the brains of panic disorder patients react throughout the duration of disorder-related script-driven imagery.
In this study, seventeen patients with panic disorder and an equal number of normal controls (HC) were exhibited to state-of-the-art illness-tied and unbiased narration dialogues during the time of having brain activity evaluated using an fMRI. Subjects were told to think of the images with as much senses and detail as they could summon.
Significant interaction effects were seen across all ratings of valence, anxiety, and arousal. Patients suffering of disorder in relation to normal controls evaluated PD-associated compared to impartial narrations as more stimulating, more fear-inducing, and more uncomfortable.
Panic disorder patients showed greater right amygdala activation compared to HC in reaction to PD-associated versus control scripts. In addition, subjects displayed less activity in numerous prefrontal areas such as the left ventrolateral PFC (vlPFC), right ventrolateral vlPFC, right ventromedial PFC (vmPFC), left dorsomedial PFC (dmPFC) and right dorsolateral PFC (dlPFC). Lessened stimulation was discovered in multiple domains of the cingulate cortex: so in the left rostral ACC (rACC), in the right rostral ACC and in the dorsal posterior cingulate cortex (dPCC).
The current study is earliest to show augmented amygdala activation in disordered individuals at the time of imagination of panic-associated narrations. It adds to the current literature on panic-disorder and is helpful in our understanding of panic-disorder which may aid in treatment recommendations in the future.
Source:
Burkhardt, A., Buff, C., Brinkmann, L., Feldker, K., Gathmann, B., Hofmann, D., & Straube, T. (2019). Brain activation during disorder related script-driven imagery in panic disorder: a pilot study. Scientific Reports (9), 2415. Retrieved from https://doi.org/10.1038/s41598-019-38990-0
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