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Figures
- Fig. 1
Schematic overview of a trial in the concurrent but distinct target–distractor task.
- Fig. 2
Mean postscanning scene ratings for valence, arousal and anxiety (disorder-related – neutral) for patients with panic disorder and healthy controls. Ratings were given on 9-point Likert scales as follows: valence, 1 = negative, 5 = neutral, 9 = positive; arousal, 1 = calm, 9 = intense; anxiety, 1 = low, 9 = high.
- Fig. 3
Differential brain activation for disorder-related compared with neutral distractor scenes in patients with panic disorder versus healthy controls in a priori–defined regions of interest (panic disorder > control, panic-related > neutral, all p < 0.005, uncorrected; p < 0.05, corrected; only selected effects are shown). ACC = anterior cingulate cortex; L = left; MCC = midcingulate cortex; R = right.
- Fig. 4
Correlation of panic disorder parameter estimates in the left insula (panic-related > neutral) and fear of cardiovascular symptoms as well as correlation of panic disorder parameter estimates in the brainstem (panic-related > neutral) and fear of respiratory symptoms. L = left.
Tables
- Table 1
Demographic and clinical characterization of patients with panic disorder and healthy controls
Characteristic Group; mean ± SD* Statistic p value Panic disorder Control Sex, female:male 20:6 19:7 χ2 = 0.103 0.75 Age, (range) yr 24.88 ± 6.12 (18–46) 24.46 ± 2.79 (19–32) t = −0.321 0.75 Education, yr 12.46 ± 0.99 12.52 ± 1.05 t = 0.205 0.84 Diagnosis, no. — — — — Panic disorder 13 NA — — Panic disorder with agoraphobia 13 NA — — PAS score 20.46 ± 7.05 NA — — ASI score Total 45.92 ± 2.88 10.12 ± 1.67 t = −10.76 < 0.001 Cardiovascular symptoms 9.58 ± 0.98 1.5 ± 0.40 t = −7.63 < 0.001 Respiratory symptoms 14.23 ± 1.25 2.69 ± 0.60 t = −8.31 < 0.001 Publicly observable symptoms 11.92 ± 1.03 4.65 ± 0.56 t = −6.20 < 0.001 Loss of control 10.19 ± 0.90 1.27 ± 0.39 t = −9.10 < 0.001 BDI score 14.23 ± 8.94 0.92± 2.08 t = −7.39 < 0.001 Comorbidities, no. Mild depressive episode 3 — — — Generalized anxiety disorder 4 — — — Somatization disorder and hypochondria 1 — — — Social or specific phobia 2 — — — Bulimia nervosa 1 — — — OCD 1 — — — ASI = Anxiety Sensitivity Scale; BDI = Beck Depression Inventory; NA = not applicable; OCD = obsessive–compulsive disorder; PAS = Panic and Agoraphobia Scale; SD = standard deviation.
↵* Unless indicated otherwise.
- Table 2
Significant hyperactivations for disorder-related versus neutral scenes across all patients relative to healthy controls revealed by small volume–corrected analysis (p ≤ 0.05, corrected)
Region Lateralization Talairach coordinates of peak voxel (x, y, z) t maximum t average k Amygdala L −17, −7, −8 3.49 3.196 17 Amygdala R 23, 3, −14 3.284 3.059 15 Insula L −31, −1, 18 4.166 3.313 45 Insula L −45, 8, −8 4.365 3.298 84 Brainstem L −3, −35, −8 4.311 3.444 134 Brainstem L −7, −33, −28 4.079 3.431 37 Thalamus, lat part L −15, −19, 6 4.548 3.433 41 Anterior cingulate cortex L −3, 19, 34 3.926 3.314 21 Anterior cingulate cortex L −3, 37, 16 3.415 3.108 22 Midcingulate cortex L/R −1, −1, 30 3.868 3.282 100 Midcingulate cortex L/R −5, 19, 38 4.26 3.412 60 L = left; R = right.
- Table 3
Significant hyperactivations for disorder-related versus neutral scenes across all patients relative to healthy controls revealed by whole-brain analysis in 2 clusters (p ≤ 0.05, corrected)*
Region Lateralization Talairach coordinates of peak voxel (x, y, z) F maximum F average k Cluster 1 L/R 1, −39, −2 4.38 3.40 504 Culmen R 1, −39, −2 4.38 3.40 378 Posterior cingulate cortex R 17, −43, 8 4.20 3.48 68 Brainstem/culmen L −10, −30, −7 4.03 3.37 19 Posterior cingulate cortex R 24, −54, 10 3.55 3.16 39 Cluster 2 L −47, 8, −3 4.51 3.28 399 Superior temporal gyrus L −47, 8, −3 4.51 3.26 185 Insula L −38, −1, −7 4.11 3.34 76 Precentral gyrus L −61, 5, 13 4.01 3.24 69 Temporal lobe L −35, −8, −13 3.88 3.36 30 Inferior frontal gyrus L −48, 3, 17 3.74 3.25 39 L = left ; R = right.
↵* The watershed algorithm of Neuroelf (v0.9c; http://neuroelf.net/; i.e., the splitclustercoords function) was used to assess local maxima of clusters.
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