Department of Psychiatry and Psychotherapy, Charite Campus Mitte,Charite - Universitatsmedizin Berlin, Chariteplatz 1, 10117 Berlin, Germany.
Curr Pharm Des. 2012;18(35):5619-26. doi: 10.2174/138161212803530808.
The validity of experimentally induced panic attacks as a model to study the pathophysiology of panic disorder has been questioned. Unspecific, unpleasant and aversive effects as well as specific patterns of psychovegetative symptoms pointing to different subtypes of panic disorder patients have been observed. These findings raise the question of challenge paradigms as a valuable tool to identify different vulnerabilities in patients with panic disorder.
We compared the two most widely studied panicogenic drugs sodium lactate and cholecystokinine tetrapeptide (CCK-4) with placebo in 25 patients with panic disorder and matched healthy control subjects. Psychophysiological changes were measured using the Acute Panic Inventory (API) and visual analogue scales for anxiety and arousal.
In patients with panic disorder 18 out of 25 experienced a sodium lactate- or a CCK-4 induced panic attack. Lactate or CCK-4 induced symptoms and induced panic attacks were only correlated in healthy controls, but not in patients with panic disorder.
The mechanisms of lactate and CCK-4 induced panic attacks are distinct in panic disorder patients but not in healthy controls. Different neurobiological vulnerabilities may be uncovered by different challenges.
实验性诱发恐慌发作作为研究恐慌症病理生理学的模型的有效性一直存在争议。人们观察到非特异性、不愉快和厌恶的效应，以及指向不同类型恐慌症患者的特定心理植物神经症状模式。这些发现提出了挑战范式作为识别恐慌症患者不同脆弱性的有价值工具的问题。
我们比较了 25 名恐慌症患者和匹配的健康对照组中两种研究最广泛的致恐慌药物——乳酸钠和胆囊收缩素四肽（CCK-4）与安慰剂的作用。使用急性恐慌量表（API）和焦虑和唤醒的视觉模拟量表测量心理生理变化。
在 25 名恐慌症患者中，有 18 名出现了乳酸钠或 CCK-4 引起的恐慌发作。乳酸或 CCK-4 引起的症状和引起的恐慌发作仅在健康对照组中相关，而在恐慌症患者中不相关。
乳酸钠和 CCK-4 引起的恐慌发作在恐慌症患者中的机制不同，但在健康对照组中则不同。不同的挑战可能揭示不同的神经生物学脆弱性。
