Laboratory of Panic and Respiration, National Institute for Translational Medicine Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil.
Braz J Psychiatry. 2012 Jun;34 Suppl 1:S32-41. doi: 10.1590/s1516-44462012000500004.
Respiratory changes are associated with anxiety disorders, particularly panic disorder (PD). The stimulation of respiration in PD patients during panic attacks is well documented in the literature, and a number of abnormalities in respiration, such as enhanced CO2 sensitivity, have been detected in PD patients. Investigators hypothesized that there is a fundamental abnormality in the physiological mechanisms that control breathing in PD.
The authors searched for articles regarding the connection between the respiratory system and PD, more specifically papers on respiratory challenges, respiratory subtype, and current mechanistic concepts.
Recent evidences support the presence of subclinical changes in respiration and other functions related to body homeostasis in PD patients. The fear network, comprising the hippocampus, medial prefrontal cortex, amygdala and its brainstem projections, may be abnormally sensitive in PD patients, and respiratory stimulants like CO2 may trigger panic attacks. Studies indicate that PD patients with dominant respiratory symptoms are particularly sensitive to respiratory tests compared to those who do not manifest dominant respiratory symptoms, representing a distinct subtype. The evidence of changes in several neurochemical systems might be the expression of the complex interaction among brain circuits.
呼吸变化与焦虑障碍有关，特别是惊恐障碍（PD）。文献中有充分的证据表明，PD 患者在惊恐发作期间会刺激呼吸，并且已经在 PD 患者中检测到呼吸的许多异常，例如增强的 CO2 敏感性。研究人员假设 PD 患者控制呼吸的生理机制存在根本异常。
作者搜索了有关呼吸系统与 PD 之间联系的文章，更具体地说是关于呼吸挑战、呼吸亚型和当前机制概念的论文。
最近的证据支持 PD 患者存在与呼吸和其他与身体内稳态相关的功能的亚临床变化。恐惧网络，包括海马体、内侧前额叶皮层、杏仁核及其脑干投射，可能在 PD 患者中异常敏感，而 CO2 等呼吸刺激物可能引发惊恐发作。研究表明，与没有表现出主要呼吸症状的 PD 患者相比，以呼吸症状为主的 PD 患者对呼吸测试更为敏感，代表一种特殊的亚型。几种神经化学系统的变化证据可能是大脑回路之间复杂相互作用的表现。
