Neurosci Biobehav Rev. 2014 Oct;46 Pt 3:472-96. doi: 10.1016/j.neubiorev.2014.10.002.
Panic disorder (PD) patients are specifically sensitive to 5–7% carbon dioxide. Another startling feature of clinical panic is the counterintuitive lack of increments in ‘stress hormones’. PD is also more frequent in women and highly comorbid with childhood separation anxiety (CSA). On the other hand, increasing evidence suggests that panic is mediated at dorsal periaqueductal grey matter (DPAG). In line with prior studies showing that DPAG-evoked panic-like behaviours are attenuated by clinically-effective treatments with panicolytics, we show here that (i) the DPAG harbors a hypoxia-sensitive alarm system, which is activated by hypoxia and potentiated by hypercapnia, (ii) the DPAG suffocation alarm system is inhibited by clinically-effective treatments with panicolytics, (iii) DPAG stimulations do not increase stress hormones in the absence of physical exertion, (iv) DPAG-evoked panic-like behaviours are facilitated in neonatally-isolated adult rats, a model of CSA, and (v) DPAG-evoked responses are enhanced in the late diestrus of female rats. Data are consistent with the DPAG mediation of both respiratory and non-respiratory types of panic attacks.
惊恐障碍（PD）患者对 5-7%的二氧化碳特别敏感。临床惊恐的另一个惊人特征是“应激激素”没有递增。PD 在女性中更为常见，并且与儿童分离焦虑（CSA）高度共病。另一方面，越来越多的证据表明，惊恐是在背侧导水管周围灰质（DPAG）中介导的。与先前的研究一致，该研究表明 DPAG 诱发的类似惊恐的行为被惊恐症药物的临床有效治疗所减弱，我们在这里表明：（i）DPAG 具有缺氧敏感的报警系统，该系统被缺氧激活，并被高碳酸血症增强；（ii）DPAG 窒息报警系统被惊恐症药物的临床有效治疗所抑制；（iii）DPAG 刺激在没有体力消耗的情况下不会增加应激激素；（iv）DPAG 诱发的类似惊恐的行为在新生分离的成年大鼠中得到促进，这是 CSA 的一种模型；（v）DPAG 诱发的反应在雌性大鼠的晚发情期增强。这些数据与 DPAG 介导的呼吸和非呼吸类型的惊恐发作一致。
