Laboratório de Pânico e Respiração, Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Intramural Program, National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA.
Braz J Psychiatry. 2021 Nov-Dec;43(6):605-612. doi: 10.1590/1516-4446-2020-1573.
Decades of research have highlighted the involvement of the prefrontal cortex, anterior cingulated cortex, and limbic areas (amygdala) in panic disorder (PD). However, little attention has been given specifically to the inferior frontal gyrus. The current study aimed to investigate the neural substrates, including the inferior frontal gyrus, of both panic-related and negative conditions among individuals with PD and healthy controls.
We examined 13 medication-free PD patients and 14 healthy controls with functional magnetic resonance imaging (fMRI) during exposure to negative and neutral pictures and a set of specific panic-related pictures.
Subtraction between the conditions indicated activation of the left amygdala region and the right inferior frontal gyrus in PD patients during the specific panic-related condition, whereas the left amygdalar region and left inferior frontal gyrus were activated during the negative condition in controls.
These results suggest that in patients with PD, a prominent bottom-up process is involved in specific panic-related conditions, which might be associated with weak modulation of the left frontal area. These data add to our current understanding of the neural correlates of PD and can contribute to future clinical interventions targeting the functional reestablishment of these regions.
数十年的研究强调了前额叶皮层、前扣带皮层和边缘区域（杏仁核）在惊恐障碍（PD）中的作用。然而，人们对下额叶的关注较少。本研究旨在探讨包括下额叶在内的惊恐相关和负性条件下的神经基础，包括惊恐障碍患者和健康对照组。
我们使用功能磁共振成像（fMRI）检查了 13 名未服用药物的 PD 患者和 14 名健康对照者，在暴露于负性和中性图片以及一组特定的惊恐相关图片时进行检查。
在特定的惊恐相关条件下，PD 患者在减去条件后，左侧杏仁核区域和右侧下额叶 gyrus 被激活，而在对照组中，左侧杏仁核区域和左侧下额叶 gyrus 在负性条件下被激活。
这些结果表明，在 PD 患者中，一个突出的自上而下的过程参与了特定的惊恐相关条件，这可能与左侧额叶区域的调节减弱有关。这些数据增加了我们对 PD 神经相关性的理解，并为未来针对这些区域功能重建的临床干预提供了帮助。
