Pan Anguang, Liu Shaojie, Hu Shijun, Dai Jin, Yi Juan
Department of Radiology, Xishan Hospital, the Seventh People's Hospital of Wenzhou, Wenzhou, Zhejiang, China.
Hainan Province's Capital City Compulsory Isolation Drug Rehabilitation Center Hospital, Haikou, Hainan, China.
Psychiatry Clin Psychopharmacol. 2023 Sep 1;33(3):229-237. doi: 10.5152/pcp.2023.23684. eCollection 2023 Sep.
Gray matter alterations play a role in the panic disorder's pathophysiology origin. However, the current literature seemed inadequate to reach a consistent conclusion. Therefore, we conducted this gray matter meta-analysis on panic disorder.
A systematic review and a voxel-wise meta-analysis based on voxel-based morphometry were conducted for the gray matter studies in patients with panic disorder. The Seed-based d Mapping toolbox was applied for the voxel-wise meta-analysis. Fourteen gray matter studies (954 subjects) were enrolled in the current meta-analysis. The subgroup analysis of typical-onset versus late-onset patients was also performed. At last, the clinical severity was meta-regressed with gray matter alterations.
Significant gray matter alterations were found in the left para-cingulate gyrus and the right amygdala of panic disorder patients. The subgroup analysis of typical-onset panic disorder patients showed a similar pattern. However, gray matter alterations were demonstrated in the bilateral opercular cortex of late-onset panic disorder patients. A significant association between the clinical severity and the gray matter alterations was found in the fronto-cingulate regions of panic disorder patients.
Gray matter alterations might represent a significant pillar of panic disorder's neurobiology, especially for the amygdala, cingulate, and frontal regions. Future gray matter studies in panic disorder should be needed to reconfirm this pattern of gray matter alterations.
灰质改变在惊恐障碍的病理生理学起源中起作用。然而，目前的文献似乎不足以得出一致的结论。因此，我们对惊恐障碍进行了这项灰质荟萃分析。
对惊恐障碍患者的灰质研究进行了基于体素形态学的系统评价和体素级荟萃分析。基于种子点的d映射工具箱用于体素级荟萃分析。本荟萃分析纳入了14项灰质研究（954名受试者）。还对典型发病与晚发患者进行了亚组分析。最后，对临床严重程度与灰质改变进行了元回归分析。
惊恐障碍患者左侧扣带回旁回和右侧杏仁核存在显著的灰质改变。典型发病惊恐障碍患者的亚组分析显示出类似的模式。然而，晚发惊恐障碍患者双侧岛盖皮质出现灰质改变。在惊恐障碍患者的额扣带区域发现临床严重程度与灰质改变之间存在显著关联。
灰质改变可能是惊恐障碍神经生物学的一个重要支柱，特别是对于杏仁核、扣带回和额叶区域。未来需要对惊恐障碍进行灰质研究以再次证实这种灰质改变模式。
