Reiman E M, Raichle M E, Butler F K, Herscovitch P, Robins E
Nature. 1984;310(5979):683-5. doi: 10.1038/310683a0.
Panic disorder is characterized by recurrent anxiety attacks in the absence of a frightening stimulus. It is a common disorder, affecting 2-5% of the general population and 10-14% of patients seen in cardiology practice. Infusion of sodium (DL)lactate precipitates an anxiety attack in most persons with this disorder but rarely does so in normal controls, suggesting a neurobiological basis for the problem. Despite this observation, the pathophysiology of panic disorder remains unknown. We have now used positron emission tomography to measure cerebral blood flow (CBF) in patients with panic disorder in the absence of a panic attack. Analysis of CBF in regions thought to mediate symptoms of panic, anxiety and vigilance reveals a significant (P less than 0.005) abnormal asymmetry of CBF (left less than right) located in a region of the parahippocampal gyrus. This asymmetry was present in seven patients with panic disorder and a positive response to lactate infusion but was absent in six normal controls and in three patients with panic disorder associated with a negative response to lactate. We believe this to be the first study to identify a discrete brain abnormality in patients with this severe form of anxiety.
惊恐障碍的特征是在没有恐惧刺激的情况下反复出现焦虑发作。这是一种常见的疾病，影响着2%至5%的普通人群以及10%至14%在心脏病科就诊的患者。输注（DL）乳酸钠会使大多数患有这种疾病的人引发焦虑发作，但在正常对照者中很少出现这种情况，这表明该问题存在神经生物学基础。尽管有此观察结果，但惊恐障碍的病理生理学仍不清楚。我们现在利用正电子发射断层扫描技术在没有惊恐发作的情况下测量惊恐障碍患者的脑血流量（CBF）。对被认为介导惊恐、焦虑和警觉症状的区域的CBF分析显示，在海马旁回的一个区域存在显著（P小于0.005）的CBF异常不对称（左侧小于右侧）。这种不对称在7名对乳酸输注有阳性反应的惊恐障碍患者中存在，但在6名正常对照者和3名对乳酸有阴性反应的惊恐障碍患者中不存在。我们认为这是第一项在患有这种严重焦虑形式的患者中识别出离散脑异常的研究。
