TY - JOUR
T1 - Emotional processing in panic disorder and its subtypes
T2 - An fMRI study using emotional faces
AU - Pattyn, T.
AU - Schmaal, L.
AU - Eede, F. Van Den
AU - Cassiers, L.
AU - Penninx, B. W.
AU - Sabbe, B. C.G.
AU - Veltman, D. J.
N1 - Funding Information: The infrastructure for the NESDA study ( www.nesda.nl ) is funded through the Geestkracht program of the Netherlands Organisation for Health Research and Development (ZonMw, grant number 10-000-1002) and financial contributions by participating universities and mental health care organizations (VU University Medical Center, GGZ inGeest, Leiden University Medical Center, Leiden University, GGZ Rivierduinen, University Medical Center Groningen, University of Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Rob Giel Onderzoekscentrum). We are also very grateful for the Cassiers bequest for research on panic disorder (CAPRI). LS is supported by a NHMRC Career Development Fellowship (1140764). Funding Information: The infrastructure for the NESDA (www.nesda.nl) is funded by the Geestkracht program of the Netherlands Organization for Health Research and Development (Zon-Mw, grant no.10-000-1002) and is supported by the following participating universities and mental healthcare organizations: VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Scientific Institute for Quality of Healthcare (IQ healthcare), the Netherlands Institute for Health Services Research (NIVEL), and the Netherlands Institute of Mental Health and Addiction (Trimbos). We are very much grateful for the bequest Cassiers for panic research on panic disorder (CAPRI UA) grant no. 5739. Harvard Oxford Atlas, We are very grateful for the training data for FIRST, particularly to David Kennedy at the CMA, and also to: Christian Haselgrove, Center for Morphometric Analysis, Harvard; Bruce Fischl, Martinos Center for Biomedical Imaging, MGH; Janis Breeze and Jean Frazier, Child and Adolescent Neuropsychiatric Research Program, Cambridge Health Alliance; Larry Seidman and Jill Goldstein, Department of Psychiatry of Harvard Medical School; Barry Kosofsky, Weill Cornell Medical Center. Funding Information: The infrastructure for the NESDA ( www.nesda.nl ) is funded by the Geestkracht program of the Netherlands Organization for Health Research and Development (Zon-Mw, grant no. 10-000-1002 ) and is supported by the following participating universities and mental healthcare organizations: VU University Medical Center, GGZ inGeest, Arkin, Leiden University Medical Center, GGZ Rivierduinen, University Medical Center Groningen, Lentis, GGZ Friesland, GGZ Drenthe, Scientific Institute for Quality of Healthcare (IQ healthcare), the Netherlands Institute for Health Services Research (NIVEL), and the Netherlands Institute of Mental Health and Addiction (Trimbos). We are very much grateful for the bequest Cassiers for panic research on panic disorder ( CAPRI UA ) grant no. 5739 . Publisher Copyright: © 2021 Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/5/15
Y1 - 2021/5/15
N2 - Background: Inconsistent findings regarding the pathophysiology of panic disorder (PD) could result from clinical heterogeneity. Identifying subtypes could enhance insights into the neurobiological substrates of PD. Methods: An emotional faces fMRI paradigm was used in a group of PD patients (n = 73) and healthy controls (n = 58). The overall PD group was further divided into three previously identified subtypes: a cognitive-autonomic (n = 22), an autonomic (n = 16) and an aspecific (n = 35) subtype. Differences in brain activity levels in response to emotional facial expressions between groups were examined for six regions of interests, namely the amygdala, ventromedial prefrontal cortex, anterior cingulate, fusiform gyrus, lingual gyrus and insula. Results: PD patients showed lower activity in the rostral anterior cingulate in response to angry faces than healthy controls, which was mainly driven by the autonomic subtype. No significant differences were found in other brain regions when comparing PD patients with controls or when comparing across PD subtypes. Limitations: Sample sizes in subgroups were relatively small Conclusions: The role of the rostral anterior cingulate cortex for emotional processes critical in panic disorder is highlighted by this study and provides, albeit preliminary, evidence for the use of a subtype approach to advance our neurobiological insights in PD considering its involvement in the appraisal of autonomic viscero-sensory symptoms.
AB - Background: Inconsistent findings regarding the pathophysiology of panic disorder (PD) could result from clinical heterogeneity. Identifying subtypes could enhance insights into the neurobiological substrates of PD. Methods: An emotional faces fMRI paradigm was used in a group of PD patients (n = 73) and healthy controls (n = 58). The overall PD group was further divided into three previously identified subtypes: a cognitive-autonomic (n = 22), an autonomic (n = 16) and an aspecific (n = 35) subtype. Differences in brain activity levels in response to emotional facial expressions between groups were examined for six regions of interests, namely the amygdala, ventromedial prefrontal cortex, anterior cingulate, fusiform gyrus, lingual gyrus and insula. Results: PD patients showed lower activity in the rostral anterior cingulate in response to angry faces than healthy controls, which was mainly driven by the autonomic subtype. No significant differences were found in other brain regions when comparing PD patients with controls or when comparing across PD subtypes. Limitations: Sample sizes in subgroups were relatively small Conclusions: The role of the rostral anterior cingulate cortex for emotional processes critical in panic disorder is highlighted by this study and provides, albeit preliminary, evidence for the use of a subtype approach to advance our neurobiological insights in PD considering its involvement in the appraisal of autonomic viscero-sensory symptoms.
KW - Anterior cingulate cortex
KW - Anxiety
KW - NESDA
KW - Panic disorder
KW - Subtype
UR - http://www.scopus.com/inward/record.url?scp=85104145808&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.jad.2021.03.069
DO - https://doi.org/10.1016/j.jad.2021.03.069
M3 - Article
C2 - 33845429
SN - 0165-0327
VL - 287
SP - 427
EP - 432
JO - Journal of affective disorders
JF - Journal of affective disorders
ER -