The Explorative Analysis to Revise Fear Network Model for Panic Disorder

Abstract

Functional connectome analysis in panic disorder (PDO) is a relatively new field for research. We tried to investigate the functional connectome alterations in PDO to re-examine the precision and role of fear network model for the pathophysiology of PDO.We enrolled 53 PDO patients and 54 controls with imaging data in this study. After preprocessing, we calculated the connectivity matrix of functional connectivity in whole brain for each subject. Then network-based statistics (The University of Melbourne and Melbourne Health, Australia) of connectome was used to perform group comparisons between patients and controls. The correlation between network measures of significant subnetwork and illness duration or severity of PDO was also performed.Within the 6 network models, only 1 network survived after multiple corrections. We found decreased functional connectivity in the edges between the following nodes: the left parahippocampal gyrus, bilateral precentral gyri, bilateral middle cingulate gyri, bilateral supramarginal gyri, bilateral calcarine fissures, and right lingual gyrus. The central hubs were the left parahippocampal gyrus and left precentral gyrus. The importance of limbic areas and connection with sensory and motor regions might shed light on the revision of fear network model for the pathophysiology of PDO.

Connectivity Correlates of Anxiety Symptoms in Drug‐Naive Parkinson's Disease Patients

“…Interestingly, PD-ANX patients present a disrupted connectivity within the precentral gyrus also compared to PD-noANX patients. This is consistent with previous reports in patients with panic disorder compared to controls, 45 which provides a possible background for the panic attack-related motor symptoms, such as fright, fear to lose control, and escape behavior. 21,46 Overall, these findings suggest that the presence of anxiety may be even more detrimental to motor programming and execution of goal-directed tasks in PD patients.…”

Fear Network Model in Panic Disorder: The Past and the Future

“…Our functional connectome study of PD also showed that the sensory regions, such as occipital lobe (calcarine gyrus and lingual gyrus) and parietal lobe (supramarginal gyrus, SMG), might be altered and influenced by the limbic system [130]. The hyperperfusion of cerebral blood flow in parietal and temporal lobes have been reported in PD [45].…”

“…In addition, cuneus was responsible for visuospatial attention of threat [127], voice identifications, faces processing and proneness to anxiety reactions [128,129]. In addition, the connectome study of PD showed decreased edge strength of functional connectivity from the right lingual gyrus [130]. The residual alterations in the fractional amplitude of low frequency fluctuations might also occur in the occipital lobe even after antidepressant therapy with remitted status [131].…”

“…The functional connectome study of PD can also support the concept of advanced FNM. Recently our report showed that the alterations in the network including sensory and motor regions, which were connected with parahippocampus central hub [130]. The alterations of parahippocamopus has been mentioned in PD, such as the elevated cerebral blood flow, reduced GM volume and increased benzodiazepine receptor bindings [19,30,147].…”

ADORA2A variation and adenosine A1 receptor availability in the human brain with a focus on anxiety-related brain regions: modulation by ADORA1 variation

“…Anxiety is a fundamental emotion eliciting considerable reactions like increased attention, heart rate, and energy metabolism 1 . In case of pathological anxiety/anxiety disorders, dysregulation in brain regions of the "fear network" occurs, e.g., hyperactivation of amygdala, hippocampus, thalamus, and cingulum, as well as decreased interconnectivity between these regions 2,3 . Anxiety and arousal are tightly connected, both counteract sleep, and both are strongly linked to the adenosinergic system [4][5][6][7] .…”