Hostname: page-component-78c5997874-m6dg7 Total loading time: 0 Render date: 2024-11-08T06:31:14.443Z Has data issue: false hasContentIssue false

Temporal and right frontal lobe alterations in panic disorder: a quantitative volumetric and voxel-based morphometric MRI study

Published online by Cambridge University Press:  08 January 2010

T. Sobanski*
Affiliation:
Department of Psychiatry and Psychotherapy, University of Jena, Germany
G. Wagner
Affiliation:
Department of Psychiatry and Psychotherapy, University of Jena, Germany
G. Peikert
Affiliation:
Department of Psychiatry and Psychotherapy, University of Jena, Germany
U. Gruhn
Affiliation:
Department of Psychiatry and Psychotherapy, University of Jena, Germany
K. Schluttig
Affiliation:
Department of Psychiatry and Psychotherapy, University of Jena, Germany
H. Sauer
Affiliation:
Department of Psychiatry and Psychotherapy, University of Jena, Germany
R. Schlösser
Affiliation:
Department of Psychiatry and Psychotherapy, University of Jena, Germany
*
*Address for correspondence: T. Sobanski, M.D., Department of Psychiatry, Psychotherapy, and Psychosomatic Medicine, Thüringen-Kliniken GmbH, Rainweg 68, 07318 Saalfeld/Saale, Germany. (Email: [email protected])

Abstract

Background

With regard to current neurobiological theories, the aim of our study was to examine possible alterations of temporal and frontal lobe volume in panic disorder (PD).

Method

Seventeen in-patients with PD and a group of healthy control subjects (HC) matched for age and gender were investigated by quantitative volumetric magnetic resonance imaging (MRI). Structures of interest were: the temporal lobe, the amygdala–hippocampus complex (AHC) and the frontal lobe. In addition, a voxel-based morphometry (VBM) analysis implemented in Statistical Parametric Mapping 5 (SPM5) was used for a more detailed assessment of possible volume alterations. Modulated grey matter (GM) images were used to test our a priori hypotheses and to present the volumetric results.

Results

Quantitative volumetric MRI revealed a bilateral reduction in temporal lobe volume in patients with PD compared to HC subjects. The AHC was normal. The right frontal lobe volume was also decreased. Using VBM we detected a significant GM volume reduction in the right middle temporal gyrus [Brodmann area (BA) 21] in patients with PD. In addition, there was a reduction in GM volume in the medial part of the orbitofrontal cortex (BA 11).

Conclusions

Our results of reduced temporal and frontal lobe volume in PD are in agreement with prior studies. By using a recent VBM approach we were able to assess the abnormalities more precisely. The location of GM volume reduction in the right middle temporal gyrus and medial orbitofrontal cortex lends further support to recent aetiological models of PD.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ashburner, J, Friston, KJ (2005). Unified segmentation. NeuroImage 26, 839851.Google Scholar
Bach-Cuadra, M, De Craene, M, Duay, V, Macq, B, Pollo, C, Thiran, JP (2006). Dense deformation field estimation for atlas-based segmentation of pathological MR brain images. Computer Methods and Programs in Biomedicine 84, 6675.Google Scholar
Bandelow, B (1995). Assessing the efficacy of treatments for panic disorder and agoraphobia. II. The Panic and Agoraphobia Scale. International Clinical Psychopharmacology 10, 7381.Google Scholar
Bandelow, B, Hajak, G, Holzrichter, S, Kunert, HJ, Rüther, E (1995). Assessing the efficacy of treatments for panic disorder and agoraphobia. I. Methodological problems. International Clinical Psychopharmacology 10, 8393.Google Scholar
Bisaga, A, Katz, J, Antonini, A, Wright, E, Margouleff, C, Gorman, J, Eidelberg, D (1998). Cerebral glucose metabolism in women with panic disorder. American Journal of Psychiatry 155, 11781183.Google Scholar
Boshuisen, ML, Ter Horst, GJ, Paans, AMJ, Reinders, AA, den Boer, JA (2002). rCBF differences between panic disorder patients and control subjects during anticipatory anxiety and rest. Biological Psychiatry 52, 126135.CrossRefGoogle ScholarPubMed
Brandt, CA, Meller, J, Keweloh, L, Hoschel, K, Staedt, J, Munz, D, Stoppe, G (1998). Increased benzodiazepine receptor density in the prefrontal cortex in patients with panic disorder. Journal of Neural Transmission 105, 13251333.CrossRefGoogle ScholarPubMed
Bremner, JD, Innis, RB, White, T, Fujita, M, Silbersweig, D, Goddard, AW, Staib, L, Stern, E, Cappiello, A, Woods, S, Baldwin, R, Charney, DS (2000). SPECT [I-123]iomazenil measurement of the benzodiazepine receptor in panic disorder. Biological Psychiatry 47, 96–106.CrossRefGoogle ScholarPubMed
Bystritsky, A, Leuchter, AF, Vapnik, T (1999). EEG abnormalities in nonmedicated panic disorder. Journal of Nervous and Mental Disease 187, 113114.Google Scholar
Bystritsky, A, Pontillo, D, Powers, M, Sabb, FW, Craske, MG, Bookheimer, SY (2001). Functional MRI changes during panic anticipation and imagery exposure. Neuroreport 12, 39533957.CrossRefGoogle ScholarPubMed
Charney, DS (2003). Neuroanatomical circuits modulating fear and anxiety behaviors. Acta Psychiatrica Scandinavica 108, 3850.CrossRefGoogle Scholar
Coplan, JD, Lydiard, RB (1998). The neurobiology of anxiety disorders. Brain circuits in panic disorder. Biological Psychiatry 44, 12641276.CrossRefGoogle Scholar
Dantendorfer, K, Prayer, D, Kramer, J, Amering, M, Baischer, W, Berger, P, Schoder, M, Steinberger, K, Windhaber, J, Imhof, H, Katschnig, H (1996). High frequency of EEG and MRI abnormalities in panic disorder. Psychiatry Research 68, 4153.Google Scholar
De Cristofaro, M, Sessarego, A, Pupi, A, Biondi, F, Faravelli, C (1993). Brain perfusion abnormalities in drug-naive lactate-sensitive panic patients: a SPECT study. Biological Psychiatry 33, 505512.Google Scholar
Fontaine, R, Breton, G, Dery, R, Fontaine, S, Elie, R (1990). Temporal lobe abnormalities in panic disorder: an MRI study. Biological Psychiatry 27, 304310.CrossRefGoogle ScholarPubMed
Free, SL, Bergin, PS, Fish, DR, Cook, MJ, Shorvon, SD, Stevens, JM (1995). Methods for normalization of hippocampal volumes measured with MR. American Journal of Neuroradiology 16, 637643.Google Scholar
Gorman, J, Kent, J, Sullivan, G, Coplan, J (2000). Neuroanatomical hypotheses of panic disorder, revised. American Journal of Psychiatry 157, 493505.CrossRefGoogle ScholarPubMed
Hasler, G, Nugent, AC, Carlson, PJ, Carson, RE, Geraci, M, Drevets, WC (2008). Altered cerebral gamma-aminobutyric acid type A-benzodiazepine receptor binding in panic disorder determined by [11C]flumazenil positron emission tomography. Archives of General Psychiatry 65, 11661175.CrossRefGoogle ScholarPubMed
Hayasaka, S, Phan, KL, Liberzon, I, Worsley, KJ, Nichols, TE (2004). Nonstationary cluster-size inference with random field and permutation methods. NeuroImage 22, 676687.CrossRefGoogle ScholarPubMed
Kaschka, W, Feistel, H, Ebert, D (1995). Reduced benzodiazepine receptor binding in panic disorders measured by iomazenil SPECT. Journal of Psychiatric Research 29, 427434.CrossRefGoogle ScholarPubMed
Kent, JM, Coplan, JD, Mawlawi, O, Martinez, JM, Browne, ST, Slifstein, M, Martinez, D, Abi-Dargham, A, Laruelle, M, Gorman, JM (2005). Prediction of panic response to a respiratory stimulant by reduced orbitofrontal cerebral blood flow in panic disorder. American Journal of Psychiatry 162, 13791381.CrossRefGoogle ScholarPubMed
Kent, JM, Rauch, SL (2003). Neurocircuitry of anxiety disorders. Current Psychiatry Reports 5, 266273.Google Scholar
Klauschen, F, Goldman, A, Barra, V, Meyer-Lindenberg, A, Lundervold, A (2009). Evaluation of automated brain MR image segmentation and volumetry methods. Human Brain Mapping 30, 13101327.CrossRefGoogle ScholarPubMed
Kolb, B, Whishaw, IQ (1996). Fundamentals of Human Neurophysiology. W.H. Freeman & Co.: New York.Google Scholar
Konen, CS, Kastner, S (2008). Two hierarchically organized neural systems for object information in human visual cortex. Nature Neuroscience 11, 224231.Google Scholar
Kuikka, J, Pitkanen, A, Lepola, U, Partanen, K, Vainio, P, Bergstrom, K, Wieler, H, Kaiser, H, Mittelbach, L, Koponen, H (1995). Abnormal regional benzodiazepine receptor uptake in the prefrontal cortex in patients with panic disorder. Nuclear Medicine Communications 16, 273280.CrossRefGoogle ScholarPubMed
LeDoux, JE (1996). The Emotional Brain. Simon and Shuster: New York.Google Scholar
Maddock, RJ, Buonocore, MH, Kile, SJ, Garrett, AS (2003). Brain regions showing increased activation by threat-related words in panic disorder. Neuroreport 14, 325328.CrossRefGoogle ScholarPubMed
Massana, G, Serra-Grabulosa, JM, Salgado-Pineda, P, Gasto, C, Junque, C, Massana, J, Mercader, JM (2003 a). Parahippocampal gray matter density in panic disorder: a voxel-based morphometric study. American Journal of Psychiatry 160, 566568.Google Scholar
Massana, G, Serra-Grabulosa, JM, Salgado-Pineda, P, Gasto, C, Junque, C, Massana, J, Mercader, JM, Gomez, B, Tobena, A, Salamero, M (2003 b). Amygdalar atrophy in panic disorder patients detected by volumetric magnetic resonance imaging. NeuroImage 19, 8090.Google Scholar
Meyer, JH, Swinson, R, Kennedy, SH, Houle, S, Brown, GM (2000). Increased left posterior parietal-temporal cortex activation after d-fenfluramine in women with panic disorder. Psychiatry Research 98, 133143.CrossRefGoogle ScholarPubMed
Morgan, MA, LeDoux, JE (1995). Differential contribution of dorsal and ventral medial prefrontal cortex to the acquisition and extinction of conditioned fear in rats. Behavioral Neuroscience 109, 681688.Google Scholar
Nordahl, T, Semple, W, Gross, M, Mellman, T, Stein, M, Goyer, P, King, A, Uhde, T, Cohen, R (1990). Cerebral glucose metabolic differences in patients with panic disorder. Neuropsychopharmacology 3, 261272.Google ScholarPubMed
Nordahl, T, Stein, MB, Benkelfat, C, Semple, WE, Andreason, P, Zemetkin, A, Uhde, TW, Cohen, RM (1998). Regional cerebral metabolic asymmetries replicated in an independent group of panic patients. Biological Psychiatry 44, 998–1006.Google Scholar
Oldfield, RC (1971). The assessment and analysis of handedness: the Edinburgh inventory. Neuropsychologia 9, 97–113.Google Scholar
Ontiveros, A, Fontaine, R, Breton, G, Elie, R, Fontaine, S, Dery, R (1989). Correlation of severity of panic disorder and neuroanatomical changes on magnetic resonance imaging. Journal of Neuropsychiatry and Clinical Neuroscience 1, 404408.Google ScholarPubMed
Quirk, GJ, Russo, GK, Barron, JL, Lebron, K (2000). The role of ventromedial prefrontal cortex in the recovery of extinguished fear. Journal of Neuroscience 20, 62256231.Google Scholar
Regier, DA, Boyd, JH, Burke, Jr. JD, Rae, DS, Myers, JK, Kramer, M, Robins, LN, George, LK, Karno, M, Locke, BZ (1988). One-month prevalence of mental disorders in the United States. Archives of General Psychiatry 45, 977986.CrossRefGoogle ScholarPubMed
Reiman, EM, Raichle, ME, Robins, E, Butler, FK, Herscovitch, P, Fox, PT, Perlmutter, J (1986). The application of positron emission tomography to the study of panic disorder. American Journal of Psychiatry 143, 469477.Google Scholar
Sheline, YL, Sanghavi, M, Mintun, MA, Gado, MH (1999). Depression duration but not age predicts hippocampal volume loss in medically healthy women with recurrent major depression. Journal of Neuroscience 19, 50345043.Google Scholar
Simeon, D, Guralnik, O, Hazlett, EA, Spiegel-Cohen, J, Hollander, E, Buchsbaum, MS (2000). Feeling unreal: a PET study of depersonalization disorder. American Journal of Psychiatry 157, 17821788.Google Scholar
Talairach, J, Tournoux, P (1988). Co-Planar Stereotaxic Atlas of the Human Brain. Thieme Medical Publishers: New York.Google Scholar
Uchida, RR, Del-Ben, CM, Santos, AC, Araujo, D, Crippa, JA, Guimaraes, FS, Graeff, FG (2003). Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging. Brazilian Journal of Medical and Biological Research 36, 925929.CrossRefGoogle ScholarPubMed
Vythilingam, M, Anderson, ER, Goddard, A, Woods, SW, Staib, LH, Charney, DS, Bremner, JD (2000). Temporal lobe volume in panic disorder: a quantitative magnetic resonance imaging study. Psychiatry Research 99, 7582.Google Scholar
Wurthmann, C, Bogerts, B, Gregor, J, Baumann, B, Effenberger, O, Döhring, W (1997). Frontal CSF enlargement in panic disorder: a qualitative CT-scan study. Psychiatry Research 76, 8387.Google Scholar