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Panic disorder: vascular evaluation with transcranial Doppler ultrasonography.
S Fontaine1, A Ontiveros, R Fontaine
1Department of Radiology, Hôpital Saint-Luc, Montreal.
Summary
Transcranial Doppler ultrasonography revealed altered middle cerebral artery blood flow during induced panic attacks in patients with panic disorder. These findings suggest impaired cerebrovascular autoregulation in panic disorder.
Area of Science:
- Neuroscience
- Vascular Neurology
- Psychiatry
Background:
- Panic disorder is associated with neurophysiologic and neuroanatomic abnormalities.
- Cerebrovascular function during panic attacks requires further investigation.
Purpose of the Study:
- To evaluate cerebrovascular blood flow changes during sodium lactate-induced panic attacks using transcranial Doppler (TCD) ultrasonography.
- To assess alterations in middle cerebral artery (MCA) flow velocity in patients with panic disorder compared to controls.
Main Methods:
- Thirty patients with panic disorder (DSM-III-R) and 25 healthy controls underwent intravenous sodium lactate infusion.
- Middle cerebral artery (MCA) blood flow velocity was measured using TCD ultrasonography before and during the infusion.
- Parameters analyzed included flow acceleration, maximal velocity, and velocity variations.
Main Results:
- Patients with panic disorder exhibited significantly faster flow acceleration in the MCA compared to controls (p < 0.05).
- Lactate-sensitive patients showed higher maximal velocity and velocity variations in the right MCA (p < 0.05).
Conclusions:
- Abnormalities in local cerebrovascular autoregulation are suggested in patients with panic disorder during induced panic attacks.
- TCD ultrasonography can detect these cerebrovascular changes associated with panic disorder.