Balance control in quiet upright standing in patients with panic disorder

The postural stability of 30 panic disorder (PD) patients and 30 sex- and age-matched healthy control subjects (age range 27-40 years) was investigated by static posturographic tests of quiet standing on stable and foam surfaces with open and closed eyes. Postural stability was evaluated by sway velocity (SV) and power density of relative power spectrum (RPS) in five frequency ranges. There were no differences of SV between two groups during stance with open eyes on both surfaces. The SV of the PD patients standing with closed eyes was significantly higher compared to controls for the stance on the stable surface (anterior-posterior plane) and on the foam surface (both anterior-posterior and medial-lateral planes). The stance on foam surface did not cause any significant changes in power density of postural sways of healthy subjects, while this parameter was significantly higher for PD patients, especially in closed eyes condition when a sensory conflict may exist. The higher value of SV and RPS (0.5-1.0 Hz) in patients compared to controls suggests that the visual information has more important role in the postural balance when sensory conflict exists during stance on foam surface. We proposed that the altered information from the visual and proprioceptive inputs may induce anxiety and panic symptoms in PD patients, which enhances the sensory conflict, leads to abnormal work of the vestibular system and disturbs the standing balance.