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Fear Network Model in Panic Disorder: The Past and the Future
Chien-Han Lai1,2,3
1Institute of Biophotonics, National Yang-Ming University, Taipei, Taiwan.
Psychiatry Investigation
|September 5, 2018
Summary
The fear network model (FNM) in panic disorder (PD) involves brain regions beyond the traditional frontal and limbic areas. Recent studies suggest expanded sensory regions, including the insula, temporal, parietal, and occipital lobes, are crucial in PD pathophysiology.
Area of Science:
- Neuroscience
- Psychiatry
Background:
- Panic disorder (PD) pathophysiology is often explained by the fear network model (FNM).
- Alterations in the FNM are linked to autonomic nervous system (ANS) disturbances common in PD.
- Traditional FNM focused on frontal and limbic regions with dysregulated feedback mechanisms.
Purpose of the Study:
- To review the traditional and advanced fear network models in panic disorder.
- To discuss the role of the insula, temporal, parietal, and occipital lobes in PD pathophysiology.
- To support the advanced FNM concept using white matter and functional connectome studies.
Main Methods:
- Review of neuroimaging studies.
- Analysis of white matter and functional connectome studies.
- Synthesis of evidence for an expanded FNM.
Main Results:
- Recent neuroimaging reveals extended FNM areas including sensory regions: occipital, parietal, temporal cortex, and insula.
- The insula may integrate sensory information from various lobes via the thalamus.
- An emerging model suggests fronto-limbic-insula and temporooccipito-parietal dysregulation in PD.
Conclusions:
- The advanced FNM incorporates broader brain regions, including sensory areas.
- Further research on these extended sensory regions is needed to confirm the advanced FNM's role in PD.
- A refined FNM model offers a more comprehensive understanding of panic disorder pathophysiology.
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