The modulating impact of cigarette smoking on brain structure in panic disorder: a voxel-based morphometry study

Area of Science:

• Neuroscience
• Psychiatry
• Radiology

Background:

• Cigarette smoking is linked to anxiety disorders, including panic disorder (PD).
• Brain structural changes in PD patients partially overlap with those seen in smokers.
• The confounding effect of smoking on PD-related brain alterations requires investigation.

Purpose of the Study:

• To investigate the impact of smoking as a confounder on brain structural alterations in panic disorder.
• To examine gray matter volume differences in the defensive system network of PD patients and controls, considering smoking status.

Main Methods:

• A multicenter magnetic resonance imaging (MRI) study involving 143 PD patients (71 smokers) and 178 healthy controls (62 smokers).
• Voxel-based morphometry analysis of T1-weighted images was used to assess brain structural changes in predefined regions of the defensive system network.

Main Results:

• Panic disorder was associated with reduced gray matter volume in the amygdala and hippocampus, but this effect was primarily observed in non-smokers.
• These PD-related structural differences were absent in participants who smoked.
• Bilateral amygdala volumes showed a dose-dependent reduction with increasing health burden (neither PD nor smoking > either PD or smoking > both PD and smoking).

Conclusions:

• Smoking status significantly modulates or masks commonly observed structural brain abnormalities in panic disorder.
• The influence of smoking should be a critical consideration in MRI studies of anxiety and fear-related disorders.
• Further research is needed to explore how smoking-induced brain alterations may contribute to the risk of developing psychopathology.