Does hyperventilation alter the prefrontal hemodynamics of panic disorder during cognitive task? A functional...

Cerebral hypofrontality has been implicated in the pathophysiology of panic disorder, (PD). This study examined the effect of symptom provocation on prefrontal cortex activity during a cognitive task in PD patients and healthy controls (HC) using functional near-infrared spectroscopy (fNIRS).

We included 20 drug-naïve PD patients and 20 HC. Participants performed the N-back task before and after hyperventilation, while prefrontal activation was recorded using fNIRS. Two-way repeated-measures ANOVA was used to analyze changes in task performance and brain activation.

There was a significant group effect for two-back D', F(1, 32) = 4.93, p = 0.03, η² = 0.13, indicating that PD participants performed worse than HC. A significant time × group interaction was observed during the zero-back task in LBA8 and right prefrontal regions: RBA10, RBA8, and RBA46 (all p < 0.05), suggesting that the HC group showed greater activation changes after hyperventilation.

Our findings highlight working memory deficits and prefrontal hypofunction in PD. The absence of right prefrontal deactivation after hyperventilation in the PD group, compared to HC, suggests altered right-hemisphere involvement in PD pathophysiology.