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Lactate sensitivity and cardiac cholinergic function in panic disorder

V K Yeragani¹, K Srinivasan, R Balon

¹Department of Psychiatry, Wayne State University School of Medicine, Detroit, Mich.

The American Journal of Psychiatry

|August 1, 1994

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Patients with panic disorder exhibit exaggerated cardiac vagal withdrawal during lactate infusions, indicated by significant changes in heart rate variability compared to healthy individuals. This suggests a distinct autonomic response in panic disorder.

Area of Science:

Autonomic Nervous System Research
Cardiovascular Physiology
Psychiatric Research

Background:

Panic disorder is associated with altered autonomic nervous system function.
Lactate infusions are known to provoke panic-like symptoms in susceptible individuals.
Heart rate variability (HRV) analysis provides insights into autonomic balance.

Purpose of the Study:

To investigate heart rate variability (HRV) changes during lactate infusion in patients with panic disorder.
To compare the autonomic response to lactate in panic disorder patients versus healthy controls.
To explore the role of cardiac vagal withdrawal in panic disorder pathophysiology.

Main Methods:

Spectral analysis of continuous time series signals was used to assess HRV.

Related Experiment Videos

Lactate and placebo infusions were administered intravenously to six panic disorder patients and nine healthy subjects.

Sympathovagal ratios and high-frequency power were analyzed before and during infusions.

Main Results:

A significant decrease in high-frequency power and an increase in sympathovagal ratios were observed post-lactate infusion.
These HRV changes were significantly more pronounced in panic disorder patients compared to controls.
Results were adjusted for the amount of lactate infused to ensure accurate comparison.

Conclusions:

Patients with panic disorder demonstrate an exaggerated cardiac vagal withdrawal in response to lactate infusion.
This exaggerated response suggests a heightened sensitivity or altered autonomic regulation in panic disorder.
Findings support the hypothesis of abnormal autonomic functioning contributing to panic disorder symptoms.