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Abnormal brain hemodynamic responses during passive orthostatic challenge in panic disorder
C Faravelli1, M Marinoni, R Spiti
1Department of Neurology and Psychiatry, Florence University Medical School, Italy.
The American Journal of Psychiatry
|March 1, 1997
Summary
Patients with panic disorder exhibit reduced cerebral blood flow (CBF) during postural changes, even after symptom remission. This suggests panic disorder may involve subclinical autonomic dysfunction.
Area of Science:
- Neuroscience
- Cardiovascular Physiology
- Psychiatry
Background:
- Autonomic dysregulation and cerebral blood flow (CBF) abnormalities are linked to anxiety disorders, particularly panic disorder.
- The tilting-table test offers a non-anxiogenic method to investigate these physiological variations.
Purpose of the Study:
- To explore autonomic dysregulation and CBF abnormalities in panic disorder patients using a tilting-table test.
- To compare physiological responses between acute panic disorder, remitted panic disorder, and healthy controls.
Main Methods:
- Monitoring middle cerebral artery mean flow velocity (MCAV), heart rate, and blood pressure during a 70-degree tilting-table test.
- Studying three groups: acute panic disorder (n=11), remitted panic disorder (n=9), and healthy controls (n=10).
Main Results:
- Patients with acute and remitted panic disorder showed a significant percent reduction in MCAV upon tilting compared to controls.
- No significant differences in heart rate or blood pressure were observed between groups during the test.
Conclusions:
- Panic disorder patients, irrespective of acute or remitted status, demonstrate an exaggerated drop in CBF during postural changes.
- These findings suggest panic disorder may represent a subclinical form of autonomic dysreactivity, similar to dysautonomic illnesses.