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Brain circuits in panic disorder

J D Coplan1, R B Lydiard

  • 1Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, New York 10032, USA.

Biological Psychiatry
|December 23, 1998
PubMed
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This review explores panic disorder (PD) pathophysiology, focusing on "fear circuitries." Advances in neuroscience refine understanding of PD mechanisms and treatments, guiding future research on brain transmitter systems and neurocircuits.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Neurobiology

Background:

  • Panic disorder (PD) pathophysiology is increasingly understood through preclinical models of fear circuitries.
  • Advances in neurosciences refine understanding of PD mechanisms and effective treatments.
  • Perturbations in brain transmitter systems (serotonin, norepinephrine, GABA, CRF) may underlie panic-anxiety.

Purpose of the Study:

  • To review the pathophysiology of panic disorder (PD) within the context of newly described fear circuitries.
  • To refine understanding of PD pathophysiology and treatment mechanisms using neuroscientific advances.
  • To generate testable hypotheses for future neurobiological and psychopharmacologic research.

Main Methods:

  • Review of current neuroscientific literature on panic disorder.

Related Experiment Videos

  • Analysis of preclinical models of fear circuitries.
  • Integration of neuroimaging and challenge studies to bridge preclinical and clinical findings.

    • Main Results:

    • Dysfunction in brain transmitter systems (serotonin, norepinephrine, GABA, CRF) is implicated in PD pathogenesis.
    • Neuroimaging confirms hypothesized dysfunction in human prefrontal cortex and subcortical components.
    • Models propose dysfunction of cortical inhibition or excessive activation of limbic structures leading to amygdalofugal pathway activation.

    Conclusions:

    • Restoration of homeostasis is a key therapeutic component for antipanic therapy.
    • Neuroimaging is critical for understanding the interaction of cortical and subcortical components in panic neurocircuitry.
    • Challenge studies are crucial for investigating brain stem dysfunction in PD.