Abstract
BackgroundThe amygdala has been known to play a pivotal role in mediating fear-related responses including panic attacks. Given the functionally distinct role of the amygdalar subregions, morphometric measurements of the amygdala may point to the pathophysiological mechanisms underlying panic disorder. The current study aimed to determine the global and local morphometric alterations of the amygdala related to panic disorder.MethodsVolumetric and surface-based morphometric approach to high-resolution three-dimensional T1-weighted images was used to examine the structural variations of the amygdala, with respect to extent and location, in 23 patients with panic disorder and 31 matched healthy individuals.ResultsThere were no significant differences in bilateral amygdalar volumes between patients with panic disorder and healthy individuals despite a trend-level right amygdalar volume reduction related to panic disorder (right, β = -0.23, p = 0.09, Cohen's d = 0.51; left, β = -0.18, p = 0.19, Cohen's d = 0.45). Amygdalar subregions were localized into three groups including the superficial, centromedial, and laterobasal groups based on the cytoarchitectonically defined probability map. Surface-based morphometric analysis revealed shape alterations in the laterobasal and centromedial groups of the right amygdala in patients with panic disorder (false discovery rate corrected p < 0.05).ConclusionsThe current findings suggest that subregion-specific shape alterations in the right amygdala may be involved in the development and maintenance of panic disorder, which may be attributed to the cause or effects of amygdalar hyperactivation.
Highlights
Patients with panic disorder demonstrate a series of physiological and cognitive symptom clusters that are associated with recurrent and unexpected panic attacks, anticipatory anxiety, and phobic avoidance [1,2,3,4]
There were no significant differences in bilateral amygdalar volumes between patients with panic disorder and healthy individuals despite a trend-level right amygdalar volume reduction related to panic disorder
The current findings suggest that subregion-specific shape alterations in the right amygdala may be involved in the development and maintenance of panic disorder, which may be attributed to the cause or effects of amygdalar hyperactivation
Summary
Patients with panic disorder demonstrate a series of physiological and cognitive symptom clusters that are associated with recurrent and unexpected panic attacks, anticipatory anxiety, and phobic avoidance [1,2,3,4]. The prefrontal cortex in combination with the hippocampus may play an important role in higher-level cognitive control over the amygdala, manifesting the cognitive component of panic symptoms [6, 7]. Previous studies have suggested that the amygdala in connections with the prefrontal cortex, insula, and hippocampus plays an important organizing role in conditioned fear learning [8,9,10]. Despite the analogy between panic disorder and fear conditioning and avoidance response model with regard to amygdalar involvement in core symptom manifestations, biological differences between these conditions should be considered [6, 11]. The amygdala has been known to play a pivotal role in mediating fear-related responses including panic attacks. The current study aimed to determine the global and local morphometric alterations of the amygdala related to panic disorder.
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