The Role of the Anterior Cingulate Cortex in Posttraumatic Stress and Panic Disorders

Abstract

Abstract Anxiety and fear are normal human emotional states that serve to alert an individual to potential threat in the environment. However, individuals with anxiety disorders persistently experience such emotional states in the absence of true danger, leading to significant distress and impairment (APA, 2000). Anxiety disorders are marked by episodes of fear or apprehension that may be either elicited by a specific stimulus or unprovoked. In posttraumatic stress disorder (PTSD), such episodes of intense fear may be triggered by recollections of a previous traumatic event and are typically accompanied by heightened physiologic arousal. In panic disorder (PD), periods of intense fear and physiologic arousal may be initially unprovoked and over time may tend to occur in specific settings from which escape would be difficult. Patients with PD often report fearing that they may have a heart attack or die or lose control, and they typically develop apprehension concerning further attacks. With the advent of neuroimaging techniques, researchers have begun to investigate the brain systems mediating anxiety disorders and to formulate neurocircuitry models of them. Medial prefrontal cortical regions, including anterior cingulate cortex (ACC), have typically been included in such models of anxiety disorders. The ultimate goal of this type of research is to understand the neurobiological substrates of anxiety disorders in order to assist in diagnosis, improve treatment, and predict treatment response.