Automatic Processing Of Threatening Voices In Patients With Panic Disorder: An Event-related Potential Study

Objective: Panic disorder (PD), also known as panic distubance, is characterizedby acute fear of dying and sense of out of control,followed by automic nervoussyptoms,such as fluster,chest tightness,drip sweat and shortness of breath.The etiologyand pathogenesis of panic disorder is not clear. In recent years, some scholars putforward the information processing abnormalities may be an important factor leadingto panic disorder. Cognitive bias towards threatening information may influence theoccurrence and development of panic disorder. In daily life threatening voice affectmood adjustment, easily leading to a variety of mental illness.Whether threatening voiceaffect the occurrence and development of panic disorder or not is notclear.Event-related potential is the brain potential change evoked by stimulus.It canquickly and accurately reflect dynamic change in information processing in the brain.Mismatch negativity is the only component to accurately reflect the electrophysiologicalautomated information processing.Since the simple operation and low requirements forthe subjects,it was widely used in the clinical study. It is lack of research on panicdisorder to threat information automatic processing.The present study aims to explore the automaic processing of threatening voices in patients with panic disorder with theevent-related potential(ERP).Methods: The Participants in the study included19PD patients and17healthyvolunteers.All patients met the diagnostic criteria for panic disorder.There were nodifference in age,sex ratio,years of education,and intelligence between the twogroups.The subjects watched silent movie with earphone.The voice from headset werethe sound sequence presented by voice software.The protocol used Reverse-oddballparadigm.The complex sound materials synthesized by software,,including threateningvoices and neutral voices,were used as auditory stimulus.All the electroencephalogramwere recorded throughout the whole test.Extract MMN(mismatch negativity) at the endof the test.The differences in the amplitude and latency of auditory MMN between thegroups required analysis,Then correlation analysis was used to analysis the amplitude ofMMN and HAMA,PDSS score of the patients.Results:1. The analysis of the amplitude of MMN.There was no significant difference between the MMN of the patients and that ofthe volunteers(F(1,34)=1.385,p=0.247).There was a interaction of emotion type×group(F(1,34)=4.914,p=0.033). The amplitude of MMN in panic disorder was lower than thatin the volunteers,evoked by threatening voices.Compared with the neutralvoices,threatening stimulis induced lower amplitude of MMN of the patient group.There was significant interaction effect among emotion type, hemisphere,and group(F(1,34)=5.257,p=0.028).Threatening sounds evoked lower amplitude of MMN thanneutral sounds in the frontal areas and central areas in the PD group.(F(1,34)=3.672,p=0.042)2.There was no main effect of group for the latency of MMN.3.The amplitude of MMN was no correlation with HAMA and PDSS score of thepatients.Conclusion:1.The study suggested processing disorder of auditory information in the patients at the stage of automatic processing,the performance of the automatic processing of threatsounds weakened..2. The patients’abnormality on automatic processing of auditory threat informationwas not related with anxiety state and the severity of the disease.MMN may be therelated index of panic disorder,rather than indicator of state.