Magnetic Resonance Investigation Of Resting State Brain Function In Patients With Panic Disorder

Objective:Panic disorder(PD)is an important anxiety disorder.The sudden onset of acute panic attacks is the main clinical feature,and the pathogenesis is still unclear.Patients with PD often attack spontaneously without a cause and have expectancy anxiety during attack period,indicating that the patients with PD have brain dysfunctions in the resting state.Resting-state functional MRI(Rest-f MRI)can reflect spontaneous neural activity in the human brain by depending on low-frequency fluctuations signals in human brain blood oxygenation levels in the resting state.In this study,the fractional amplitude of low-frequency fluctuation(f ALFF)and local homogeneity(Re Ho)are used to study the difference of brain function between PD patients and healthy control group under resting state,and further study on the pathogenesis of patients with PD.Methods:Twenty-four patients with PD who are diagnosed by DSM-IV SCID and twenty-five healthy controls(control group)are enrolled in this study and the two groups are well matched with ages,genders and length of education.All subjects are given the Hamilton Anxiety Scale(HAMA)and 17 Hamilton Depression Scale(HAMD-17)scores.In addition,the severity of PD patients is assessed through Panic Disorder Symptoms Scale(PASS)and Panic Disability Severity Scale(PDSS).The whole brain Rest-f MRI and 3D T1 images are scanned in the case group and the control group using 3.0T functional MRI while the subjects are under resting state.The DPABI and REST software are used to treat the images under the platform of MATLAB12.0.The age,gender and head motion parameters are concomitant variables.The difference between Re Ho and f ALFF in the case group and the control group is statistically analyzed,and the correlation analysis between Re Ho and f ALFF values and PASS and PDSS scores is analyzed statistically.Results:1.Compared with the normal group,the Re Ho values of the left orbitofrontal area(BA11 area),the right cerebellum and the left parahippocampal cortex(BA35 area)are increased,and the Re Ho valuesof the left anterior cingulate cortex(BA24),the right frontal pole(BA10 area),the left somatosensory cortex(BA3 area)are decreased;2.Compared with the normal group,the f ALFF value of the right fusiformgyrus(BA37 area)is increased in the PD group.3.There is a positive correlation between the Re Ho value and the PASS clinical score in the left orbitofrontal area(PD11)of PD patients.There is a positive correlation between the Re Ho value and the PASS clinical scorein the left somatosensory cortex(BA3 area)of PD patients.There is no significant correlation between f ALFF and PASS and PDSS clinical score in PD patients.Conclusions:1.The inhibition of amygdala in the "top-down" pathway in the frightened loops of patients with PD may be weakened;2.Patients with panic disorder in the non-seizure state before the anterior cingulate gyrus,hippocampus paralysis,somatosensory cortex,cerebellum,fusiform gyrus and other brain activity abnormalities,may be the incidence of PD patients with important neurological basis.3.The Re Ho values of left orbitofrontal region and left somatosensory cortex may be clinical evaluation index for the severity of PD.