White matter microstructural changes are associated with alcohol use in patients with panic disorder

Background: A close relationship between panic disorder (PD) and alcohol use disorder (AUD) has been suggested. We aimed to investigate alterations in white matter (WM) volume or integrity in patients with PD comorbid with AUD.

Methods: Forty-nine patients with PD, free of comorbid AUD (PD-AUD), and 20 patients with PD comorbid with AUD (PD+AUD) were investigated. All subjects were assessed using the Panic Disorder Severity Scale, Anxiety Sensitivity Inventory-Revised (ASI-R), Beck Depression Inventory, and CAGE questionnaire. Voxel-based morphometry and tract-based spatial statistics were used for imaging analysis.

Results: Increased fractional anisotropy (FA), as well as decreased mean diffusivity and radial diffusivity were observed in multiple WM tracts, including the body and splenium of the corpus callosum and the retrolenticular part of the internal capsule, in the PD+AUD group compared to the PD-AUD group. CAGE scores in the PD+AUD group and ASI-R scores in the PD-AUD group were significantly correlated with FA values for the corpus callosum. No WM volume differences were found.

Limitations: The present study should be considered preliminary due to relatively small sample size.

Conclusions: Our findings revealed microstructural changes in multiple WM tracts, including the corpus callosum and internal capsule, suggesting they could be significant neural correlates of AUD in patients with PD.