Background: Emotional dysregulation, particularly unconscious catastrophic cognitions, plays a pivotal role in the genesis of panic disorder (PD). However, no studies have yet applied the percentage of amplitude fluctuation (PerAF) metric in resting-state functional magnetic resonance imaging to examine spontaneous neural functioning and its relation to catastrophic cognitions in PD.
Objectives: To explore the interplay between resting-state neural activity, functional connectivity (FC), and unconscious emotion regulation in individuals with PD.
Design: Cross-sectional study.
Methods: The study encompassed 51 participants, including 26 PD patients and 25 healthy individuals. The PerAF algorithm was employed to explore the local spontaneous neural activity in PD. Regions exhibiting aberrant spontaneous neural activity were used as seed points for whole-brain FC analysis. Correlations were utilized to examine associations between local neural activity patterns and neurocognitive assessments in PD.
Results: The study revealed that compared to healthy individuals, PD patients exhibited elevated PerAF values in key emotion-regulation-related brain regions, including the ventromedial prefrontal cortex (vmPFC), striatum, amygdala, dorsomedial prefrontal cortex (dmPFC), and cerebellum. In addition, the resting-state FC between vmPFC and precuneus, as well as between the cerebellum and precuneus, was weakened in PD patients. Furthermore, positive associations were noted between PerAF measurements of vmPFC and amygdala and catastrophizing scores.
Conclusion: PD involves regional and network-level alterations in resting-state brain activity. The fronto-striatal-limbic circuits play a critical role in catastrophic-style emotion regulation in PD patients. Reduced FC within the default mode network and cerebellum-default mode network may signify a coordination anomaly in introspection and cognitive activities in PD. These findings complement the model of implicit emotion regulation in PD and suggest potential intervention targets.
Keywords: catastrophic cognition; emotion regulation; functional connectivity; panic disorder; prefrontal cortex.
Understanding emotion control and brain activity in panic disorder using brain scans Panic disorder is a condition where people experience sudden and intense episodes of fear and anxiety. This study investigates how the brains of people with panic disorder function when they are at rest and how they manage their emotions. We used a special brain scan called resting-state fMRI to measure spontaneous brain activity. We studied 51 people, including 26 with panic disorder and 25 healthy individuals. Our results showed that people with panic disorder have higher levels of brain activity in areas related to emotion control, such as the ventromedial prefrontal cortex (vmPFC), striatum, amygdala, dorsomedial prefrontal cortex (dmPFC), and cerebellum. Additionally, connections between certain brain areas, such as the vmPFC and precuneus, and the cerebellum and precuneus, were weaker in those with panic disorder. We also found that higher activity in the vmPFC and amygdala was linked to stronger feelings of catastrophic thinking, where minor issues are perceived as major problems. These findings suggest that panic disorder is associated with changes in brain activity and connectivity, particularly in regions involved in emotion regulation. Understanding these changes can help us develop better treatments for panic disorder by targeting specific brain areas and networks involved in managing emotions.
© The Author(s), 2024.