Decreased gray matter volume of the medial orbitofrontal cortex in panic disorder with agoraphobia: A preliminary study

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Abstract

Background: Patients with panic disorder with agoraphobia (PDA) have clinical symptoms such as the fear of being outside or of open spaces from which escape would be difficult. Although recent neurobiological studies have suggested that fear conditioning and extinction are associated with PDA, no study has examined the possible structural abnormalities in patients with PDA. Methods: This preliminary study compares the gray matter volume among patients with PDA, those with panic disorder without agoraphobia (PDW), and healthy controls (HC) using high-resolution 3.0. T magnetic resonance imaging (MRI) with voxel-based morphometry (VBM). Results: Compared with HC, patients with PDA showed decreased gray matter volume in their left medial orbitofrontal gyrus. However, differences were not found in the gray matter volumes of patients with PDW and whole panic disorder compared with HC. Conclusions: These findings suggest that the phobic avoidance found in patients with PDA arise from abnormalities in the medial orbitofrontal cortex, which plays an important role in fear extinction. Future studies should investigate the neuroanatomical substrates of PDA and distinguish them from those of PDW.

Original languageEnglish
Pages (from-to)195-200
Number of pages6
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Volume45
DOIs
Publication statusPublished - 2013 Aug 1

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Agoraphobia
Panic Disorder
Prefrontal Cortex
Fear
Gray Matter
Magnetic Resonance Imaging

Keywords

  • Agoraphobia
  • Gray matter
  • Panic disorder
  • Prefrontal cortex
  • Voxel-based morphometry

ASJC Scopus subject areas

  • Biological Psychiatry
  • Pharmacology

Cite this

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title = "Decreased gray matter volume of the medial orbitofrontal cortex in panic disorder with agoraphobia: A preliminary study",
abstract = "Background: Patients with panic disorder with agoraphobia (PDA) have clinical symptoms such as the fear of being outside or of open spaces from which escape would be difficult. Although recent neurobiological studies have suggested that fear conditioning and extinction are associated with PDA, no study has examined the possible structural abnormalities in patients with PDA. Methods: This preliminary study compares the gray matter volume among patients with PDA, those with panic disorder without agoraphobia (PDW), and healthy controls (HC) using high-resolution 3.0. T magnetic resonance imaging (MRI) with voxel-based morphometry (VBM). Results: Compared with HC, patients with PDA showed decreased gray matter volume in their left medial orbitofrontal gyrus. However, differences were not found in the gray matter volumes of patients with PDW and whole panic disorder compared with HC. Conclusions: These findings suggest that the phobic avoidance found in patients with PDA arise from abnormalities in the medial orbitofrontal cortex, which plays an important role in fear extinction. Future studies should investigate the neuroanatomical substrates of PDA and distinguish them from those of PDW.",
keywords = "Agoraphobia, Gray matter, Panic disorder, Prefrontal cortex, Voxel-based morphometry",
author = "Na, {Kyoung Sae} and Byung-Joo Ham and Min-Soo Lee and Leen Kim and Kim, {Yong Ku} and Heon-Jeong Lee and Ho-Kyoung Yoon",
year = "2013",
month = "8",
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doi = "10.1016/j.pnpbp.2013.04.014",
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T1 - Decreased gray matter volume of the medial orbitofrontal cortex in panic disorder with agoraphobia

T2 - A preliminary study

AU - Na, Kyoung Sae

AU - Ham, Byung-Joo

AU - Lee, Min-Soo

AU - Kim, Leen

AU - Kim, Yong Ku

AU - Lee, Heon-Jeong

AU - Yoon, Ho-Kyoung

PY - 2013/8/1

Y1 - 2013/8/1

N2 - Background: Patients with panic disorder with agoraphobia (PDA) have clinical symptoms such as the fear of being outside or of open spaces from which escape would be difficult. Although recent neurobiological studies have suggested that fear conditioning and extinction are associated with PDA, no study has examined the possible structural abnormalities in patients with PDA. Methods: This preliminary study compares the gray matter volume among patients with PDA, those with panic disorder without agoraphobia (PDW), and healthy controls (HC) using high-resolution 3.0. T magnetic resonance imaging (MRI) with voxel-based morphometry (VBM). Results: Compared with HC, patients with PDA showed decreased gray matter volume in their left medial orbitofrontal gyrus. However, differences were not found in the gray matter volumes of patients with PDW and whole panic disorder compared with HC. Conclusions: These findings suggest that the phobic avoidance found in patients with PDA arise from abnormalities in the medial orbitofrontal cortex, which plays an important role in fear extinction. Future studies should investigate the neuroanatomical substrates of PDA and distinguish them from those of PDW.

AB - Background: Patients with panic disorder with agoraphobia (PDA) have clinical symptoms such as the fear of being outside or of open spaces from which escape would be difficult. Although recent neurobiological studies have suggested that fear conditioning and extinction are associated with PDA, no study has examined the possible structural abnormalities in patients with PDA. Methods: This preliminary study compares the gray matter volume among patients with PDA, those with panic disorder without agoraphobia (PDW), and healthy controls (HC) using high-resolution 3.0. T magnetic resonance imaging (MRI) with voxel-based morphometry (VBM). Results: Compared with HC, patients with PDA showed decreased gray matter volume in their left medial orbitofrontal gyrus. However, differences were not found in the gray matter volumes of patients with PDW and whole panic disorder compared with HC. Conclusions: These findings suggest that the phobic avoidance found in patients with PDA arise from abnormalities in the medial orbitofrontal cortex, which plays an important role in fear extinction. Future studies should investigate the neuroanatomical substrates of PDA and distinguish them from those of PDW.

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KW - Gray matter

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KW - Prefrontal cortex

KW - Voxel-based morphometry

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