A focal brain abnormality in panic disorder, a severe form of anxiety
Panic disorder is characterized by recurrent anxiety attacks in theabsence of a frightening stimulus\ It is a common disorder,
affecting 2-5% of the general population and 10-14% of patients
seen in cardiology practice2,3. Infusion of sodium (DL)lactate
precipitates an anxiety attack in most persons with this disorder
but rarely does so in normal controls, suggesting a neurobiological
basis for the problem~. Despite this observation, the patho-
physiology of panic disorder remains unknown. We have nowused
positron emission tomography to measure cerebral blood flow
(CBF) in patients with panic disorder in the absence of a panic
attack. Analysis of CBF in regions thought to mediate symptoms
of panic, anxiety and vigilance reveals a significant (P < 0.005)
abnormal asymmetry of CBF (left < right) located in a region of
the parahippocampal gyrus. This asymmetry was present in seven
patients with panic disorder and a positive response to lactate
infusion but was absent in six normal controls and in three patients
with panic disorder associated with a negative response to lactate.
We believe this to be the first study to identify a discrete brain
abnormality in patients with this severe form of anxiety.
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