Etiology, triggers and neurochemical circuits associated with unexpected, expected, and laboratory-induced panic attacks

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:46

Review

Johnson, Philip L.^1,2,3  Federici, Lauren M.^1,3  Shekhar, Anantha^2,3,4 

[1] Indiana Univ Sch Med, Dept Anat & Cell Biol, Indianapolis, IN 46202 USA

[2] Indiana Univ Sch Med, Dept Psychiat, Inst Psychiat Res, Indianapolis, IN 46202 USA

[3] Indiana Univ Sch Med, Stark Neurosci Res Inst, Indianapolis, IN 46202 USA

[4] Indiana Univ Sch Med, Indiana Clin & Translat Sci Inst, Indianapolis, IN 46202 USA

关键词: Panic;    Anxiety;    CO2;    Lactate;    Perifornical hypothalamus;    Periaqueductal gray;    Amygdala;    Insula;   

DOI  :  10.1016/j.neubiorev.2014.07.027

来源: Elsevier

【 摘 要 】

Panic disorder (PD) is a severe anxiety disorder that is characterized by recurrent panic attacks (PA), which can be unexpected (uPA, i.e., no clear identifiable trigger) or expected (ePA). Panic typically involves an abrupt feeling of catastrophic fear or distress accompanied by physiological symptoms such as palpitations, racing heart, thermal sensations, and sweating. Recurrent uPA and ePA can also lead to agoraphobia, where subjects with PD avoid situations that were associated with PA. Here we will review recent developments in our understanding of PD, which includes discussions on: symptoms and signs associated with uPA and ePAs; Diagnosis of PD and the new DSM-V; biological etiology such as heritability and gene x environment and gene x hormonal development interactions; comparisons between laboratory and naturally occurring uPAs and ePAs; neurochemical systems that are associated with clinical PAs (e.g. gene associations; targets for triggering or treating PAs), adaptive fear and panic response concepts in the context of new NIH RDoc approach; and finally strengths and weaknesses of translational animal models of adaptive and pathological panic states. (C) 2014 Elsevier Ltd. All rights reserved.

【 授权许可】

Free