Abnormal resting-state functional connectivity in panic disorder: An exploratory whole-brain MRI study

Abstract

Background

Panic disorder (PD) is characterized by prolonged anxiety about panic attacks, significantly impairing social functioning. Despite this impact, resting-state brain function anomalies in PD are insufficiently understood. We conducted a data-driven investigation of resting-state functional connectivity (rsFC) in PD.

Methods

MRI scans and clinical assessments were performed on PD patients and healthy controls (HCs). Differences in rsFC were analyzed using the cluster-wise analysis of 9045 connections among 135 regions across the brain. For significant clusters, correlations between rsFC and clinical scores for panic and anxiety symptoms were examined.

Results

Thirty-nine patients and 44 HCs were included in the analyses. A significant cluster-level difference in rsFC was observed between groups, involving connections between the medial occipital region and the paracingulate gyrus within the anterior cingulate cortex (ACC). In this cluster, PD patients exhibited higher rsFC in 11 connections, with eight of these showing positive correlations with State-Trait Anxiety Inventory scores.

Limitations

The comprehensive analysis of 9045 connections may have diluted statistical power, potentially obscuring other relevant connections.

Conclusions

Increased rsFC between the medial occipital region and the ACC was observed in PD. This suggests that anxiety-evoking visual imagery generated in the occipital lobe may disproportionately influence self-referential thought process mediated by the ACC. Interventions targeting visual imagery may help alleviate daily anxiety in PD patients.