Yunbo Yang1, Ulrike Lueken1, Jan Richter1, Alfons Hamm1, André Wittmann1, Carsten Konrad1, Andreas Ströhle1, Bettina Pfleiderer1, Martin J Herrmann1, Thomas Lang1, Martin Lotze1, Jürgen Deckert1, Volker Arolt1, Hans-Ulrich Wittchen1, Benjamin Straube1, Tilo Kircher1. 1. Department of Psychiatry and Psychotherapy and Marburg Center for Mind, Brain, and Behavior, Philipps-University Marburg, Marburg, Germany (Yang, Konrad, Straube, Kircher); Department of Psychiatry, Psychosomatics, and Psychotherapy, Center of Mental Health, University Hospital of Würzburg, University of Würzburg, Würzburg, Germany (Lueken, Herrmann, Deckert); Department of Psychology, Humboldt-Universität zu Berlin, Berlin, Germany (Lueken); Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany (Richter, Hamm); Department of Psychiatry and Psychotherapy, Campus Charité Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany (Wittmann, Ströhle); Department of Psychiatry, Agaplesion Diakonieklinikum Rotenburg (Wümme), Germany (Konrad); Department of Clinical Radiology, University of Münster, Münster, Germany (Pfleiderer); Christoph-Dornier-Foundation for Clinical Psychology, Bremen, Germany (Lang); Department of Psychiatry and Psychotherapy, University of Hamburg, Hamburg, Germany (Lang); Functional Imaging Unit, Institute for Diagnostic Radiology and Neuroradiology, University of Greifswald, Greifswald, Germany (Lotze); Department of Psychiatry, University of Münster, Münster, Germany (Arolt); and Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany (Wittchen).
Abstract
OBJECTIVE: Cognitive-behavioral therapy (CBT) has been hypothesized to act by reducing the pathologically enhanced semantic, anxiety-related associations of patients with panic disorder. This study investigated the effects of CBT on the behavioral and neural correlates of the panic-related semantic network in patients with panic disorder. METHODS: An automatic semantic priming paradigm specifically tailored for panic disorder, in which panic symptoms (e.g., "dizziness") were primed by panic triggers (e.g., "elevator") compared with neutral words (e.g., "bottle"), was performed during functional MRI scanning with 118 patients with panic disorder (compared with 150 healthy control subjects) before and 42 patients (compared with 52 healthy control subjects) after an exposure-based CBT. Neural correlates were investigated by comparing 103 pairs of matched patients and control subjects at the baseline (for patients) or T1 (for control subjects) assessment and 39 pairs at the posttreatment or T2 assessment. RESULTS: At baseline or T1, patients rated panic-trigger/panic-symptom word pairs with higher relatedness and higher negative valence compared with healthy control subjects. Patients made faster lexical decisions to the panic-symptom words when they were preceded by panic-trigger words. This panic-priming effect in patients (compared with control subjects) was reflected in suppressed neural activation in the left and right temporal cortices and insulae and enhanced activation in the posterior and anterior cingulate cortices. After CBT, significant clinical improvements in the patient group were observed along with a reduction in relatedness and negative valence rating and attenuation of neural activation in the anterior cingulate cortex for processing of panic-trigger/panic-symptom word pairs. CONCLUSIONS: The findings support a biased semantic network in panic disorder, which is normalized after CBT. Attenuation of anterior cingulate cortex activation for processing of panic-related associations provides a potential mechanism for future therapeutic interventions.
OBJECTIVE: Cognitive-behavioral therapy (CBT) has been hypothesized to act by reducing the pathologically enhanced semantic, anxiety-related associations of patients with panic disorder. This study investigated the effects of CBT on the behavioral and neural correlates of the panic-related semantic network in patients with panic disorder. METHODS: An automatic semantic priming paradigm specifically tailored for panic disorder, in which panic symptoms (e.g., "dizziness") were primed by panic triggers (e.g., "elevator") compared with neutral words (e.g., "bottle"), was performed during functional MRI scanning with 118 patients with panic disorder (compared with 150 healthy control subjects) before and 42 patients (compared with 52 healthy control subjects) after an exposure-based CBT. Neural correlates were investigated by comparing 103 pairs of matched patients and control subjects at the baseline (for patients) or T1 (for control subjects) assessment and 39 pairs at the posttreatment or T2 assessment. RESULTS: At baseline or T1, patients rated panic-trigger/panic-symptom word pairs with higher relatedness and higher negative valence compared with healthy control subjects. Patients made faster lexical decisions to the panic-symptom words when they were preceded by panic-trigger words. This panic-priming effect in patients (compared with control subjects) was reflected in suppressed neural activation in the left and right temporal cortices and insulae and enhanced activation in the posterior and anterior cingulate cortices. After CBT, significant clinical improvements in the patient group were observed along with a reduction in relatedness and negative valence rating and attenuation of neural activation in the anterior cingulate cortex for processing of panic-trigger/panic-symptom word pairs. CONCLUSIONS: The findings support a biased semantic network in panic disorder, which is normalized after CBT. Attenuation of anterior cingulate cortex activation for processing of panic-related associations provides a potential mechanism for future therapeutic interventions.
Authors: Aet O'Leary; Noèlia Fernàndez-Castillo; Gabriela Gan; Yunbo Yang; Anna Y Yotova; Thorsten M Kranz; Lena Grünewald; Florian Freudenberg; Ester Antón-Galindo; Judit Cabana-Domínguez; Anais Harneit; Janina I Schweiger; Kristina Schwarz; Ren Ma; Junfang Chen; Emanuel Schwarz; Marcella Rietschel; Heike Tost; Andreas Meyer-Lindenberg; Christiane A Pané-Farré; Tilo Kircher; Alfons O Hamm; Demian Burguera; Nina Roth Mota; Barbara Franke; Susann Schweiger; Jennifer Winter; Andreas Heinz; Susanne Erk; Nina Romanczuk-Seiferth; Henrik Walter; Andreas Ströhle; Lydia Fehm; Thomas Fydrich; Ulrike Lueken; Heike Weber; Thomas Lang; Alexander L Gerlach; Markus M Nöthen; Georg W Alpers; Volker Arolt; Stephanie Witt; Jan Richter; Benjamin Straube; Bru Cormand; David A Slattery; Andreas Reif Journal: Mol Psychiatry Date: 2022-08-10 Impact factor: 13.437
Authors: W Tommy Baumel; Lu Lu; Xiaoqi Huang; Andrew T Drysdale; John A Sweeny; Qiyong Gong; Chad M Sylvester; Jeffrey R Strawn Journal: Biomark Neuropsychiatry Date: 2022-04-22
Authors: Janna Marie Bas-Hoogendam; Nynke A Groenewold; Moji Aghajani; Gabrielle F Freitag; Anita Harrewijn; Kevin Hilbert; Neda Jahanshad; Sophia I Thomopoulos; Paul M Thompson; Dick J Veltman; Anderson M Winkler; Ulrike Lueken; Daniel S Pine; Nic J A van der Wee; Dan J Stein Journal: Hum Brain Mapp Date: 2020-07-03 Impact factor: 5.399