Multiple white matter volume reductions in patients with panic disorder: relationships between orbitofrontal Gyrus volume and symptom severity and social dysfunction

PLoS One. 2014 Mar 24;9(3):e92862. doi: 10.1371/journal.pone.0092862. eCollection 2014.

Abstract

Numerous brain regions are believed to be involved in the neuropathology of panic disorder (PD) including fronto-limbic regions, thalamus, brain stem, and cerebellum. However, while several previous studies have demonstrated volumetric gray matter reductions in these brain regions, there have been no studies evaluating volumetric white matter changes in the fiber bundles connecting these regions. In addition, although patients with PD typically exhibit social, interpersonal and occupational dysfunction, the neuropathologies underlying these dysfunctions remain unclear. A voxel-based morphometry study was conducted to evaluate differences in regional white matter volume between 40 patients with PD and 40 healthy control subjects (HC). Correlation analyses were performed between the regional white matter volumes and patients' scores on the Panic Disorder Severity Scale (PDSS) and the Global Assessment of Functioning (GAF). Patients with PD demonstrated significant volumetric reductions in widespread white matter regions including fronto-limbic, thalamo-cortical and cerebellar pathways (p<0.05, FDR corrected). Furthermore, there was a significant negative relationship between right orbitofrontal gyrus (OFG) white matter volume and the severity of patients' clinical symptoms, as assessed with the PDSS. A significant positive relationship was also observed between patients' right OFG volumes and their scores on the GAF. Our results suggest that volumetric reductions in widespread white matter regions may play an important role in the pathology of PD. In particular, our results suggest that structural white matter abnormalities in the right OFG may contribute to the social, personal and occupational dysfunction typically experienced by patients with PD.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cerebral Cortex / diagnostic imaging*
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Organ Size
  • Panic Disorder / diagnostic imaging*
  • Panic Disorder / drug therapy
  • Radiography
  • Severity of Illness Index*
  • Social Behavior Disorders / diagnostic imaging*
  • Social Behavior Disorders / drug therapy

Grants and funding

This study was supported by grants from the Ministry of Health, Labor and Welfare (Kokoro 200400762A, 200500806A, and 200632005A, B) (Dr. Hirayasu), and from the Grant-in-Aid for Young Scientists (B) of the Japan Society for the Promotion of Science (13 25861023) (Dr. Asami) of Japan. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.