Universität zu Köln

Wittmann, A., Schlagenhauf, F., Guhn, A., Lueken, U., Gaehlsdorf, C., Stoy, M., Bermpohl, F., Fydrich, T., Pfleiderer, B., Bruhn, H., Gerlach, A. L., Kircher, T., Straube, B., Wittchen, H. -U., Arolt, V., Heinz, A. and Stroehle, A. (2014). Anticipating agoraphobic situations: the neural correlates of panic disorder with agoraphobia. Psychol. Med., 44 (11). S. 2385 - 2397. NEW YORK: CAMBRIDGE UNIV PRESS. ISSN 1469-8978

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Abstract

Background. Panic disorder with agoraphobia is characterized by panic attacks and anxiety in situations where escape might be difficult. However, neuroimaging studies specifically focusing on agoraphobia are rare. Here we used functional magnetic resonance imaging (fMRI) with disorder-specific stimuli to investigate the neural substrates of agoraphobia. Method. We compared the neural activations of 72 patients suffering from panic disorder with agoraphobia with 72 matched healthy control subjects in a 3-T fMRI study. To isolate agoraphobia-specific alterations we tested the effects of the anticipation and perception of an agoraphobia-specific stimulus set. During fMRI, 48 agoraphobia-specific and 48 neutral pictures were randomly presented with and without anticipatory stimulus indicating the content of the subsequent pictures (Westphal paradigm). Results. During the anticipation of agoraphobia-specific pictures, stronger activations were found in the bilateral ventral striatum and left insula in patients compared with controls. There were no group differences during the perception phase of agoraphobia-specific pictures. Conclusions. This study revealed stronger region-specific activations in patients suffering from panic disorder with agoraphobia in anticipation of agoraphobia-specific stimuli. Patients seem to process these stimuli more intensively based on individual salience. Hyperactivation of the ventral striatum and insula when anticipating agoraphobia-specific situations might be a central neurofunctional correlate of agoraphobia. Knowledge about the neural correlates of anticipatory and perceptual processes regarding agoraphobic situations will help to optimize and evaluate treatments, such as exposure therapy, in patients with panic disorder and agoraphobia.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Wittmann, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlagenhauf, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Guhn, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lueken, U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gaehlsdorf, C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoy, M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bermpohl, F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Fydrich, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfleiderer, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruhn, H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Gerlach, A. L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Kircher, T. UNSPECIFIED UNSPECIFIED UNSPECIFIED Straube, B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wittchen, H. -U. UNSPECIFIED UNSPECIFIED UNSPECIFIED Arolt, V. UNSPECIFIED UNSPECIFIED UNSPECIFIED Heinz, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Stroehle, A. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-433450
DOI:	10.1017/S0033291713003085
Journal or Publication Title:	Psychol. Med.
Volume:	44
Number:	11
Page Range:	S. 2385 - 2397
Date:	2014
Publisher:	CAMBRIDGE UNIV PRESS
Place of Publication:	NEW YORK
ISSN:	1469-8978
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OBSESSIVE-COMPULSIVE DISORDER; RANDOMIZED CONTROLLED-TRIAL; NEUROANATOMICAL HYPOTHESIS; SOCIAL ANXIETY; FMRI; ACTIVATION; STIMULI; BRAIN; FEAR; MULTICENTER Multiple languages Psychology, Clinical; Psychiatry; Psychology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/43345