. 2015 May 26;5(5):e572. doi: 10.1038/tp.2015.67

Table 1. Studies of pH or lactate-related brain changes in patients with panic disorder.

Reference	Population	Panicogen or challenge	Region of interest	Finding
27	Panic disorder (treated), n=7 Healthy subjects, n=7	Hyperventilation	Whole brain	↑ Brain lactate in panic disorder patients, compared with healthy subjects.
37	Panic disorder, n=13 Healthy subjects, n=10	Lactate infusion	Insula	> And longer brain lactate responses in the insula during and after lactate infusion in panic disorder patients, compared with healthy controls. Lactate responses did not normalize following fluoxetine treatment (3–4 months duration).
29	Panic disorder, n=15 Healthy subjects, n=10	Lactate infusion	Whole brain	↑ Global brain lactate increases following lactate infusion in panic disorder patients compared with healthy subjects. No lateralization of brain lactate response. No regional loci of elevated lactate observed.
26	Panic disorder (treated), n=9 Healthy subjects, n=11	Hyperventilation	Whole brain	Lower pCO₂ during hyperventilation and slower pCO₂ recovery following hyperventilation in patients with panic disorders compared with healthy controls.
29	Panic disorder, n=15 Healthy subjects, n=15	Visual stimuli	Occipital cortex	Greater ↑ in stimulation-related lactate/N-acetylaspartate in patients with panic disorder compared with healthy subjects.
36	Panic disorder, in remission, n=13 Panic disorder, n=8 Healthy subjects, n=12	Visual stimuli	Occipital cortex	Panic disorder patients (regardless of remission status) had greater activity-dependent ↑ in brain lactate compared with healthy subjects.
40	Healthy subjects, n=6	Inhalation of room air, 5% CO₂ or hyperventilation. Visual stimuli	Whole brain	T1ρ (surrogate marker of brain pH) is a valid marker for pH changes in human brain and changes seen are dependent on brain activity.
41	Panic disorder, n=13 Healthy subjects, n=13	Visual stimuli	Occipital cortex	↑ Activity-dependent T1ρ in panic disorder patients compared with healthy subjects.
39	Panic disorder, n=15 Healthy subjects, n=12 Experienced divers, n=15	7% CO₂ inhalation	Brainstem	↑ Brain stem activation in patients with panic disorder in response to CO₂ inhalation as compared with both healthy controls and experienced divers.