Abstract
Introduction: Although progress has been made in the development of effective pharmacological and psychotherapeutic interventions, about 20∼40% of all patients with panic disorder still do not respond to treatment. There are no neuro-imaging studies that have predicted pharmacotherapy treatment outcome in Panic disorder. The objective of this study is to compare the brain WM connectivity between treatment responder in patients with panic disorder(RPD) and treatment non-responder in patients with panic disorder(NRPD)
Methods: 64 right-handed patients with PD (RPD, n=37; NRPD, n=27) enrolled this study. All patients were interviewed and diagnosed with the diagnostic criteria in Structured Clinical Interview for DSM-IV and examined by means of MRI at 3 Tesla. Beck Depression Inventory (BDI), Beck Anxiety Inventory(BAI), Panic Disorder Severity Scale (PDSS), Albany Panic and Phobia Questionnaire (APPQ)and Anxiety Sensitivity Inventory-Revised (ASI-R) were administered. Fractional Anisotropy (FA) data were compared using tract-based spatial statistics (TBSS).
Results: TBSS results showed that the FA values of patients in NRPD were significantly higher than RPD in cluster of white matter such as near right precentral gyrus, posterior corona radiate, posterior thalamic radiation, precuneus, splenium of corpus callosum, inferior parietal lobe, para-hippocampal gyrus. Conducting correlation analysis among RPD showed significant positive correlations between ASI public scales and FA of right posterior corona radiata. Conducting correlation analysis among NRPD showed significant positive correlations between ASI cognition and FA of right middle frontal lobe.
Conclusion: These results suggest that structural changes such as fronto-limbic network and precuneus, which are related to default mode network, could influence the response of medication in panic disorder. Further studies with a larger numbers of patients should be replicated to confirm our findings.