Panic Disorder – Neuropsychiatric Profile

Česká verzia

Authors: prof. MUDr. Peter Kukumberg, PhD.
Authors place of work: II. Neurologická klinika FNsP a LF UK Bratislava
Published in the journal: Cesk Slov Neurol N 2007; 70/103(1): 6-15
Category: Minimonography

Venované pamiatke nestora československej neurológie akademikovi Jozefovi Černáčkovi, DrSc.: V krušných posledných rokoch jeho života mi otváral byt z vozíčka, aby som spoznával jeho udivujúci ľudský rozmer – symbiózu stoickej múdrosti a neutíchajúcej všestrannej zvedavosti, vzácnu harmóniu rozumu a citu a nerezignujúci postoj k nepriazni osudu. Autor

Summary

Dominant specific fear (panic) classifies panic disorder to quad vitam benign and quad sanationem chronic psychiatric diseases. A panic attack is a cardinal symptom complex: about 30-minutes’ mostly spontaneous repeating paroxysm of panic with various manifestations of neurovegetative excess. Anticipation fear and agoraphobia develop in more severe or unrecognized cases. Similar organicly conditioned situations (e.g., myocardial infarction) as well as independent neurological affections (neurogenic tetanic syndrome, hyperventilation syndrome) must be eliminated. There is about 8% prevalence in population, and it culminates in the middle age. Congenital (genetically bound) neurotransmitter dysfunction (especially noradrenergic and serotogenic one) in predilection sites of the brainstem, limbic structures, cortical areas with apt neurophysiological (EEG, evoked potentials, etc.) and imaging (CT, MRI, PET, etc.) correlates has been suggested. From the view of pathophysiology, hypersensitivity of respiration centres in the brainstem has been considered. The so-called catastrophic processing of innocent body sensations represents a psychogenic pathogenetic impulse. A panic attack may be also provoked (modelled) in many ways (sodium lactate, CO2, etc.). The early combination of focused pharmacotherapy and psychotherapy gives the best effects. A panic disorder also appears to be a noticeable ethalon of neuropsychiatric disharmony probably rudimentary or deliberated protective archetype – a pattern of man (not associated with a classical stress reaction).

Key words:
panic disorder – panic attack – neurovegetative excess - anticipation fear – agoraphobia – locus coeruleus – neurotransmitters – hypersensitivity of respiration centres – sodium lactate

Zdroje

1. Medzinárodná štatistická klasifikácia chorôb a príbuzných zdravotných problémov MKCH 10. Bratislava: Obzor 1993.

2. DSM IV American Psychiatric Association. Diagnostic and Statistical Manual. 4th ed. Washington DC: American Psychiatric Press 1994.

3. Klein DF. False suffocation alarm, spontaneous panics, and related conditions. Arch Gen Psychiatry 1993; 50: 306-17.

4. Gorman JM, Liebowitz MR, Fyer AJ, Stein J. A neuroanatomical hypothesis for panic disorder. Am J Psychiatry 1989; 146: 148-61.

5. Gorman JM, Kent JM, Sullivan GM, Coplan JD. A neuroanatomical hypothesis of panic disorder, revised. Am J Psychiatry 2000; 157: 493-505.

6. Clark MD, Ehlers A. An overview of the cognitive theory and treatment of panic disorder. Appl Prev Psychol 1993; 2: 131-9.

7. Goddard AW, Charney DS. Toward an integrated neurobiology of panic disorder. J Clin Psych 1997; 58(Suppl 2): 4-11.

8. Kukumberg P. Psychoneurologická entita: panická porucha. Lekársky obzor 1993; 42: 79 -86.

9. Kukumberg P. Koncepčné línie panickej poruchy. Čas Lék Česk 1996; 135: 167-9.

10. Kukumberg P. Panická porucha: psycho-neurologický nexus. Česko-slovenská psychiatrie 1994; 90: 142-5.

11. Kukumberg P. Skica panickej poruchy. Neurologie pro praxi 2003; 6: 312-4.

12. Kukumberg P et al. Neurologicko-psychiatrické záchvatové stavy. Bratislava: HERBA (Malá lekárska knižnica, zv. 8; 2nd ed) 2003.

13. Kukumberg P, Ulč I et al. Panická porucha. Praha: MAXDORF Jessenius 2001.

14. Raboch J, Seifertová D, Praško J. Panické stavy. Praha: Česká psychiatrická společnost a Smith-Kline & Beecham 1997.

15. Praško J, Ondráčková I, Šípek J. Panická porucha a její léčení. Praha: Psychiatrické centrum 1997.

16. Bradwein J, Koszycki D, Shriqui C. Enhanced sensitivity to cholecystokinin tetrapeptide in panic disorder. Arch Gen Psychiatry 1991; 48: 603-10.

17. Pacchierotti C, Castrogiovanni CH, Cavicchiolli CH, Luisi S, Morgante G, Deleo V et al. Panic disorder in menopause: a case control study. Maturitas, European Menopause J 2004; 48: 147-54.

18. Kukumberg P, Strečko A. Increased neuronal excitability in panic disorder. Br J Psychiatry1993; 163: 839-40.

19. Torres AR, Dedomenico MA, Crepaldi LA, Miguel CE. Obsessive-Compulsive Symptoms in Patients With Panic Disorder. Comprehensive Psychiatry 2004; 45: 219-24.

20. Kukumberg P. Panická porucha a migréna. Čes a Slov Neurol Neurochir 1999; 62/95: 57-59.

21. Domsche K, Freitag MCH, Kuhlenbaumer, Schirmaker A, Sand P, Nyhuis P et al. Association of the functional V 158 M catechol – O – methy l -transferase polymorphism with panic disorder in women. Int J Neuropsychopharmacology 2004; 7: 83-8.

22. Yudofsky CS, Ales ER. Essentials of Neuropsychiatry and clinical neurosciences. Washington DC, London (UK): American Psychiatric Publishing, Inc.; 2004.

23. Kukumberg P. Panická porucha a srdce. Prakt Lék 2004; 84: 5-7.

24. Isao ICJ, DobalianA, Naliboff DB. Panic disorder and pain in a national sample of persons living with HIV. Pain 2004; 109: 172-80.

25. Carta GM, Hardoy CM, Boi FM, Mariotti S, Carpinieollo B, Usai P. Association between panic disorder, major depresssive disorder and celiac disease. J Psychosomatic Research 2002; 53: 789– 93.

26. Shear KM, Cooper MA, Klerman LG. A psychodynamic model of panic disorder. Am J Psychiatry 1993; 150: 859-66.

27. Strohle A. Die experimentelle Provokation von Panikattacken als humanexperimentelles Angstmodel. Nervenartz 2003; 74: 733-9.

28. Nutt D J, Lawson C. Panic attacks – a neurochemical overview of models and mechanisms. Br J Pharmacol 1992; 160: 165-78.

29. Liebowitz MR, Gorman JM, Fyer AJ, Dillon D, Davies S, Stein JM. Lactate provocation of panic attacks: biochemical and physiological findings. Arch Gen Psych 1985; 42: 709-719.

30. Dager SR, Strauss WL, Marro KL, Richards TL, Metyger GD, Artru AA. Proton magnetic resonance spectroscopy investigation of hyperventilation in subjects with panic disorder and comparison subjects. Am J Psychiatry 1995; 152: 666-72.

31. Kellner M, Herzog L, Yassouridis A, Holsboer M, Wiedermann K. Possible Role of Atrial Natriumuretic Hormone in Pituitary – Adrenocortical Unresponsiveness in Lactate-Induced Panic. Am J Psychiatry 1995; 152: 1365-7.

32. Nardi EA, Nascimento I, Valenca A, Lopes LF, Mezzasalma AM, Zin AW. Panic disorder in a breath-holding challenge test. Arq Neuropsiquiatr 2003; 61(33B): 718-22.

33. Kukumberg P, Kuchar M. Panická porucha a epilepsia. Lekársky obzor 1998; 47: 27-9.

34. Knott JV, Lapierre DY. Effects of Lactate-Induced Panic Attacks on Brain Stem. Auditory Evoked Potentials. Neuropsychobiology 1986; 16: 9-14.

35. Kukumberg P, Smiešková A, Magula J. Changes of brainstem auditory evoked potentials in panic disorder. Studia Psychologica 1994; 36: 360-1.

36. Kukumberg P, Pristašová E, Provazník V, Kalnokiová A. Somatosensory evoked potential in panic disorder. Eur Arch Psychiat Clin Neuros 1996; 246: 333-4.

37. Rolf GJ, Furman MJ, Durrant D, Turner MS. Panic, Agoraphobia, and Vestibular Dysfunction. Am J Psychiatry 1996: 153: 503-512.

38. Jagla F, Kukumberg P, Jergelová M. Optokinetic nystagmus changes in patients with panic disorder. Homeostasis 2001; 40: 84-5.

39. Marchesi C, Fonto S, Balista CH, Cimmino C, Maggini C. Relationship between Alexithymia and Panic Disorder: A Longitudinal Study to Answer an Open Question. Psychother Psychosom 2005; 74: 56-60.

40. Dengler W, Wiedermann G, Pauli P. Associations between cortical slow potentials and clinical rating scales in panic disorder: a 1.5 – year follow – up study. Eur Psychiatry 1999; 14: 399-404.

41. Kukumberg P, Benetin J, Kuchar M. Vplyv hypervetilácie na motorický evokovaný potenciál u panickej poruchy. Čes a Slov Neurol Neurochir 1998; 61/94: 76-8.

42. Kukumberg P, Longaeurová I, Kuchar M, Jagla F, Kalnokiová A, Urge O. Panic Disorder And Saliva (Pilot Study). Psychiatria 2002; 9: 71-2.

43. Kukumberg P, Benetin J, Kuchar M, Bojar Z. EMG records in nasal hyperventilation. Electroencephalogr Clin Neurophysiol 1993; 96: 88.

44. Fontaine S, Ontiveros A, Fontaine R, Élie R. Panic disorder: vascular evaluation with transcranial Doppler ultrasonography. Cand Assoc Radiol J 1991; 42: 412-6.

45. Massana G, Serra-Grabulosa MS, Salgado-Pineda P, Gasto C, Junque C, Massana J et al. Amygdalar atrophy in panic disorder patients detected by volumetric magnetic resonance imaging. Neuroimage 2003;19: 80-90.

46. Uchida RR, Del-Beno MC, Santos CA, Araujo D, Crippa JA, Guimaraes FS et al. Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging. Braz J Med Biol Res 2003; 36: 925–9.

47. Reiman EM, Raichle ME, Robins E, Mintun MA, Fusselman MJ, Fox PT et al. Neuroanatomical correlates of a lactate-induced anxiety attacks. Arch Gen Psychiatry 1989; 46: 493–500.

48. Weissman MM. Family genetic studies of panic disorder. J Psychiat Res 1993; 27(Suppl 1): 69- 78.

49. Hamilton PS, Fyer JA, Durner M, Eiman AH, Deleon DBA, Hodge ES et al. Further genetic evidence for a panic disorder syndrome mapping to chromosome 13q. PNAS 2003; 100: 2550-5.

50. Philibert AR, Nelson JJ, Bedell B, Goedken R, Sandhu HK, Noyes R Jr et al. Role of Elastin Polymorphisms in Panic Disorder. Am J Med Genet B Neuropsychiatr Genet 2003; 117: 7-10.

51. Inada Y, Yoneda H, Koh J, Sakai J, Himei A, Kinoshita Y et al. Positive association between panic disorder and polymorphism of the serotonin 2A receptor gene. Psychiatry Research 2003; 118: 25-31.

52. Kukumberg P. Retrocollis s okulogýrnymi krízami po krátkodobej aplikácii prochlorperazinových čípkov v II. mesiaci gravidity. Prakt Lék 1974; 54: 95–6.

53. Sheehan VS. The Management of Panic Disorder. J Clin Psychiatry 2002; 63(Suppl 14): 17-21.

54. Kukumberg P. Neurological considerations about panic disorder. Eur J Neurol 1995; 2: 390-1.