Electroencephalographic findings in panic disorder.

Some studies have reported the importance of electroencephalography (EEG) as a method for investigating abnormal parameters in psychiatric disorders. Different findings in time and frequency domain analysis with regard to central nervous system arousal during acute panic states have already been obtained. This study aimed to systematically review the EEG findings in panic disorder (PD), discuss them having a currently accepted neuroanatomical hypothesis for this pathology as a basis, and identify limitations in the selected studies. Literature search was conducted in the databases PubMed and ISI Web of Knowledge, using the keywords electroencephalography and panic disorder; 16 articles were selected. Despite the inconsistency of EEG findings in PD, the major conclusions about the absolute power of alpha and beta bands point to a decreased alpha power, while beta power tends to increase. Different asymmetry patterns were found between studies. Coherence studies pointed to a lower degree of inter-hemispheric functional connectivity at the frontal region and intra-hemispheric at the bilateral temporal region. Studies on possible related events showed changes in memory processing in PD patients when exposed to aversive stimuli. It was noticed that most findings reflect the current neurobiological hypothesis of PD, where inhibitory deficits of the prefrontal cortex related to the modulation of amygdala activity, and the subsequent activation of subcortical regions, may be responsible to trigger anxiety responses. We approached some important issues that need to be considered in further researches, especially the use of different methods for analyzing EEG signals.

[1]  S. A. Gordeev Clinical-psychophysiological studies of patients with panic attacks with and without agoraphobic disorders , 2008, Neuroscience and Behavioral Physiology.

[2]  Fernando Lopes da Silva,et al.  Comprar Niedermeyer's Electroencephalography, 6/e (Basic Principles, Clinical Applications, and Related Fields ) | Fernando Lopes Da Silva | 9780781789424 | Lippincott Williams & Wilkins , 2010 .

[3]  Mario Beauregard,et al.  Mind does really matter: Evidence from neuroimaging studies of emotional self-regulation, psychotherapy, and placebo effect , 2007, Progress in Neurobiology.

[4]  F. L. D. Silva,et al.  Event-related EEG/MEG synchronization and desynchronization: basic principles , 1999, Clinical Neurophysiology.

[5]  M. D. de Carvalho,et al.  Current findings of fMRI in panic disorder: contributions for the fear neurocircuitry and CBT effects , 2010, Expert review of neurotherapeutics.

[6]  M. Tansella,et al.  ANXIETY AND EEG ALPHA ACTIVITY IN NEUROTIC PATIENTS , 1975, Acta psychiatrica Scandinavica.

[7]  J. Rohrbaugh,et al.  Relationship of genetically transmitted alpha EEG traits to anxiety disorders and alcoholism. , 1995, American journal of medical genetics.

[8]  Evian Gordon,et al.  EEG Alpha Asymmetry in Schizophrenia, Depression, PTSD, Panic Disorder, ADHD and Conduct Disorder , 2010, Clinical EEG and neuroscience.

[9]  Anita Miller,et al.  Task-dependent changes in frontal brain asymmetry: effects of incentive cues, outcome expectancies, and motor responses. , 2001, Psychophysiology.

[10]  P. Pauli,et al.  Decreased duration and altered topography of electroencephalographic microstates in patients with panic disorder , 1998, Psychiatry Research: Neuroimaging.

[11]  W. Klimesch,et al.  EEG alpha oscillations: The inhibition–timing hypothesis , 2007, Brain Research Reviews.

[12]  K. Steinberger,et al.  High frequency of EEG and MRI brain abnormalities in panic disorder , 1996, Psychiatry Research: Neuroimaging.

[13]  M. Toth,et al.  Neurobiology of Anxiety , 2007 .

[14]  D. Clark A cognitive approach to panic. , 1986, Behaviour research and therapy.

[15]  G Wiedemann,et al.  Frontal brain asymmetry as a biological substrate of emotions in patients with panic disorders. , 1999, Archives of general psychiatry.

[16]  G Wiedemann,et al.  Behavioral and neurophysiological evidence for altered processing of anxiety-related words in panic disorder. , 1997, Journal of abnormal psychology.

[17]  Alexander C McFarlane,et al.  An integrative assessment of brain and body function 'at rest' in panic disorder: a combined quantitative EEG/autonomic function study. , 2011, International Journal of Psychophysiology.

[18]  A. Iwanami,et al.  Auditory event-related potentials in panic disorder , 1997, European Archives of Psychiatry and Clinical Neuroscience.

[19]  A. Bystritsky,et al.  EEG abnormalities in nonmedicated panic disorder. , 1999, The Journal of nervous and mental disease.

[20]  D. Bakish,et al.  Relaxation-induced EEG alterations in panic disorder patients. , 1997, Journal of anxiety disorders.

[21]  A. von Stein,et al.  Different frequencies for different scales of cortical integration: from local gamma to long range alpha/theta synchronization. , 2000, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[22]  Pedro Ribeiro,et al.  Alterações na distribuição de potência cortical em função da consolidação da memória no aprendizado de datilografia , 2004 .

[23]  K. Coburn,et al.  The value of quantitative electroencephalography in clinical psychiatry: a report by the Committee on Research of the American Neuropsychiatric Association. , 2006, The Journal of neuropsychiatry and clinical neurosciences.

[24]  Paul Pauli,et al.  Electrocortical evidence for an early abnormal processing of panic-related words in panic disorder patients. , 2005, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.

[25]  V. Knott,et al.  Quantitative EEG correlates of panic disorder , 1996, Psychiatry Research: Neuroimaging.

[26]  A. Engel,et al.  Beta-band oscillations—signalling the status quo? , 2010, Current Opinion in Neurobiology.

[27]  Robert Plonsey,et al.  Bioelectromagnetism: Principles and Applications of Bioelectric and Biomagnetic Fields , 1995 .

[28]  S. Rauch,et al.  Neurobiology of emotion perception II: implications for major psychiatric disorders , 2003, Biological Psychiatry.

[29]  Associations between cortical slow potentials and clinical rating scales in panic disorder: a 1.5- year follow-up study , 1999, European Psychiatry.

[30]  Justine M. Kent,et al.  Neuroanatomical Hypothesis of Panic Disorder, Revised , 2004 .

[31]  A. Beck Cognitive therapy and the emotional disorders: A. T. Beck , 1987, British Journal of Psychiatry.

[32]  V. Knott,et al.  Auditory evoked potentials in panic disorder. , 1991, Journal of psychiatry & neuroscience : JPN.

[33]  Aysegul Gunduz,et al.  EEG Correlates of Startle Reflex with Reactivity to Eye Opening in Psychiatric Disorders: Preliminary Results , 2006, Clinical EEG and neuroscience.

[34]  K. McDowell,et al.  [Changes in cortical power distribution produced by memory consolidation as a function of a typewriting skill]. , 2004, Arquivos de neuro-psiquiatria.

[35]  A. Walker Electroencephalography, Basic Principles, Clinical Applications and Related Fields , 1982 .

[36]  G. Manfro,et al.  P50 sensory gating in panic disorder. , 2006, Journal of psychiatric research.

[37]  R. Piedade,et al.  Carbon dioxide-induced panic attacks and quantitative electroencephalogram in panic disorder patients , 2010, The world journal of biological psychiatry : the official journal of the World Federation of Societies of Biological Psychiatry.

[38]  L. Bellodi,et al.  EEG power modifications in panic disorder during a temporolimbic activation task: relationships with temporal lobe clinical symptomatology. , 1993, The Journal of neuropsychiatry and clinical neurosciences.

[39]  P. Pauli,et al.  Implicit and explicit memory processes in panic patients as reflected in behavioral and electrophysiological measures. , 2005, Journal of behavior therapy and experimental psychiatry.

[40]  Bernice Porjesz,et al.  EEG coherence: topography and frequency structure , 2009, Experimental Brain Research.

[41]  E. Niedermeyer Alpha rhythms as physiological and abnormal phenomena. , 1997, International journal of psychophysiology : official journal of the International Organization of Psychophysiology.