Probing the circuitry of panic with deep brain stimulation : Connectomic analysis and review of the literature
Copyright © 2019 Elsevier Inc. All rights reserved..
BACKGROUND: Panic attacks affect a sizeable proportion of the population. The neurocircuitry of panic remains incompletely understood.
OBJECTIVE: To investigate the neuroanatomical underpinnings of panic attacks induced by deep brain stimulation (DBS) through (1) connectomic analysis of an obsessive-compulsive disorder patient who experienced panic attacks during inferior thalamic peduncle DBS; (2) appraisal of existing clinical reports on DBS-induced panic attacks.
METHODS: Panicogenic, ventral contact stimulation was compared with benign stimulation at other contacts using volume of tissue activated (VTA) modelling. Networks associated with the panicogenic zone were investigated using state-of-the-art normative connectivity mapping. In addition, a literature search for prior reports of DBS-induced panic attacks was conducted.
RESULTS: Panicogenic VTAs impinged primarily on the tuberal hypothalamus. Compared to non-panicogenic VTAs, panicogenic loci were significantly functionally coupled to limbic and brainstem structures, including periaqueductal grey and amygdala. Previous studies found stimulation of these areas can also provoke panic attacks.
CONCLUSIONS: DBS in the region of the tuberal hypothalamus elicited panic attacks in a single obsessive-compulsive disorder patient and recruited a network of structures previously implicated in panic pathophysiology, reinforcing the importance of the hypothalamus as a hub of panicogenic circuitry.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:13 |
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| Enthalten in: |
Brain stimulation - 13(2020), 1 vom: 23. Jan., Seite 10-14 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Elias, Gavin J B [VerfasserIn] |
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| Links: |
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| Themen: |
Case Reports |
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| Anmerkungen: |
Date Completed 01.06.2020 Date Revised 01.06.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.brs.2019.09.010 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM301895562 |
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| 100 | 1 | |a Elias, Gavin J B |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Probing the circuitry of panic with deep brain stimulation |b Connectomic analysis and review of the literature |
| 264 | 1 | |c 2020 | |
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| 500 | |a Date Completed 01.06.2020 | ||
| 500 | |a Date Revised 01.06.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2019 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Panic attacks affect a sizeable proportion of the population. The neurocircuitry of panic remains incompletely understood | ||
| 520 | |a OBJECTIVE: To investigate the neuroanatomical underpinnings of panic attacks induced by deep brain stimulation (DBS) through (1) connectomic analysis of an obsessive-compulsive disorder patient who experienced panic attacks during inferior thalamic peduncle DBS; (2) appraisal of existing clinical reports on DBS-induced panic attacks | ||
| 520 | |a METHODS: Panicogenic, ventral contact stimulation was compared with benign stimulation at other contacts using volume of tissue activated (VTA) modelling. Networks associated with the panicogenic zone were investigated using state-of-the-art normative connectivity mapping. In addition, a literature search for prior reports of DBS-induced panic attacks was conducted | ||
| 520 | |a RESULTS: Panicogenic VTAs impinged primarily on the tuberal hypothalamus. Compared to non-panicogenic VTAs, panicogenic loci were significantly functionally coupled to limbic and brainstem structures, including periaqueductal grey and amygdala. Previous studies found stimulation of these areas can also provoke panic attacks | ||
| 520 | |a CONCLUSIONS: DBS in the region of the tuberal hypothalamus elicited panic attacks in a single obsessive-compulsive disorder patient and recruited a network of structures previously implicated in panic pathophysiology, reinforcing the importance of the hypothalamus as a hub of panicogenic circuitry | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Connectomics | |
| 650 | 4 | |a Deep brain stimulation | |
| 650 | 4 | |a Hypothalamus | |
| 650 | 4 | |a Inferior thalamic peduncle | |
| 650 | 4 | |a Panic attack | |
| 650 | 4 | |a Panic disorder | |
| 700 | 1 | |a Giacobbe, Peter |e verfasserin |4 aut | |
| 700 | 1 | |a Boutet, Alexandre |e verfasserin |4 aut | |
| 700 | 1 | |a Germann, Jürgen |e verfasserin |4 aut | |
| 700 | 1 | |a Beyn, Michelle E |e verfasserin |4 aut | |
| 700 | 1 | |a Gramer, Robert M |e verfasserin |4 aut | |
| 700 | 1 | |a Pancholi, Aditya |e verfasserin |4 aut | |
| 700 | 1 | |a Joel, Suresh E |e verfasserin |4 aut | |
| 700 | 1 | |a Lozano, Andres M |e verfasserin |4 aut | |
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