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RESPIRATORY & AUTONOMIC PATHOPHYSIOLOGY--PANIC DISORDER

呼吸系统

基本信息

批准号：
6538765
负责人：
WALTON Thompson ROTH
金额：
$ 29.25万
依托单位：
STANFORD UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
1997
资助国家：
美国
起止时间：
1997-05-15 至 2004-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/6538765
关键词：
anxiety disorders autonomic nervous system behavior test behavioral /social science research tag biomarker carbon dioxide tension chemoreceptors clinical research human subject hyperpnea noise panic disorder psychophysiology pulmonary respiration respiratory hypoxia startle reaction

项目摘要

As is now more widely recognized, Panic Disorder often results in considerable emotional suffering and a reduction in quality of life. Although progress has been made in identifying its biological substrates, much about its pathophysiology and etiology remains obscure. Latest research findings in our laboratory and laboratories of other research groups point towards a central role for respiratory mechanisms. Experiments are proposed to investigate markers and mechanisms of Panic Disorder in and outside the laboratory. Respiratory, sympathetic, and parasympathetic measures in Panic Disorder patients of two types, those with and without prominent respiratory symptoms, will be examined and compared to measures in two groups without panic attacks, Generalized Anxiety Disorder patients and controls. In the laboratory the relative importance of several possible respiratory mechanisms will be determined by examining probe-specific and group-specific effects of several kinds of probes: increased inspired CO2, increased inspiratory resistance load, and decreased inspired O2. Each is known to produce feelings of suffocation at moderate intensities, and sometimes panic in Panic Disorder patients at high intensities. Respiratory responses to a noise stressor not directly linked to suffocation fears will serve as a comparison. To resolve contradictions in the literature about slower recovery from voluntary hyperventilation in Panic Disorder, which was a specific marker for Panic Disorder in one of our recent experiments, the effects of different durations of hyperventilation will be examined. In another experiment, central and peripheral chemoreceptor thresholds and sensitivities will be distinguished in Panic Disorder for the first time. Outside the laboratory two ways of recording pCO2 (transcutaneous vs. nasal prongs) will be compared methodologically, and it will be determined whether valid indices of respiratory sinus arrhythmia that take into account variations in breathing will distinguish patients with panic attack-related driving phobia from controls. The significance of this proposal lies in the possibility of its establishing specific and sensitive physiological markers of Panic Disorder, which could lead to better diagnosis and more appropriate treatment, facilitate research in the molecular genetics of Panic Disorder, and lead to a better understanding of dysfunctional biological control mechanisms.

正如现在更广泛认识到的那样，恐慌症经常导致相当大的情感痛苦和生活质量的下降。尽管在确定其生物学底物方面取得了进展，但其病理生理学和病因学仍不清楚。我们实验室和其他研究小组实验室的最新研究成果指出呼吸机制的核心作用。本研究拟在实验室内及实验室外探讨惊恐障碍的标记物及机制。将检查两种类型的恐慌症患者（有和没有明显呼吸症状的患者）的呼吸、交感神经和副交感神经测量，并将其与两组无恐慌发作的患者（广泛性焦虑障碍患者和对照组）的测量进行比较。在实验室中，几种可能的呼吸机制的相对重要性将通过检测几种探针的特异性和组特异性效应来确定：吸入二氧化碳增加，吸入阻力负荷增加，吸入氧气减少。每一种都能产生中等强度的窒息感，有时在高强度的恐慌症患者中会产生恐慌。呼吸系统对噪音压力源的反应与窒息恐惧没有直接联系，可以作为比较。为了解决文献中关于惊恐障碍患者自发性过度通气恢复较慢的矛盾，这是我们最近的一项实验中惊恐障碍的特定标志，我们将检查不同持续时间的过度通气的影响。在另一项实验中，中枢和外周化学受体阈值和敏感性将首次在恐慌障碍中区分。在实验室外，将比较两种记录pCO2的方法（经皮与鼻尖），并确定考虑呼吸变化的呼吸性窦性心律失常的有效指标是否能区分惊恐发作相关驾驶恐惧症患者与对照组。本研究的意义在于有可能建立特异性和敏感性的惊恐障碍生理标志物，从而更好地诊断和治疗惊恐障碍，促进惊恐障碍分子遗传学的研究，更好地理解功能失调的生物控制机制。