Neural Probes of Respiratory Control and Interoception in Panic Disorder

惊恐障碍呼吸控制和内感的神经探头--NIMH的应用 以病人为中心的研究发展奖(K23)。候选人已经完成了神经成像 团契培训，并寻求高级培训，以促进未来独立神经成像的目标 情绪和焦虑症方面的研究项目。呼吸系统内感觉障碍的神经影像研究 恐慌症将作为拟议的项目。恐慌症是一种严重的精神疾病， 严重的社会经济负担，因为它在一般人口中的流行率为2%-4%，而且比率很高 (&gt；50%)治疗无效和复发。惊恐障碍的病理生理学基础尚不清楚， 尽管流行的模型反映了皮质-边缘脑功能障碍和呼吸异常的作用。这个 候选人提议测试一种新的皮质-边缘/边缘旁模型，该模型专注于胰岛素皮质及其在大脑中的作用。 内感(对身体生理状况的感觉)。完整的内感对于 生存是体内平衡失衡的警报，被认为主要是在岛内处理的 大脑皮层。虽然岛叶皮质在以前的恐慌症神经成像研究中被牵连，但一个统一的模型 对于恐慌症，具有孤岛焦点的神经回路尚未得到测试和解释。所提出的神经电路 模型将岛叶皮质功能障碍归因于引发对身体症状的误解 (内感线索)，这进而导致夸大的行为/恐惧反应，伴随着最终的常见恐慌 电路。呼吸间感觉刺激的功能磁共振成像研究 将被用来测试候选人的惊恐障碍神经回路模型，中心是岛叶皮质和 它在内感中的作用。酸/碱生理学和呼吸心理生理学的附加测试将 补充神经成像研究，以区分恐慌症的呼吸系统亚型， 据报道，恐慌症患者占50%以上。总而言之，该项目是第一个 惊恐障碍与呼吸刺激和控制的综合神经系统研究。该项目将 测试恐慌神经回路的统一模型，同时承诺向焦虑回路的一般模型提供信息。 相关性(请参阅说明)： 恐慌症(一种以频繁的、自发的恐慌性发作为特征的疾病)的原因尚不清楚 而且，目前的治疗方法未能使大多数患者病情得到缓解。目前的项目旨在勾勒出 与恐慌症有关的大脑回路功能失调，从而可能开发出更好的治疗方法。

Neural Probes of Respiratory Control and Interoception in Panic Disorder," an application for an NIMH Patient Oriented Research Caree r Development Award (K23). The candidate has completed neuroimaging fellowship training and seeks advanced training to facilitate objectives for future independent neuroimaging research programs in the mood and anxiety disorders. A neuroimaging study of respiratory interoception in panic disorder will serve as the proposed project. Panic disorder is a serious psychiatric illness that imposes significant social-economic burden given its prevalence of 2-4% in the general population, and high rates (>50%) of treatment non-response and relapse. The pathophysiological basis of panic disorder is unknown, although prevailing models reflect roles for cortico-limbic brain dysfunction and abnormal respiration. The candidate proposes to test a new cortico-limbic/paralimbic model focused on the insularcortex and its role in interoception (the sense of the physiological condition of the body). Intact interoception is essential to survival as an alarm for homeostatic imbalance, and thought to be primarily processed within the insular cortex. While the insular cortex has been implicated in previous panic neuroimaging studies, a unified model for panic neural circuitry with an insular focus has yet to be tested and explained. The proposed neural circuit model attributes dysfunction within insular cortex to trigger the misinterpretation of physical symptoms (interoceptive cues), that in turn lead to exaggerated behavioral/fear responses along a final common panic circuitry. Functional magnetic resonance imaging (fMRI) studies during respiratory interoceptive provocation will be used to test the candidate's neural circuit model for panic disorder, centered on the insular cortex and its role in interoception. Additional tests of acid/base physiology and respiration psychophysiology will complement the neuroimaging studies in order to differentiate a respiratory subtype of panic disorder, reported to account for greater than 50% of panic patients. Taken together, the project represents the first integrated neural systems study of panic disorder with respiratory provocation and control. The project will test a unified model for panic neural circuitry while promising to inform general models of anxiety circuitry. RELEVANCE (See instructions): The cause of panic disorder (a condition characterized by frequent, spontaneous panic attacks) is unknown and current treatments fail to keep most patients in remission. The current project aims to delineate the dysfunctional brain circuits involved in panic disorder so that better treatments may be developed.